Osteonecrosis in pediatric cancer survivors: Epidemiology, risk factors, and treatment

Sandesh S Rao; Jad M El Abiad; Varun Puvanesarajah; Adam S Levin; Lynne C Jones; Carol D Morris

doi:10.1016/j.suronc.2019.02.001

Osteonecrosis in pediatric cancer survivors: Epidemiology, risk factors, and treatment

Surg Oncol. 2019 Mar:28:214-221. doi: 10.1016/j.suronc.2019.02.001. Epub 2019 Feb 4.

Authors

Sandesh S Rao¹, Jad M El Abiad¹, Varun Puvanesarajah¹, Adam S Levin², Lynne C Jones¹, Carol D Morris³

Affiliations

¹ Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
² Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
³ Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA. Electronic address: [email protected].

PMID: 30851903
DOI: 10.1016/j.suronc.2019.02.001

Abstract

Several treatment regimens for childhood malignancies have been associated with the development of osteonecrosis, including radiation therapy, glucocorticoid medications, immunotherapy (including anti-angiogenic agents), and several chemotherapeutic agents. Adolescents older than 10 years are at greatest risk of developing osteonecrosis within 1 year of initiating therapy. Screening with magnetic resonance imaging in this high-risk population may be a useful method for detecting osteonecrosis. Surgery may be required for lesions that have progressed substantially despite nonoperative interventions.

Keywords: Chemotherapy; Late effects; Osteonecrosis; Pediatric cancer; Radiation.

Publication types

Review

MeSH terms

Cancer Survivors / statistics & numerical data*
Child
Humans
Incidence
Neoplasms / complications*
Osteonecrosis / epidemiology
Osteonecrosis / etiology*
Osteonecrosis / therapy*
Risk Factors