title: Height impairment after lower dose cranial irradiation in children with acute lymphoblastic leukemia.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, The Methodist Hospital, The Methodist Hospital Research Institute, Houston, Texas 77030, USA. apaulino@tmhs.org
authors.forename: Arnold C
authors.initials: AC
authors.lastname: Paulino
authors.forename: Pavan
authors.initials: P
authors.lastname: Jhaveri
authors.forename: Zoann
authors.initials: Z
authors.lastname: Dreyer
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Okcu
mesh_terms: 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*