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• W1977312574 abstract "Osteochondromas are benign neoplasms that may occur secondary to focal radiation therapy (FRT) or total-body irradiation (TBI) for the treatment of pediatric malignancies. While the majority of radiation-induced osteochondromas (RIO) carry little risk for malignant transformation, they are part of a spectrum of radiation-induced skeletal abnormalities that represent significant morbidity. The purpose of this study was to present an updated literature review and analysis on reported cases of RIO. A MEDLINE/PubMed search of articles dealing with RIO was conducted. Patients irradiated before age of 21 at time of primary diagnosis with external beam RT and later found to have osteochondroma satisfying clinical and radiological criteria were included. Cases of sporadic osteochondroma were excluded. A total of 31 articles written in the English language were found. When provided, the following data were analyzed: type of primary lesion treated with RT, radiation dose, treatment site (FRT vs TBI), patient gender, age at initial radiation, latency period between treatment and detection of RIO, lesion distribution, and potential for malignant transformation. The analysis included 121 patients with a median age of 48.9 months (range, of 2-226.8). The representation of primary tumors irradiated were ALL (22.1%), neuroblastoma (22.1%), Wilms' tumor (15.4%), AML (14.4%), Hodgkin lymphoma (6.7%), rhabdomyosarcoma (4.8%), CML (3.8%), non-Hodgkin lymphoma (1.9%), medulloblastoma (1.9%), dysgerminoma (1.9%), Langerhans histiocytosis (1.9%), osteosarcoma (1%), hemangioma (1%), and biphenotypic leukemia (1%). Median dose and age at initial RT were 21.1 Gy (range, 9.9-50.4) and 53.3 months (range, 2-233), respectively. There was a significantly greater incidence of RIO in patients irradiated at ages less than 60 months (p < 0.001). When comparing FRT to TBI there were significantly greater lesions within the axial skeleton in the TBI cohort (p < 0.0001). Furthermore, there was a shorter latency period to development of RIO in patients subjected to TBI (range, 27-156 months, median 81.2 months) compared to FRT (range, 36-344 months, median 125.4) (p = 0.0067). There were significantly more males (n = 65) reported to have RIO when compared to females (n = 24) (p < 0.0001). Malignant transformation to chondrosarcoma was rare. Age at initial RT and treatment site appear to be the most significant factors in determining the incidence and distribution of RIO, respectively. Gender also appears to be an important determinant; however, this may result from a greater baseline incidence of malignancy in male pediatric patients. This retrospective analysis provides insight into further defining current screening guidelines for radiation-induced neoplasms." @default.
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• W1977312574 date "2013-10-01" @default.
• W1977312574 modified "2023-09-25" @default.
• W1977312574 title "Radiation-Induced Osteochondromas Revisited: A Retrospective Update" @default.
• W1977312574 doi "https://doi.org/10.1016/j.ijrobp.2013.06.1595" @default.
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