Height impairment after lower dose cranial irradiation in children with acute lymphoblastic leukemia.
OBJECTIVE
The purpose of this study is to determine whether height measurements are affected by cranial radiation doses of 12-18 Gy.


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).


CONCLUSIONS
Children receiving 12-18 Gy cranial RT for ALL were found to have height impairment compared to those not receiving RT.
Paulino
Arnold C
AC
Department of Radiation Oncology, The Methodist Hospital, The Methodist Hospital Research Institute, Houston, Texas 77030, USA. apaulino@tmhs.org
Jhaveri
Pavan
P
Dreyer
Zoann
Z
Teh
Bin S
BS
Okcu
M Fatih
MF
D000293:Adolescent; D001827:Body Height / Q000528:radiation effects*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects* / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000532:radiotherapy*