Musculoskeletal
Radiation Therapy (RT) related damage
RT damage to bone depends on the:
- Age of the child at the time of therapy
- The younger the child the more severe the damage
- Growth potential of region treated with RT
- Growth plate chondrocytes most sensitive to RT
- Extent of treatment field
- The larger the treatment field, the more extensive the damage is likely to be
- RT
- Total dose
- Fractionation schedule
- Quality (orthovoltage dose magnified in bone)
- Individual genetic factors
- Administration of concurrent chemotherapy with RT can enhance damage
RT in children can cause the following long term musculoskeletal problems:
- Hypoplasia (under-development)
- Osteoporosis and increased risk of fracture
- Radionecrosis
- Risk for pathological fracture of bone (diaphysis) probably about 5% with 60 Gy
- Benign osteochondromas
- Secondary cancer
