Discussion 1

Is there something clinically that you have learned or read elsewhere that is
associated with the material that has been covered to date but isn't found in your lectures
or readings? 

I did learn a new fact. For example, if a child is to be treated at T4, they will really be
treated from T3-T5 as to cover the PTV of T4 and to fully then encompass these other vertebral
bodies and not part of them. Or if only the posterior portion of T4 needs treatment they will still
be treated to the whole T4 vertebrae including the anterior portion. The reason being,
inhomogeneous radiation dose distributions can alter local gene expression, metabolism,
endocrine signaling, and normal spinal development. This leads to spinal cord hypoplasia and
problems such as scoliosis, kyphosis and lordosis.1

So, when treating any vertebral body, the whole structure must be treated. So the
treatment field is cut off to include whole vertebral bodies. A homogeneous dose should be
intended for the spine of pediatric patients.

Reference

Furlow, B. Cancer radiotherapy poses long-term risks for children's spinal development.
Oncology Nurse Advisor.
https://www.oncologynurseadvisor.com/home/cancer-types/general-oncology/cancer-
radiotherapy-poses-long-term-risks-for-childrens-spinal-development/2/. Published April
9, 2019. Accessed April 9, 2023.