Abstract
The standing height, sitting height and leg length have been measured in 79 patients (age 16-30 years), who received cranio-spinal (c/s) irradiation (n=37) or cranial irradiation (n=42) in childhood for a brain tumour and had completed their growth. Their measurements were compared to the established standards for sitting height and leg length in British children (age 16-18 years) (Tanner and Whitehouse, 1978). To examine the effects of spinal irradiation (DXT) on spinal growth independent of GH deficiency we analysed the leg length (LL) minus sitting height (SH) SDS and utilised the cranial group as controls. There was an overall statistically significant difference (p < 0.0001) between the median c/s LL-SH SDS (1.98) and the median cranial LL-SH SDS (0.545). Within the c/s group there was a significant correlation with age at treatment (Spearman's p=0.40 : p<0.02) but no such correlation for the cranial group. After splitting age at treatment into 3 groups (0 < 5, 5 < 10 and 10+ years) there was a significant difference between the LL-SH SDS of the c/s and cranial groups for each of the age groups.
In conclusion spinal irradiation has a profound effect on spinal growth and the younger the irradiated child, the greater the subsequent skeletal disproportion. Our most conservative figures indicate that the eventual loss in height is 9cms if irradiated at one year, 7cms at five years and 5.5cms at ten years.
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Gibson, B., Shalet, S., Swindell, R. et al. EFFECT OF SPINAL IRRADIATION ON GROWTH. Pediatr Res 20, 1180 (1986). https://doi.org/10.1203/00006450-198611000-00038
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DOI: https://doi.org/10.1203/00006450-198611000-00038