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   Associations between treatment, scoliosis, pulmonary function, and physical performance in long-term survivors of sarcoma  
   
نویسنده Interiano Rodrigo B. ,Kaste Sue C. ,Li Chenghong ,Srivastava Deo Kumar ,Rao Bhaskar N. ,Warner William C. ,Green Daniel M. ,Krasin Matthew J. ,Robison Leslie L. ,Davidoff Andrew M. ,Hudson Melissa M. ,Fernandez-Pineda Israel ,Ness Kirsten K.
منبع journal of cancer survivorship - 2017 - دوره : 11 - شماره : 5 - صفحه:553 -561
چکیده    Longer survival for children with sarcoma has led to the recognition of chronic health conditions related to prior therapy. we sought to study the association of sarcoma therapy with the development of scoliosis. we reviewed patient demographics, treatment exposures, and functional outcomes for patients surviving >10 years after treatment for sarcoma between 1964 and 2002 at our institution. the diagnosis of scoliosis was determined by imaging. functional performance and standardized questionnaires were completed in a long-term follow-up clinic. we identified 367 patients, with median age at follow-up of 33.1 years. scoliosis was identified in 100 (27.2%) patients. chest radiation (relative risk (rr), 1.88 (95% confidence interval (ci), 1.21–2.92), p < 0.005) and rib resection (rr, 2.64 (ci, 1.79–3.89), p < 0.0001) were associated with an increased incidence of scoliosis; thoracotomy without rib resection was not. of 21 patients who underwent rib resection, 16 (80.8%) had the apex of scoliosis towards the surgical side. scoliosis was associated with worse pulmonary function (rr, 1.74 (ci, 1.14–2.66), p < 0.01) and self-reported health outcomes, including functional impairment (rr, 1.60 (ci, 1.07–2.38), p < 0.05) and cancer-related pain (rr, 1.55 (ci, 1.11–2.16), p < 0.01). interestingly, pulmonary function was not associated with performance on the 6-min walk test in this young population. children with sarcoma are at risk of developing scoliosis when treatment regimens include chest radiation or rib resection. identification of these risk factors allow for early intervention designed to prevent adverse long-term outcomes. cancer survivors at risk of developing scoliosis benefit from monitoring of pulmonary status and early physical therapy.
کلیدواژه Scoliosis ,Sarcoma ,Thoracotomy ,Survivors ,Rib resection
آدرس St. Jude Children’s Research Hospital, Department of Surgery, USA. University of Tennessee Health Science Center, USA, St. Jude Children’s Research Hospital, Department of Diagnostic Imaging, Department of Oncology, USA. University of Tennessee Health Science Center, Department of Radiology, USA, St. Jude Children’s Research Hospital, Department of Biostatistics, USA, St. Jude Children’s Research Hospital, Department of Biostatistics, USA, St. Jude Children’s Research Hospital, Department of Surgery, USA, St. Jude Children’s Research Hospital, Department of Surgery, USA, St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, USA, St. Jude Children’s Research Hospital, Department of Radiation Oncology, USA, St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, USA, St. Jude Children’s Research Hospital, Department of Surgery, USA. University of Tennessee Health Science Center, USA, St. Jude Children’s Research Hospital, Department of Oncology, Department of Epidemiology and Cancer Control, USA, St. Jude Children’s Research Hospital, Department of Surgery, USA. University of Tennessee Health Science Center, USA, St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, USA
 
     
   
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