Dubousset J
Rev Chir Orthop Reparatrice Appar Mot. 1980 Oct;66(7):441-51.
A follow-up study on spine deformities of 59 consecutive Wilm's tumors treated between 1950 and 1963 was conducted. The selected cases had no metastasis at any time and had reached end of growth (16 years old of bone age). Treatment was surgery, chemotherapy and radiationtherapy mostly was 200 KV and partially with CO 60. This study showed 65p. 100 kyphosis greater than 10 degree between T9 and L3 (normal less than 5 degree) and 40p. 100 scoliosis both induced by alteration of vertebral growth and by sclerosis of soft tissues. -- Kyphosis even slight seemed to induce more pain in adult age than scoliosis. -- This work demonstrates also that growth spurt produces increased deformities. Therefore it is necessary to wait the end of growth before the evaluation of the results. Finally the most important for prevention is to irradiate as symmetrically as possible in the 3 planes of the body. The results of surgical treatment are reported and principles of early bracing for prevention are mentioned.
对1950年至1963年间连续治疗的59例威尔姆斯瘤患者的脊柱畸形进行了一项随访研究。所选病例在任何时候均无转移,且已达到生长末期(骨龄16岁)。治疗方法主要是手术、化疗和放疗,放疗大多采用200千伏,部分采用钴60。该研究显示,65%的患者在T9至L3之间出现大于10度的后凸畸形(正常应小于5度),40%的患者出现脊柱侧凸,两者均由椎体生长改变和软组织硬化引起。——即使是轻微的后凸畸形,在成年后似乎也比脊柱侧凸引起更多疼痛。——这项研究还表明,生长突增会导致畸形增加。因此,在评估结果之前有必要等待生长结束。最后,预防最重要的是在身体的三个平面尽可能对称地进行照射。报告了手术治疗结果,并提及了早期支具预防的原则。