Increased Vulnerability of the Spinal Cord to Radiation or Intrathecal Chemotherapy During Adolescence: A Report From the Children's Oncology Group
ABSTRACT To assess the rate of spinal cord toxicity in adolescents resulting from chemoradiotherapy of parameningeal sarcoma.
Of 152 patients with parameningeal sarcoma treated per the Intergroup Rhabdomyosarcoma Study Group protocol from 1977 through 1989, eight developed paralyzing ascending myelitis after intrathecal chemotherapy with cytosine arabinoside, methotrexate, and hydrocortisone administered during and after radiation therapy to volumes that included part of the spinal cord. The eight cases include three not previously published.
Of eight patients who developed CNS toxicity after intrathecal chemotherapy and radiotherapy for parameningeal rhabdomyosarcoma, all but one were between 13 and 18 years of age when treated. This severe toxicity occurred in one quarter of 28 adolescents treated with the regimen in comparison with one of 123 children 12 years of age or less (P < 0.0001), a rate that was as much as 30 times higher in the adolescents. Lengthening of the spinal cord during the pubertal growth spurt may account for the apparent increased vulnerability.
Chemoradiotoxicity-associated spinal cord injury appears to be more likely to occur in adolescents than in younger or older ages. This observation appears to reverse a conventional wisdom in which the central nervous system is thought to become more resistant to the neurotoxic effects of chemoradiotherapy as it matures.
Conference Paper: The magnetic near-field of a solenoid[Show abstract] [Hide abstract]
ABSTRACT: A simple closed form expression, henceforth referred to as the near-field expression, for the magnetic field of a solenoid is developed. The expression asymptotically approaches the exact values at radial distances large with respect to the diameter of the circular cross section of the solenoid. For radial distances as small as three times the radius of the rod the error in the magnetic field is less than 2%. This value is found by comparing the exact field, as obtained by numerical integration, to the near-field valuesElectrical and Computer Engineering, 1996. Canadian Conference on; 06/1996
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ABSTRACT: Neurologic dysfunction is a common side effect of many chemotherapy drugs. For several agents neurotoxicity is common, severe, and can be dose limiting. As the list of newer chemotherapy agents and systemic targeted therapies grows, so does the number and variety of potential neurotoxicities. This article reviews the clinical features of chemotherapy-induced syndromes involving the central and peripheral nervous systems.CONTINUUM Lifelong Learning in Neurology 02/2011; 17(1 Neurologic Complications of Systemic Disease):95-112. DOI:10.1212/01.CON.0000394676.67372.87
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ABSTRACT: Rhabdomyosarcoma (RMS) is a rare type of soft tissue sarcoma that mainly affects children, but also occurs in adolescents and (young) adults (AYA). Despite dramatic survival improvements reported by international study groups in children over the past decades, the awareness of a dismal outcome for older patients with RMS has grown. In contrast to the world-wide organization of care for children with RMS, standard care in adults lags behind. A step forward in RMS management for patients of all ages is urgently needed. Both paediatric oncologists and medical oncologists are essential players in development of a concept of RMS care, but bringing two worlds together seems not so easy. This review provides an overview which highlights the similarities and differences in children and adults with RMS. Furthermore, it comes up with a novel concept to overcome the virtual gap between the treatment approach of children and AYA with RMS.Critical reviews in oncology/hematology 07/2011; 82(3):259-79. DOI:10.1016/j.critrevonc.2011.06.005 · 4.03 Impact Factor