Groot-Loonen J J, Otten B J, van't Hof M A, Lippens R J, Stoelinga G B
Department of Pediatric Oncology, University of Nijmegen, The Netherlands.
Pediatr Hematol Oncol. 1995 Jul-Aug;12(4):343-53. doi: 10.3109/08880019509029584.
The statural growth of 85 prepubertal children treated for acute lymphoblastic leukemia was evaluated in a longitudinal study over 4.5 years. Patients were divided into three groups according to central nervous system prophylaxis: 37 patients received cranial irradiation with a dose of 24 Gy, 15 received a dose of 18 Gy, and 33 were not irradiated. According to the risk of leukemia, patients were divided into normal-risk (n = 74) and high-risk (n = 11) groups. The duration of treatment was 2 years, during which all patients showed growth retardation. The relative standard deviation score for height declined from 0 to -0.7 for the irradiated patients and from 0 to -0.2 for the non-irradiated group (P = 0.0001). There was no difference in growth pattern between cranial irradiation with 18 versus 24 Gy and chemotherapeutic treatment according to high-risk versus normal-risk protocols. However, a negative synergistic effect of more intensive chemotherapy and cranial irradiation on growth was demonstrated.
在一项为期4.5年的纵向研究中，对85名接受急性淋巴细胞白血病治疗的青春期前儿童的身高增长情况进行了评估。根据中枢神经系统预防措施，患者被分为三组：37名患者接受了24 Gy剂量的颅脑照射，15名接受了18 Gy剂量的照射，33名未接受照射。根据白血病风险，患者被分为低危（n = 74）和高危（n = 11）组。治疗持续时间为2年，在此期间所有患者均出现生长迟缓。接受照射患者的身高相对标准差评分从0降至-0.7，未接受照射组从0降至-0.2（P = 0.0001）。18 Gy与24 Gy颅脑照射以及根据高危与低危方案进行的化疗之间在生长模式上没有差异。然而，更强效的化疗和颅脑照射对生长具有负协同效应。
