SKELETAL MATURITY AND BODY HEIGHT DEVELOPMENT IN CHILDREN AFTER MALIGNANT TUMOUR TREATMENT

Novotný Jan, Hrstková Hana*, Bajer Milan*, Dohnalová Ilona, Novotná Martina

Dept. of Physical Culture of Pedagogical Faculty at Masaryk University,

*Ist Pediatrics-Oncology Clinic of Masaryk University

Brno, Czech Republic

 

Introduction: Malignant tumours and its complex treatment can influence physical development. Some micro-spectroscopic, radiological and densito-metric studies proved osteopenia, osteoporosis or osteolysis in children after radiological or steroid therapy.

The aim of our study was to evaluate skeletal maturity and height development in children who underwent such a treatment.

 

Study group: 65 boys (aged 5,3 to 18,4 years; 1 to 6 years after therapy) and 53 girls (3,7 to 17,5; 1 to 5). Most occurring diagnosis: acute leukaemia (especially lymphoblastic) and malignant lymphomas. There were less solid tumours found – Wilms´s or Ewing´s tumour, soft tissue sarcoma, neuro-blastoma, retino-blastoma, etc.

 

Methods: We have determinated the bone age after the comparison of hand x-ray with Kapalín´s bone atlas. The terminal body height was predicted from current height and bone age according to Bayley as well as Prokopec.

 

Results:                                             boys (x±s)       girls (x±s)

Calendar age (years)                           12,2±3,6         10,9±4,2

Bone age (years)                                 12,0±3,9         10,7±3,9

Current height (cm)                              152,6±20,1     142,3±20,4

Predicted height (Bayley; cm)   179,5±8,37     166,4±6,95

Predicted height (Prokopec; cm)          179,4±5,96     166,8±6,10

·        We have not found any significant difference between the bone age and the calendar age in these children (boys p=0,2709; girls p=0,3216), between the current and the relevant  body height (boys p=0,7705; girls p=0,6907), and between the predicted height and the average height of adult population (boys - Bayley/Prokopec p=0,9750/0,7320; girls p=0,4096/0,1410).

·        The skeletal and calendar age difference in boys does not change with the increasing calendar age (r=0,0173). On the contrary, we can see significant bone age retardation in comparison with calendar age in girls (r= 0,3743; p<0.01).

 

Conclusions:

·        We have found significant bone age retardation in comparison with calendar age in girls, and we can not eliminate correlation between this retardation and long-term bone metabolic changes after steroid therapy.

·        We have not found  similar changes of bone age retardation in boys as  in girls.

·        We have not found some significant disorders in body height development in the treated children.

·        The side effects of the therapy can manifest after many years, therefore, there is a need for physical development monitoring during a long-term period.

 

References:

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4.      Kapalín V. Atlas standardnych RTG snímkov ruky a zapestia ceskych detí. In: Čechovský, K. Reliability of the prediction of adult body height based on skeletal age assessment. Sports Training, Med and Rehab, 1990, vol. 2, p.23-27.

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