For many pediatric cancer patients, total body irradiation (TBI) is a hazardous part of treatment during bone marrow transplant– it’s a key component of long term survival. But lengthened survival creates the ability to notice long term effects of radiation as these youngest cancer patients age. A report from University of Colorado Cancer Center study recently published in the journal Pediatric Blood & Cancer details these late effects of radiation.
These kids basically lie on a table and truly do get radiation from head to toe. There is a little blocking of the lungs, but nothing of, for example, the brain or the kidneys. Of 15 patients who received TBI before age 3, many developed endocrine and metabolic problems including testicular malfunction (78%), restrictive pulmonary disease due to high levels of blood triglycerides (74%), and cataracts (78%). Likewise, 90% of patients showed abnormally low levels of growth hormone, and 71% were considerably under height.
Additional late effects of TBI included kidney, liver, skeletal and cardiac malfunction and, three of four patients whose IQ had been tested before TBI showed cognitive decline.
The study supports the recommendations of the Children’s Oncology Group for long term follow up care for children receiving TBI (survivorshipguidelines.org). Specifically, Mulcahy-Levy hopes that increasing awareness of likely effects will help patients and their doctors’ screen for, detect, and correct likely effects of TBI.
The study shows it’s important know about these problems in order to address them appropriately and proactively.
Early side effects
Early side effects are those that occur shortly after the start of TBI and up to six months after TBI ends.
They can include:
- Nausea and vomiting;
- Sores in the mouth;
- Diarrhea (upset stomach);
- Jaw pain or swollen salivary glands;
- Dry mouth;
- Skin redness;
- Hair loss;
- Low blood counts; and
- Sore throat, problems with swallowing, or both.
Late side effects
Late side effects are those that occur six months to several years after the TBI treatment. They can include:
- Decrease in growth;
- Hormone problems; and