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Spinal deformity after intra-operative radiotherapy for paediatric patients
E Kunieda1, G Nishimura, T Kaneko
1Department of Radiology, Keio University, Tokyo, Japan. kunieda-mi@umin.ac.jp
The British Journal of Radiology
|August 20, 2009
Summary
Intra-operative radiation therapy (IORT) in children can cause late-onset spinal deformities, primarily anterior wedge-shaped changes. Dose distribution, especially asymmetric, is linked to the severity and type of spinal complication.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Spinal Surgery
Background:
- Intra-operative radiation therapy (IORT) is used for pediatric malignancies.
- Late-onset spinal complications following IORT require further investigation.
- Understanding the relationship between radiation dose and spinal deformity is crucial.
Observation:
- This study reviewed 12 children with >4 years follow-up after IORT for pediatric tumors.
- Spinal deformity was observed in 6 of 12 patients, mostly mild and asymptomatic.
- Anterior wedge-shaped deformity was common; scoliosis was less frequent.
Findings:
- Radiation dose simulations revealed that dose distribution influences spinal deformity.
- Asymmetric dose distribution, particularly in a case with nephrectomy, led to significant scoliosis.
- Mild spinal deformities (Grade 1) were asymptomatic, while severe deformity (Grade 3) was symptomatic.
Implications:
- Late-onset spinal deformities after IORT are linked to radiation dose distribution.
- Careful planning of IORT electron beam delivery can mitigate spinal complications.
- Further research into optimizing IORT techniques for pediatric patients is warranted.
