Rao, Avani D. et al. International Journal of Radiation Oncology • Biology • Physics , Volume 103 , Issue 3 , 669 – 679
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.
- Introduction
- Complexities of a Standard Dose Constraint
- Assessment of Skeletal Maturity and Completion of Growth
- Anatomic Road Map of Important Growth Plates and Clinical Correlates of Radiation-Associated Growth Toxicity
- Conclusion and Future Directions
- Supplementary Data
- References
