Disturbances in craniofacial morphology in children treated for solid tumors

Karsila-Tenovuo, S.; Jahnukainen, K.; Peltomäki, T.; Minn, H.; Kulmala, J.; Salmi, T.T.; Rönning, O.

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Volume 37, Issue 7 , Pages 586-592, October 2001

Disturbances in craniofacial morphology in children treated for solid tumors

S. Karsila-Tenovuo
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland
- Corresponding author. Tel.: +358-2-333-8344; fax: +358-2-333-8256
K. Jahnukainen
- Department of Pediatrics, University of Turku, PO Box 52, FIN-20521 Turku, Finland
T. Peltomäki
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland
H. Minn
- Turku PET Center, University of Turku, PO Box 52, FIN-20521 Turku, Finland
- Department of Oncology and Radiotherapy, University of Turku, PO Box 52, FIN-20521 Turku, Finland
J. Kulmala
- Department of Oncology and Radiotherapy, University of Turku, PO Box 52, FIN-20521 Turku, Finland
T.T. Salmi
- Department of Pediatrics, University of Turku, PO Box 52, FIN-20521 Turku, Finland
O. Rönning
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland

Received 24 November 2000; accepted 6 December 2000.

Abstract

Because of increased survival rates in childhood cancer, special interest has been focused on the side-effects of the therapy and the quality of life in long-term survivors. Our aim was to investigate craniofacial growth in children who had received different kinds of antineoplastic therapies for solid tumors. A total of 40 children treated in the Turku University Central Hospital were examined and divided into three different groups. Group 1 comprised 18 children treated for intracranial tumors with cranial irradiation (CRI) and chemotherapy (CT) including alkylating agents. Seven children out of 18 in this group received growth hormone (GH) therapy. In Group 2, 11 children with extracranial solid tumors also received multiagent CT including alkylating agents, but no CRI. Group 3 consisted of 11 children treated for Wilm's tumor with CT, which did not include alkylating agents or CRI. A total of 19 linear and four angular variables from the lateral cephalograms of the subjects were measured. Most deviations in craniofacial structures were found in children treated with combined CRI and multiagent CT. All disturbances were seen in the vertical measurements which were reduced when compared to the matched controls. It seems reasonable to assume that impaired growth following combined radio- and chemotherapy, as well as GH treatment, particularly affects cartilage-mediated growth. However, the deviations seen in the present study were fairly minor and did not usually require clinical consideration.

Keywords: Pediatrics, Intracranial tumors, Extracranial tumors, Cranial irradiation, Cephalometry, Orthodontics