title: [Long-term effects of radiation on the spine - Results of a cohort of symptomatic survivors of childhood and review of the literature].
abstract: OBJECTIVE
  The objective of the present retrospective study was to describe the clinical, radiological and bone characteristics of long-term survivors who have received radiotherapy involving some part of the vertebral column for certain childhood tumors.
  
  
  METHODS
  Monocentric descriptive study of a cohort of patients followed at Gustave-Roussy in the framework of long-term monitoring treated for a solid tumor in childhood with radiotherapy on part of the spine and having back pain and/or spinal deformity have been addressed in the Service of Musculoskeletal Rehabilitation at the Cochin Hospital. For each patient, were performed standardized radiographs of the entire spine and spinal MRI.
  
  
  RESULTS
  Eighteen patients were evaluated (average age of 35.4 ± 6.9 years; mean age at radiation therapy: 3.6 ± 2.8 years). Original tumors were nephroblastoma (9 cases), neuroblastoma (4 cases) and medulloblastoma (3 cases). Of the 15 patients analyzed by X-rays of the entire spine, 67% (10/15) patients had scoliosis (2 with a Cobb angle > 20°), 73% (11/15) had an abnormal thoracic kyphosis, 67% (10/15) had abnormal lumbar lordosis. Of the 16 patients analyzed by MRI, 75% (12/16) had discopathies or anomalies of the discal plate, 63% (10/16) had mild abnormalities of bone marrow. Muscle abnormalities were common (81%, 13/16).
  
  
  CONCLUSIONS
  The main risk factors of spinal deformities are intraductal tumor, spinal surgery, spinal radiotherapy and a young age at the time of the cancer. These cured children require dedicated monitoring. Currently, this risk is reduced with the actual techniques of radiotherapy.
authors: Université Paris V, hôpital Cochin, service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, 75014 Paris, France.
authors: Cécile
authors: C
authors: Escalas
authors: Université Paris V, hôpital Cochin, service de radiologie B, 75014 Paris, France.
authors: Christopher
authors: C
authors: Bourdet
authors: Gustave-Roussy, département de cancérologie de l'enfant et de l'adolescent, 94805 Villejuif, France.
authors: Chiraz
authors: C
authors: Fayech
authors: Institut de cancérologie de l'Ouest-Nantes, service de radiothérapie, 44800 Saint-Herblain, France; Faculté de médecine de Nantes, 44000 Nantes, France. Electronic address: charlotte.demoor@ico.unicancer.fr.
authors: Charlotte
authors: C
authors: Demoor-Goldschmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D002528:Cerebellar Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy*; D008527:Medulloblastoma / Q000532:radiotherapy; D009447:Neuroblastoma / Q000532:radiotherapy; D058958:Organs at Risk / Q000528:radiation effects*; D011832:Radiation Injuries / Q000150:complications* / Q000175:diagnosis; D011859:Radiography; D012189:Retrospective Studies; D013121:Spinal Curvatures / Q000175:diagnosis / Q000209:etiology; D013122:Spinal Diseases / Q000175:diagnosis / Q000209:etiology*; D013131:Spine / Q000000981:diagnostic imaging / Q000528:radiation effects*; D017741:Survivors; D009396:Wilms Tumor / Q000532:radiotherapy
keywords: Cancers pédiatriques; Long terme; Long-term; Pediatric cancer; Rachis; Radiotherapy; Radiothérapie; Sequelae; Survivant; Survivor; Séquelles