Disturbances in craniofacial morphology in children treated for solid tumors

Because of increased survival rates in childhood cancer, special interest h as 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 c hildren who had received different kinds of antineoplastic therapies for so lid tumors. A total of 40 children treated in the Turku University Central Hospital were examined and divided into three different groups. Group 1 com prised 18 children treated for intracranial tumors with cranial irradiation (CRI) and chemotherapy (CT) including alkylating agents. Seven children ou t of 18 in this group received growth hormone (GH) therapy. In Group 2, 11 children with extracranial solid tumors also received multiagent CT includi ng 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 cephalogram s of the subjects were measured. Most deviations in craniofacial structures were found in children treated with combined CRI and multiagent CT. All di sturbances were seen in the vertical measurements which were reduced when c ompared to the matched controls. It seems reasonable to assume that impaire d growth following combined radio- and chemotherapy, as well as GH treatmen t, particularly affects cartilage-mediated growth. However, the deviations seen in the present study were fairly minor and did not usually require cli nical consideration. (C) 2001 Elsevier Science Ltd. All rights reserved.