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The Effect of Cranial Irradiation on Growth of Children with Lymphatic Origin Tumors

Journal of the Korean Pediatric Society 1994;37(5):666-671.
Published online May 15, 1994.
The Effect of Cranial Irradiation on Growth of Children with Lymphatic Origin Tumors
Jin Seoup Jung, Yon Sook Rho, Sang Woo Kim
Department of Pediatrics, Inje University College of Medicine, Paik Hospital, Seoul, Korea
소아 림프계 종양 환아에서 두개내 방사선 조사가 신장 성장에 미치는 영향
정진섭, 노연숙, 김상우
인제대학교 의과대학 서울백병원 소아과학교실
A retrospective study was conducted to investigate the effects of CNS prophylaxis with 1,800cGy cranial irradiation on standing height growth of children with acute lymphoblastic leukemia(ALL). Seventeen longterm survivors (DFS over 5 years) of ALL and Non-Hodgkins Lymphoma who had been admitted at pediatric department of Inje University Seoul Paik Hospital from January 1982 to September 1988 were studied. The long term survivors were divided into two groups by prophylactic treatment modality; intrathecal chemotherapy alone (Group 1,7 cases), intrathecal chemotherapy with cranial irradiation (group 11, 10 cases). The heights of each groups were compared with normal standard growth of the same aged children by mean SD score (The SD score was calculated with the use of the following formula). SD score=(x-x)/SD. (x : height measurement; x : mean height for age of the normal population SD; standard deviation) The results were as follows; 1) The mean SD scores of Group I and Group II at diagnosis were -0.30 and -0.17 which were smaller than height of normal child. 2) In Group 1, the mean SD score after the end of treatment were -0.14 of 1year, 0.03 at 2 years and 0.10 at 5 years, which suggests that there were normal height velocity and catch-up growth in these patients (p<0.05). The height of 1 year after the beginning of treatment were particularly smaller than that of the normal children (p<0.05). 3) The mean SD scores 5 years after the end of treatment were 0.10 in Group I and -0.17 in Group II. Which shows strong tendency to statistical difference among these two groups. If larger numbers of patients are evaluated, it, however, may turn significant. In conclusion, 1,800cgy cranial irradiation in ALL children significantly effects on height growth. We recommend to evaluate growth hormone for patient with 1,800cGy cranial irradiation and to treat them with growth hormone.
Key Words: Cranial irradiation, Growth, Acute lymphoblastic leukemia

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