Late effects of abdominal irradiation in children: a review of the literature.
OBJECTIVE
To comprehensively summarize the most important literature regarding the late effects of radiotherapy to the abdomen in childhood and adolescence.


METHODS
Published trials, studies and series were identified using the PubMed database. The key words late effects, late sequelae, child, radiation, radiotherapy, abdomen, kidney, liver, and bowel were used.


RESULTS
A dose-volume effect is confirmed for liver irradiation. Radiation with doses <20 Gy to major parts of the liver or higher doses to smaller parts seems to be safe. Kidney function impairment due to radiation is rare in children. Renal sequelae may occur after radiation to the remaining kidney in patients who underwent nephrectomy or who received higher doses to both kidneys. Several reports describe small bowel obstruction as a sequelae of surgery, but radiotherapy seems to be less important.


CONCLUSIONS
Several retrospective reports describe radiation-associated late sequelae in children. However, there is still a lack of sufficient data regarding the characterization of dose-volume effects.
Department of Radiotherapy, University Hospital Münster, Albert-Schweitzer-Str. 33, D-48129 Münster, Germany. Tobias.Boelling@ukmuenster.de
Tobias
T
Bölling
Normann
N
Willich
Iris
I
Ernst
D000005:Abdomen / Q000528:radiation effects*; D002648:Child; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007422:Intestines / Q000528:radiation effects; D007668:Kidney / Q000528:radiation effects; D008099:Liver / Q000528:radiation effects; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects