Pediatric Oncology

Most of following text is derived from :

As a Radiation Oncologist when we want to prescribe Radiation for a child we should be aware of side effects of RT :

General Side Effects

Side Effects from RT can be classified into three groups :

1. EARLY (during treatment and the first month after RT)

2. EARLY DELAYED (up to 6 months after RT)
Scattered astrocytic and microglial reactions, perivascular collections of mononuclear cells and demyelination seen.

3. LATE (90 days to many years after RT)
Late effects in the brain include the break down of neural tissue with myelin destruction, proliferative and degenerative changes in glial cells.
Vascular changes occur with endothelial cell loss, proliferation, capillary occlusion, degeneration and hemorrhagic exudates.
Eventually this leads to vasogenic edema and cerebral atrophy.
Late Effects can be classified according to their severity.

The classification scheme outlined by the RTOG (Radiation Therapy Oncology Group) labels neurological symptoms into one of four categories based on their severity.
The classification system is as follows:

Symptom Grade Description
0 No change above baseline
I Fully functional status; Minor neurologic findings, no medications needed
II Home Care required secondary to symptoms. Medication required ( steroid/anti-seizure )
III Hospitalization needed for initial management
IV Serious neurologic impairment despite medication - paralysis - coma - seizures (>3 times/week) ; Hospitalization required