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Int J Radiat Oncol Biol Phys. 2019 Mar 1;103(3):669-679. doi: 10.1016/j.ijrobp.2018.10.026. Epub 2018 Nov 7.

A Road Map for Important Centers of Growth in the Pediatric Skeleton to Consider During Radiation Therapy and Associated Clinical Correlates of Radiation-Induced Growth Toxicity.

Author information

1
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.
2
Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.
3
Department of Orthopedic Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
4
Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
5
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: sterezak@jhmi.edu.

Abstract

With the increasing use of advanced radiation techniques such as intensity modulated radiation therapy, stereotactic radiation therapy, and proton therapy, radiation oncologists now have the tools to mitigate radiation-associated toxicities. This is of utmost importance in the treatment of a pediatric patient. To best use these advanced techniques to mitigate radiation-induced growth abnormalities, the radiation oncologist should be equipped with a nuanced understanding of the anatomy of centers of growth. This article aims to enable the radiation oncologist to better understand, predict, and minimize radiation-mediated toxicities on growth. We review the process of bone development and radiation-induced growth abnormalities and provide an atlas for contouring important growth plates to guide radiation treatment planning. A more detailed recognition of important centers of growth may improve future treatment outcomes in children receiving radiation therapy.

PMID:
30414451
DOI:
10.1016/j.ijrobp.2018.10.026
[Indexed for MEDLINE]

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