The Prevalence of Scoliosis in Patients Diagnosed with Wilms’ Tumor with Follow-up free of Disease

Abstract

Introduction: Wilms’ tumor is the most common malignant renal tumor in children. The treatment combines surgery, chemotherapy and, in some cases, radiotherapy. The musculoskeletal abnormalities have been described as the most frequent late effects related to the radiotherapy treatment. Objective: To verify the prevalence of scoliosis in patients diagnosed with Wilms’ tumor, treated with chemotherapy, and with or without radiotherapy after tumor resection, with at least 2 years of follow-up free of disease. Method: Cross-sectional study with 20 patients. Nine of those 20 patients had tumor resection surgery and received chemotherapy (CQ group) and 11 patients had tumor resection surgery and received both chemotherapy and radiotherapy (CQR group). All patients underwent a physical evaluation and a postural evaluation through computer-assisted photogrammetry. Results: Scoliosis was observed in 75% of the sample, 67% of the CQ group and 82% of the CQR group. The main postural deviations found during the physical evaluation were horizontal asymmetry of the shoulders and anterior pelvic tilt. The main postural deviations found through the computer-assisted photogrammetry evaluation were anterior pelvic tilt and angle between acromions, anterior superior iliac spines different from 0o, asymmetric horizontal alignment of the scapulae, asymmetric horizontal alignment of the pelvis and horizontal asymmetry of the scapulae in relation to T3. Conclusion: Patients diagnosed with Wilms’ tumor, treated with or without radiotherapy after tumor resection, with at least 2 years of follow-up free of disease present a high prevalence of musculoskeletal deviations, especially those related to developing scoliosis.