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Risk Factors for Portal Hypertension in a Child Receiving Radiation Therapy for a Wilms Tumor

Description

A pediatric patient receiving radiation therapy for a Wilms tumor may develop portal hypertension as a rare complication. Warwick et al identified a number of risk factors that may associated with this complication. The authors are from the National Wilms Tumor Study Group and multiple universities in the United States.


 

The risk of portal hypertension was greater for patients with Wilms tumors on the right side (0.7% at 6 years vs 0.1% for a left-sided tumor).

 

The primary risk factor was the radiation dose to the liver, with the risk increased for liver doses > 15 Gy.

 

Additional factors:

(1) female gender

(2) doxorubin therapy (which tends to be used in patients with tumors with a worse prognosis because of stage or cytogenetics)

 

Portal hypertension may be more common than it is recognized (it may be masked by other factors, a child may not survive long enough for it to develop, or it may not be diagnosed until advanced). It may take several years to evolve.

 


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