The Significance of Scoliosis in Postirradiated Wilms's Tumor and Neuroblastoma

Abstract

There is a tendency to implicate irradiation as an etiologic feature in all complications subsequent to a course of therapy. Although this is justifiable in many instances, it is important to recognize those late complications which are due to tumor invasion and repair of an infiltrated tissue rather than the direct result of irradiation. In the first instance, it may be impossible to achieve a selective effect of irradiation, since the neoplasm has already in part destroyed the normal structure. In the second instance, the tolerance of the normal tissue included in the therapy beam may inadvertently have been exceeded and late radiation injury may result. The importance of distinguishing the cause of the late change lies in the fact that only thus are protective measures and considerations possible. An excellent illustration of this problem is the development of scoliosis in the long-term survivor who has received radiotherapy for certain childhood axial tumors, such as Wilms's tumor and neuroblastoma. T...