Osteonecrosis in pediatric cancer survivors: Epidemiology, risk factors, and treatment

Sandesh S. Rao, Jad M. El Abiad, Varun Puvanesarajah, Adam Levin, Lynne C Jones, Carol D Morris

Research output: Contribution to journalReview articlepeer-review


Several treatment regimens for childhood malignancies have been associated with the development of osteonecrosis, including radiation therapy, glucocorticoid medications, immunotherapy (including anti-angiogenic agents), and several chemotherapeutic agents. Adolescents older than 10 years are at greatest risk of developing osteonecrosis within 1 year of initiating therapy. Screening with magnetic resonance imaging in this high-risk population may be a useful method for detecting osteonecrosis. Surgery may be required for lesions that have progressed substantially despite nonoperative interventions.

Original languageEnglish (US)
Pages (from-to)214-221
Number of pages8
JournalSurgical Oncology
StatePublished - Mar 1 2019


  • Chemotherapy
  • Late effects
  • Osteonecrosis
  • Pediatric cancer
  • Radiation

ASJC Scopus subject areas

  • Surgery
  • Oncology

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