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Height impairment after lower dose cranial irradiation in children with acute lymphoblastic leukemia
Author(s) -
Paulino Arnold C.,
Jhaveri Pavan,
Dreyer Zoann,
Teh Bin S.,
Okcu M. Fatih
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22781
Subject(s) - medicine , nuclear medicine , lymphoblastic leukemia , prophylactic cranial irradiation , radiation therapy , leukemia , gastroenterology , pediatrics , myocardial infarction , conventional pci
Purpose The purpose of this study is to determine whether height measurements are affected by cranial radiation doses of 12–18 Gy. Patients and Methods From 1997 to 2007, 23 children received cranial RT for T‐cell or pre‐B‐cell acute lymphoblastic leukemia (ALL). Dose fractionation schemes included 18 Gy in 9 fractions (n = 8), 18 Gy in 10 fractions (n = 5), 12.6 Gy in 7 fractions (n = 6), and 12 Gy in 8 fractions (n = 4). These patients were matched and compared to a control group of 23 patients who had ALL but no cranial RT. Height z ‐scores at diagnosis and last follow‐up were compared using the paired Student's t ‐test. Differences in z ‐scores according to host and treatment parameters were compared using the unpaired Student's t ‐test. Median follow‐up for irradiated patients was 63.5 months while for unirradiated patients was 91 months. Results The mean z ‐scores at initial diagnosis and last follow‐up were 0.14 and −0.48 for patients receiving 12–12.6 Gy ( P = 0.016), −0.16 and −0.89 for 18 Gy ( P = 0.003), and 0.34 and 0.22 for no RT ( P = 0.62). For children receiving RT, the mean difference in z ‐scores at initial diagnosis and last follow‐up was −0.67 while for those not receiving RT, it was −0.10 ( P = 0.043). Conclusion Children receiving 12–18 Gy cranial RT for ALL were found to have height impairment compared to those not receiving RT. Pediatr Blood Cancer 2011;56:279–281. © 2010 Wiley‐Liss, Inc.