Height impairment after lower dose cranial irradiation in children with acute lymphoblastic leukemia

Pediatr Blood Cancer. 2011 Feb;56(2):279-81. doi: 10.1002/pbc.22781. Epub 2010 Sep 9.

Abstract

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.

MeSH terms

  • Adolescent
  • Body Height / radiation effects*
  • Child
  • Child, Preschool
  • Cranial Irradiation / adverse effects*
  • Cranial Irradiation / methods
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Infant
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / radiotherapy*