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Pediatric Oncology
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Stephen Lowis, Rachel Cox, John Moppett, Helen Rees
The measurement of morbidity following survival from childhood cancer is most often objective, documentary records based upon physical findings. The survivor’s subjective view is at least as important, but has been relatively under-reported due to difficulties of definition, and limited availability of appropriate tools. This has begun to change, and in recent years, substantial progress has been made. Indeed, major clinical trials sponsors, such as the Medical Research Council and National Cancer Institute, require new trials to consider quality of life assessments as part of their central strategy280 (Nayfield et al., 1992, #26).
Epidemiology of Childhood Brain Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Richard J. McNally, Paul Graham Fisher
While the occurrence of brain tumors as a group is second in childhood cancer incidence only to the leukemias (principally acute lymphoblastic leukemia and acute myelogenous leukemia), the breadth and diversity of brain tumors far exceed that observed in any other organ system. Consequently, epidemiology has frequently lumped childhood brain tumors together when examining potential exposures, particularly environmental agents or parental characteristics, as potentially causal or predisposing to a tumor. This practice is understandable given the overall uncommonality of childhood cancer, then split into types of childhood tumors, and further divided into myriad subtypes of childhood brain tumors.
Effects of treatment on the abdomen and pelvis
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
There is a recognized risk of treatment-induced second malignancies (55). This is highest after treatment for childhood cancer, and the overall risk varies between 2% and 12% in survivors at 20 years. Most tumours are musculoskeletal sarcomas, lymphomas, or leukaemia (56). In the abdomen, hepatomas can occur in patients who have undergone upper abdominal radiation therapy. Second malignancies can arise within or outside the irradiation field. Studies have shown that patients treated with radiotherapy for cervical or ovarian cancer developed endometrial cancer approximately 15 years later (57). There is also a slight increase in radiation-induced secondary malignancy after prostate radiotherapy (58). Approximately 1 in 70 patients who survive longer than 10 years will develop a second malignancy, with a predilection for rectal or bladder tumours. Despite the association between radiotherapy and second malignancies, there is a lack of definitive evidence for a direct relationship.
Exploring relationships between inspiratory muscle strength and functional capacity in childhood cancer survivors: a pilot study
Published in Pediatric Hematology and Oncology, 2022
Simon Ho, Teresa York, Victoria Marchese
Advances in medical treatment for childhood cancers have led to outstanding survival with five-year survival rates approaching and, for some cancers, exceeding 85%.1 Nonetheless, the short- and long-term side effects of childhood cancer treatment can lead to significant complications and high levels of morbidity.2 Functional capacity, which is the ability to perform aerobic work,3 is often impaired in childhood cancer survivors (CCS).4,5 Arterial stiffness5,6 and impaired hemodynamic response to exercise7 have also been reported in CCS. These physical limitations in CCS are often related to a poor ability to integrate the efforts of multiple body systems.8 In a sample of 1041 adult survivors of childhood cancer, Ness et al.9 found that exercise intolerance was associated with cardiac dysfunction, blunted heart rate response to exercise, lower forced expiratory volume in one second and lower quadriceps muscle strength. These multisystem side effects can prevent CCS from fully participating in activities of daily living10 and contribute to poor outcomes in social behaviors11,12 and health-related quality of life.13,14 Thus, limitations in functional capacity in CCS should be identified early and addressed optimally to improve outcomes and reduce disability.
The RACE for children act at one year: progress in pediatric development of molecularly targeted oncology drugs
Published in Expert Review of Anticancer Therapy, 2022
Although childhood cancer is rare, an estimated 15,590 children and adolescents up to age 19 in the United States will receive a cancer diagnosis in 2021 [1]. Few oncology drugs are approved for pediatric indications: between 1953 and 2018, only 34 drugs were approved by the Food and Drug Administration (FDA) to treat childhood cancers [2]. Attempts to address the scarcity of drugs with pediatric use information through legislation such as the Pediatric Research Equity Act (PREA) [3], which authorizes FDA to require pediatric studies of drugs developed for adult indications, have been largely ineffective in driving pediatric development of oncology drugs, due to exemptions for orphan drug designation, and waivers for indications that do not occur in children [4]. As a result, off-label use of anticancer drugs approved for the treatment of adults is common [5]. Because the pharmacokinetics and pharmacodynamics of the drug may differ in children, this practice may result in increased risk of adverse drug reactions [5,6]. There is an unmet need for more pediatric research to evaluate new therapies to treat childhood cancers.
Nutritional Status and Growth Deficit in Children and Adolescents with Cancer at Different Moments of Treatment
Published in Nutrition and Cancer, 2021
Débora Santana Alves, Dayane Tonaco Assunção, Nayara Cristina da Silva, Cássia Maria Oliveira, Anna Beatriz Costa Neves Amaral, Ana Elisa Madalena Rinaldi, Geórgia das Graças Pena
Cancer is still among the leading causes of death in children and adolescents worldwide (1,2). The most common type of childhood cancer is leukemia and this is seen most often in children aged 2 to 5 years. The second most common type is central nervous system tumors, which occur mainly in children aged 10 to 15 years. Treatment options for both types of tumor include chemotherapy, radiotherapy, surgery and bone marrow transplantation (3,4). The tumor and the type of treatment may contribute to malnutrition, the latter sometimes causing gastrointestinal disturbance, food inappetence and mucositis, which reduce food intake (5,6). Thus, malnutrition in children and adolescents undergoing cancer treatment remains a recurring complication that may lead to a worse prognosis of the disease.