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Review
. 2010 Jan;20(1):21-9.
doi: 10.1016/j.semradonc.2009.09.001.

Radiation-related treatment effects across the age spectrum: differences and similarities or what the old and young can learn from each other

Matthew J Krasin  1 , Louis S Constine, Debra L Friedman, Lawrence B Marks
Affiliations
Review

Radiation-related treatment effects across the age spectrum: differences and similarities or what the old and young can learn from each other

Matthew J Krasin et al. Semin Radiat Oncol. 2010 Jan.

Abstract

Radiation related effects in children and adults limit the delivery of effective radiation doses and result in long-term morbidity affecting function and quality of life. Improvements in our understanding of the etiology and biology of these effects, including the influence of clinical variables, dosimetric factors, and the underlying biological processes have made treatment safer and more efficacious. However, the approach to studying and understanding these effects differs between children and adults. Using the pulmonary and skeletal organ systems as examples, comparisons are made across the age spectrum for radiation related effects, including pneumonitis, pulmonary fibrosis, osteonecrosis, and fracture. Methods for dosimetric analysis, incorporation of imaging and biology as well a length of follow-up are compared, contrasted, and discussed for both organ systems in children and adults. Better understanding of each age specific approach and how it differs may improve our ability to study late effects of radiation across the ages.

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Figures

Fig 1
Fig 1
MLD plotted against pneumonitis risk in adults and children.
Fig 2
Fig 2
Probability of symptomatic radiation pneumonitis for 99 patients with Hodgkin’s disease receiving radiation with or without bleomycin based on percent volume of total lung irradiated above 24 Gy
Figure 3
Figure 3
Trends for pulmonary function studies following radiation therapy to the chest in adult patients.
Figure 4
Figure 4
Dosimetry, fracture and subsequent repair and healing of a femoral fracture following a cart-wheel in a child managed with radiation therapy to the thigh for rhabdomyosarcoma.
Figure 5
Figure 5
Cumulative incidence of fractures in a clinical trial of 129 pediatric and young adult patients receiving radiation therapy for soft-tissue and bone sarcomas.
Figure 6
Figure 6
A long term survivor of whole-bone radiation for Ewing’s sarcoma demonstrating limb shortening, volume loss and hypoplasia.
See this image and copyright information in PMC

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