Journal Article

Final height in survivors of childhood cancer compared with Height Standard Deviation Scores at diagnosis

S. L. Knijnenburg, S. Raemaekers, H. van den Berg, I. W. E. M. van Dijk, J. A. Lieverst, H. J. van der Pal, M. W. M. Jaspers, H. N. Caron, L. C. Kremer and H. M. van Santen

in Annals of Oncology

Published on behalf of European Society for Medical Oncology

Volume 24, issue 4, pages 1119-1126
Published in print April 2013 | ISSN: 0923-7534
Published online November 2012 | e-ISSN: 1569-8041 | DOI: https://dx.doi.org/10.1093/annonc/mds580
Final height in survivors of childhood cancer compared with Height Standard Deviation Scores at diagnosis

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Background

Our study aimed to evaluate final height in a cohort of Dutch childhood cancer survivors (CCS) and assess possible determinants of final height, including height at diagnosis.

Patients and methods

We calculated standard deviation scores (SDS) for height at initial cancer diagnosis and height in adulthood in a cohort of 573 CCS. Multivariable regression analyses were carried out to estimate the influence of different determinants on height SDS at follow-up.

Results

Overall, survivors had a normal height SDS at cancer diagnosis. However, at follow-up in adulthood, 8.9% had a height ≤−2 SDS. Height SDS at diagnosis was an important determinant for adult height SDS. Children treated with (higher doses of) radiotherapy showed significantly reduced final height SDS. Survivors treated with total body irradiation (TBI) and craniospinal radiation had the greatest loss in height (−1.56 and −1.37 SDS, respectively). Younger age at diagnosis contributed negatively to final height.

Conclusion

Height at diagnosis was an important determinant for height SDS at follow-up. Survivors treated with TBI, cranial and craniospinal irradiation should be monitored periodically for adequate linear growth, to enable treatment on time if necessary. For correct interpretation of treatment-related late effects studies in CCS, pre-treatment data should always be included.

Keywords: childhood cancer; final height; late effects; short stature; survivor

Journal Article.  4254 words.  Illustrated.

Subjects: Medical Oncology

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