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Zelcer, Shayna, Danielle Cataudella, A. Elizabeth L. Cairney, and Susan L. Bannister. "Palliative Care of Children With Brain Tumors." Archives of Pediatrics & Adolescent Medicine 164, no. 3 (March 1, 2010): 225. http://dx.doi.org/10.1001/archpediatrics.2009.284.
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Baron, Mary C. "Advances in the Care of Children with Brain Tumors." Journal of Neuroscience Nursing 23, no. 1 (February 1991): 39–43. http://dx.doi.org/10.1097/01376517-199102000-00008.
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Ioakeim-Ioannidou, Myrsini, and Shannon M. MacDonald. "Evolution of Care of Orbital Tumors with Radiation Therapy." Journal of Neurological Surgery Part B: Skull Base 81, no. 04 (August 2020): 480–96. http://dx.doi.org/10.1055/s-0040-1713894.
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AbstractOrbital tumors are rare lesions comprising 0.1% of all tumors and less than 20% of all ocular diseases. These lesions in children and adults differ significantly in their incidence, tumor type, and treatment management. Although surgery and systemic therapies are commonly used in the management of these diseases, radiation therapy has become a widely used treatment for both benign and malignant tumors of the orbit. Radiotherapy is used as a definitive treatment to provide local control while avoiding morbidity associated with surgery for some tumors while it is used as an adjuvant treatment following surgical resection for others. For many tumors, radiation provides excellent tumor control with preservation of visual function. This article is dedicated for presenting the most common applications of orbital radiotherapy. A brief overview of the commonly available radiation therapy modalities is given. Dose constraint goals are reviewed and acute and long-term side effects are discussed. Orbital tumors covered in this article include optic glioma, ocular melanoma, retinoblastoma, orbital rhabdomyosarcoma, orbital lymphoma, and lacrimal gland tumors. Background information, indications for radiotherapy, and goals of treatment for each case example are described.
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Balcha, Chalew Alemayehu, Damte Shimelis Awoke, and Daniel Hailu Kefene. "A-5-year analysis of pediatric brain tumors in a tertiary care center, in a sub-saharan African country." Ethiopian Journal of Pediatrics and Child Health 17, no. 1 (October 2, 2022): 31–42. http://dx.doi.org/10.4314/ejpch.v17i1.4.
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Background: Tumors of the central nervous system (CNS) are the second most common group of cancers in childhood, exceeded by the leukemias. It is the most common pediatric solid tumor accounting for 20% of all childhood malignancies. The pattern and outcome of these tumors in children has not been studied in Ethiopia. This study aimed to assess the epidemiology and out-come of pediatric brain tumors in a tertiary care center in Addis Ababa, Ethiopia.Methods: A retrospective review of medical records of children less than 15 years of age diag-nosed with primary brain tumor in Tikur Anbessa Specialized Hospital Department of pediatrics from January 1, 2014 to January 1, 2019 was done. Treatment outcome was assessed clinically based on resolution of symptoms and absence of neurologic disabilityResults: There were 86 children with the diagnosis of brain tumor in the study period and 49/86 (57%) were males and the male to female ratio was 1.5:1. The age at presentation ranges from 2.4-14 years (mean 7.1 years). Headache was the commonest presentation among 65/86 (75.5%) children while early morning vomiting accounted for 57/86 (66.2%). Ataxia and gait abnormality contributed to 42/86 (48.8%). Among the 41 children whose pathologic result was available, the commonest tumor was medulloblastoma 13/41 (31.7%), followed by astrocytoma 8/41 (19.5 %) and craniopharyngioma 5/41 (12.1%). Six months and 5 years survival was 40% (35/86) and 2.3% (2/86) respectively.Conclusion: Medulloblastoma and astrocytoma were common brain tumors in children, we had the longest PSI and as a result, very low survival which calls for early diagnosis and treatment.
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Laz, Mafia Afshin, Md Mazidul Islam, Kaisar Yamin, Md Abu Jafor, Md Monowar Hossain, Sheikh Zahid Boksh, and AHM Abdul Hai. "Solid Tumor in Children: A Single Centre Experience." Sir Salimullah Medical College Journal 29, no. 2 (April 7, 2022): 117–20. http://dx.doi.org/10.3329/ssmcj.v29i2.58967.
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Introduction: Now a days, number of childhood tumors are gradually increasing throughout the world. But in Bangladesh we have no actual tumor register. In this study we just try to find out the demographic presentation of solid tumor in a tertiary care center of Dhaka city.
Methods and materials: it is a retrospective descriptive type of observational study. Study was held in department of pediatric surgery, Sir Salimullah medical college Mitford hospital Dhaka from January 2016 to December 2020.
Results: total number of the patients were 37. Male 15 and female 22. Male female ratio is 1:1.7. Age range of the patients from 9 days to 13 years. Mean age 135.83 days. Among 37 patients, 29 had malignant tumors and rest of 8 patients had benign tumor. Ovarian tumors were highest, 10. Then nephroblastoma 9, neuroblastoma 7, non Hodgkin lymphoma 3, sacrococcygeal teratoma 3, adrenal benign tumor 1, soft tissue sarcoma in pelvis 1, rhabdomyosarcoma of urinary bladder1, rectal carcinoma 1 and rhabdomyosarcoma of lower limb 1 accordingly. Most of the patients were went through surgery first then sent for chemotherapy according to histology.
Conclusion: In spite of a tertiary medical care center in Dhaka city, our number of patient is not satisfactory. Lack of proper awareness in public, lots of patient did not reach to proper center, those who attained hospital, may lost. And our poor record keeping system is also responsible for adequate informations.
Sir Salimullah Med Coll J 2021; 29(2): 117-120
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Kuhlen, Michaela, Jessica I. Hoell, Gabriele Gagnon, Stefan Balzer, Arndt Borkhardt, and Gisela Janßen. "Palliative Outpatient Care in Children with Hematologic Malignancies Compared to Solid Tumors." Blood 128, no. 22 (December 2, 2016): 5977. http://dx.doi.org/10.1182/blood.v128.22.5977.5977.
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Abstract Background: The palliative care needs of children with cancer strongly depend on tumor entity and localization. However, little is known about the needs of children with hematologic malignancies (HM), as a much larger body of publications deals with the needs of children with solid tumors. Methods: Patient data were extracted from the database of one of the largest pediatric palliative care teams (PPCT) in Germany. Information included demographic data, diagnoses, patient contacts, symptoms, and medications. Children with HM were compared to other malignancies using bivariate analyses. Results: Between 01/2013 and 05/2016, the PPCT cared for a total of 178 patients. Of the 58 children with cancer (3 bone tumors, 25 brain tumors, 6 neuroblastomas, 9 soft tissue sarcomas, 9 other solid tumors), 6 (10.3%) had a hematologic malignancy (2 acute lymphoblastic leukemia, 2 acute myeloid leukemia, 1 T-cell lymphoma, 1 Burkitt lymphoma). Two patients underwent hematopoietic stem cell transplantation. Median age of patients with HM at the beginning of PCT was 12.1 years (range 5.4-18.9 years), 5 children were male. The number of children with HM cared for in the home setting was likely low due to the fact that most children with relapsed or refractory leukemia die during intensive chemotherapy and are thus still cared for in hospital. Time from start of palliative home care to death was the same in children with HM compared to non HM (54 vs. 53 days in care), although the range of days in palliative care was larger in children with non HM (1 to 226 days) compared to children with HM (10 to 116 days). The number of home visits was equal (9.7 vs. 9.4) as was the number of home visits per days in care (0.18 vs. 0.18). In both patient groups, most patients died at home or in hospice. The leading symptoms in children with HM were weakness and anxiety, whereas the most frequently reported symptom in patients with non HM was difficulty to move around (i.e. walk). Other frequently reported symptoms in non HM were neurological and gastrointestinal problems. In children with non HM, the occurring symptoms were much more variable. Mucosal bleeding, hematoma and/or petechiae were recurring problems in children with leukemia requiring platelet transfusions in the home setting, however, not a single child developed massive external hemorrhage. More children with non HM needed morphine-based pain medication (33% vs. 54%). Overall, less drugs for symptom control either regular or on demand medication were needed in children with HM. All patients with HM were continued on palliative chemotherapy. Although anti-infectious prophylaxis was discontinued at the beginning of palliative home care, sepsis did not occur in any child. Four of the HM patients died due to disease-related progressive weakness, one through an acute event (most likely intracranial hemorrhage), and one patient with a T-cell lymphoma and a large mediastinal mass died during palliative sedation. Conclusions: Children with hematologic malignancies who are referred to outpatient palliative care appear to have an equal length of care compared to other cancer patients. A lower number of medications (including morphine-based drugs) is necessary, however transfusion rates are higher. As might have been a fear of both parents and treating physicians, not a single child developed massive external hemorrhage. Better knowledge about the special symptoms and needs of children with hematologic malignancies will enable PPCTs to provide best possible care. Disclosures No relevant conflicts of interest to declare.
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Hemenway, Molly. "NFB-21. Neurofibromatosis Type I in the Setting of Neuro-Oncology." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i132. http://dx.doi.org/10.1093/neuonc/noac079.481.
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Abstract Neurofibromatosis Type I (NF1) is an autosomal dominant genetic syndrome that is inherited or sporadic. Neuro-Oncology nurses are experienced in the multidisciplinary care of NF1 patients due to an increased incidence of brain tumors and the treatment of plexiform neurofibromas with Mek inhibitors. However, these children are also at higher risk of rare solid tumors, specifically malignant peripheral nerve sheath tumors (MPNST). Most brain tumors in NF1 have a good prognosis. Conversely, MPNST has an extremely poor prognosis. While patients with MPNST are often cared for by solid tumor care teams, the identification and diagnosis of the tumors occur under the care of the neuro-oncology care team. Complex care coordination for patients with NF1 and cancer is required. Specifically, patients with NF1 are more sensitive to chemotherapy, have a higher incidence of radiation-induced secondary tumors, and need monitoring for NF1 related health impacts. Nurses and nurse practitioners with expertise in neuro-oncology, NF1, and solid tumors must collaborate to provide comprehensive care. Teaching tools and clinical strategies have been developed to maintain patients’ continuity with the primary oncology team while gaining the support of subspecialists. The genetic basis, inheritance pattern, and characteristics of Neurofibromatosis Type I will be discussed as well as rare oncologic diagnoses that are more prevalent in children/young adults with NF1. The multidisciplinary approach to the care of the patient with NF1 and a rare cancer diagnoses at a tertiary care center as well as the optimization of care of patients with NF1 and other underlying syndromes and rare cancers will be reviewed. Increased knowledge of NF1 and the associated health impacts and risk of cancers will improve the care of all patients with NF1.
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Abecassis, Isaac Josh, Brian Hanak, Jason Barber, Martin Mortazavi, and Richard G. Ellenbogen. "A Single-Institution Experience with Pineal Region Tumors: 50 Tumors Over 1 Decade." Operative Neurosurgery 13, no. 5 (April 1, 2017): 566–75. http://dx.doi.org/10.1093/ons/opx038.
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Abstract BACKGROUND: Pineal region tumors are rare intracranial tumors that are more common in children than adults. Surgical management of tumors in this region using a tailored approach is a strategy that enhances extent of resection and neurological outcome. OBJECTIVE: To review our institutional experience with pineal region tumors in children and adults over the past 10 years. METHODS: Our institutional pathology database and patient records were retrospectively reviewed for details regarding clinical and radiological presentation, surgical management, extent of resection, morbidity, and neurological outcome. Statistical analysis was performed to assess for variables related to functional outcomes. RESULTS: Fifty patients were identified as having undergone surgical management of a pineal region tumor with at least 1 year of follow-up. Forty-one percent presented with a Karnofsky Performance Scale (KPS) score of 70 or less, all of whom had concomitant hydrocephalus that required urgent treatment. The following variables were statistically significant to KPS score on admission: age, tumor volume, preoperative hydrocephalus, length of hospitalization (total and intensive care unit), and elevations in serum tumor markers. The median postoperative (2 months) KPS score was 90. The following variables were statistically significant with respect to change in KPS score postoperatively: tumor maximum diameter, KPS score on admission, and intensive care unit length of stay. The specific surgical strategy did not correlate to extent of tumor resection, morbidity, immediate neurological outcome, and progression-free survival. CONCLUSION: Extent of resection, neurological outcome, and progression-free survival in the patients in our series were not related to the specific surgical approach employed and its perioperative complications.
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McGuire Cullen, Patsy. "Pharmacologic Supportive Care of Children With Central Nervous System Tumors." Journal of Pediatric Oncology Nursing 12, no. 4 (January 1995): 230–32. http://dx.doi.org/10.1177/104345429501200409.
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CULLEN, P. "Pharmacologic supportive care of children with central nervous system tumors." Journal of Pediatric Oncology Nursing 12, no. 4 (October 1995): 230–32. http://dx.doi.org/10.1016/1043-4542(95)90008-x.
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Fernandez, Karen S., Rober J. Lucia, Rachel Buchheit, Michele J. Holman, Penelope Sandiford, and Laura M. Sollenberger. "Early introduction of palliative care for children with solid tumors." Journal of Clinical Oncology 32, no. 31_suppl (November 1, 2014): 23. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.23.
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23 Background: Patients with solid tumors (ST) have the highest rate of relapse and mortality among pediatric oncology. Many patients suffer from acute and chronic therapy-related toxicity that have major implications in the patients’ lives. An early introduction of palliative care consultation (PCC) for patients with ST was implemented in 2012. Objectives: To assess the impact of the early introduction of PCC for children with ST on 1) Facilitation of interdisciplinary meetings (IDM) and goals of care 2) Counseling support including coping, advocacy, self-care, 3) Grieving, 4) End-of-life decision making/planning, and 5) Bereavement. Methods: An audit of all PCC from November/2012 to May/2014 was performed. Newly diagnosed patients with high risk ST (metastatic disease, need for HSCT or risk for relapse of > 30%) were eligible for early PCC (36/44). Patients with brain tumors were excluded (19). Counselors were introduced to the patient/family at diagnosis. The perception of the intervention was explored among physicians and counselors. Results: 29/35 patients (72%) were offered early PCC, 1 declined the intervention. 17/29 developed disease relapse or progression (58%), 11/17 died. 9/29 had high risk ST without relapse (31%), 6/29 had loss of physical function (21%), 5/29 had other chronic diseases (17%). 20 had IDM for re-direction of goals of care. 25 (86%) received at least 1 of 3 counseling aspects. 20 received grieving support during treatment (6 due to loss of physical function, 4 during relapse and 11 during the dying process). 11 received end-of-life and bereavement support. Median number of visits/patient was 14. Pediatric oncologists felt early PCC favored effective communication between patients/families and medical teams, counselors felt early PCC was critical for rapport and trust building for an effective and productive professional relationship that strengthen the continuity of care. Conclusions: Early PCC for children with ST is feasible, and well-accepted by patients/families and physicians. It facilitates the comprehensive care of patients with ST throughout the disease trajectory.
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Shah, Niketa C., Amit Ray, Ute Bartels, James Rutka, Eric Bouffet, James Drake, Cynthia E. Hawkins, and Annie Huang. "Diffuse intrinsic brainstem tumors in neonates." Journal of Neurosurgery: Pediatrics 1, no. 5 (May 2008): 382–85. http://dx.doi.org/10.3171/ped/2008/1/5/382.
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✓ The authors report on 2 newborn infants with the unusual presentation of intrinsic brainstem tumors. Both nondysmorphic, full-term neonates had cranial nerve palsies and hypotonia. Diagnoses of diffuse intrinsic brainstem gliomas were made on the basis of magnetic resonance imaging, which showed large expansive, nonenhancing intrinsic pontine masses. Intrinsic pontine tumors, characteristically seen in school-age children, are most often high-grade gliomas that are almost invariably fatal. However, the microanatomy and natural history of pontine tumors in neonates are unknown. With parental consent, both newborns were treated expectantly with supportive care but died of progressive disease by 2 weeks of age. In one child, postmortem examination revealed a primary brainstem primitive neuroectodermal tumor. The authors conclude that, as in older children, neonatal intrinsic brainstem tumors may be of a highly malignant nature. The rapid tumor progression in both cases indicates that where a diagnostic procedure may pose significant risks, supportive observation can aid in distinguishing malignant from benign tumor growth.
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Eccles, Eamon, Yan Han, Hao Liu, David Walker, Sarah Rush, Jonathan Finlay, and Scott Coven. "EPID-11. ESTABLISHING A BASELINE TIME-FRAME FOR SYMPTOM ONSET TO DEFINITIVE DIAGNOSIS FOR CHILDREN WITH NEWLY-DIAGNOSED CNS TUMORS: AN EXPANDED, MULTI-INSTITUTIONAL COLLABORATIVE STUDY." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii320—iii321. http://dx.doi.org/10.1093/neuonc/noaa222.197.
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Abstract BACKGROUND We have previously documented the presence of diagnostic delays in children with central nervous system (CNS) tumors in the United States. This study serves to expand and validate the previously established baseline from symptom onset to definitive diagnosis in children with newly-diagnosed CNS tumors. DESIGN: The medical records of children with newly-diagnosed CNS tumors were retrospectively reviewed from January 2004 to December 2017 at Nationwide Children’s Hospital, Akron Children’s Hospital and Riley Hospital for Children at IU Health. Records were reviewed for age, gender, tumor type, presenting symptoms, number of healthcare visits prior to diagnosis, time interval (in months) from onset of symptoms to definitive diagnosis and any associated genetic syndromes. RESULTS Of the 768 patients with newly-diagnosed CNS tumors, the median time interval from symptom onset to definitive diagnosis was 40.5 days while the mean symptom interval was 144 days (range < 1 to 5,475 days). The median age of diagnosis was 7 years, with a male predominance (57%). This expanded cohort continues to reveal that pediatric brain tumor patients most often seek care at the primary care level, although many patients were seen in various multiple subspecialty clinics prior to diagnosis. CONCLUSIONS This multi-institutional cohort study updates our previously documented single state time interval and provides a consistent Midwest “benchmark” to improve awareness for children with brain tumors through the adaptation of the UK ‘HeadSmart,’ now renamed ‘BrainFirst.’ Additionally, future work could include a prospective registry to better examine potential risk factors for delays in diagnosis.
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Arakawa, Yoshiki, Hirokazu Takami, Kiyotaka Isobe, Kai Yamasaki, Katsuya Maebayashi, Takayuki Hashimo, Keita Tarashima, et al. "PEDT-6 A RANDOMIZED CONTROLLED CLINICAL STUDY OF RADIOTHERAPY COMBINED WITH CHEMOTHERAPY IN PATIENTS WITH NEWLY DIAGNOSED CENTRAL NERVOUS SYSTEM GERM CELL TUMOR, JCCG CNSGCT2021." Neuro-Oncology Advances 4, Supplement_3 (December 1, 2022): iii10—iii11. http://dx.doi.org/10.1093/noajnl/vdac167.037.
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Abstract Background Central nervous system (CNS) germ cell tumors account for 15.3% of all CNS tumors in children and adolescents and young adults. Five histologic types and mixed types exist and can be classified into the following clinical risk groups: germinomas, malignant germ cell tumors, and other germ cell tumors. In germinomas, platinum-based chemotherapy and whole ventricle/brain irradiations 23.4 Gy/13 fraction are the standard of care, but late adverse events related to radiation therapy are a problem. In malignant germ cell tumors, chemotherapy with alkylating agents and platinum, craniospinal irradiation (CSI), and local radiation therapy (local dose 50-59.4 Gy/25-33 fractions) have become the standard of care, but the 10-year OS is poor at about 60% and late radiation therapy-related adverse events are an issue. For various reasons, it is not easy to establish a standard of care for mature teratomas and immature teratomas, which constitute the other germ cell tumors, but it is essential to collect knowledge on tumor characteristics and prognosis. Methods and Patients The Japan Children's Cancer Group Brain Tumor Committee has planned a study to validate the classification by histological diagnosis and ancillary tumor markers, a phase III study to test the non-inferiority of radiation dose reduction to standard therapy for germinomas, a phase II study to test the superiority of high-dose chemoradiation with methotrexate intrathecal injection excluding CSI to standard therapy for malignant germ cell tumors, observational studies to elucidate pathogenesis of other germ cell tumors. Discussion If these hypotheses are proven, it is expected to reduce late adverse events and prolong survival with radiotherapy in children and adolescent/young adult generation patients.
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Chu, Thomas P. C., Anjali Shah, David Walker, and Michel P. Coleman. "How Do Biological Characteristics of Primary Intracranial Tumors Affect Their Clinical Presentation in Children and Young Adults?" Journal of Child Neurology 33, no. 8 (May 3, 2018): 503–11. http://dx.doi.org/10.1177/0883073818767562.
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We demonstrated the pattern in presentation of primary intracranial tumors in a population-based cohort of patients aged 0-24 years identified from the National Cancer Registry for England, using linked medical records from primary care and hospitals. We used generalized additive models to estimate temporal changes in presentation rates. Borderline and malignant tumors presented at a similar rate in primary care (6.4 and 6.6 consultations per 100 patients each month) and in hospital (3.4 and 3.6). Benign tumors presented earlier but less frequently (rate = 4.4 and rate ratio = 0.75, 95% CI = 0.60-0.93, in primary care; rate = 2.6 and rate ratio = 0.83, 95% CI = 0.77-0.89, in hospital). Many tumors began presenting shortly before their diagnosis, but less aggressive tumors were likely to present earlier in primary care. Earlier detection of less aggressive tumors in primary care may reduce the risk of complications and morbidity among survivors.
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Ellenbogen, Yosef, Kaiyun Yang, and Olufemi Ajani. "Transition of Care for Children with High-Grade Central Nervous System Tumors." Journal of Pediatric Neurology 18, no. 06 (September 28, 2020): 301–6. http://dx.doi.org/10.1055/s-0040-1716909.
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AbstractThe increase in survival rates of children with high-grade central nervous system tumors has highlighted the necessity for and challenges associated with transition of care as these children grow into adult life. Late recurrence and treatment effects are some of the conditions that require care after transition. Several models of transition have been proposed in the literature. An effective transition will not only ensure adequate continuity of care but will also include assessment of effectiveness of the transition by health care personnel and the patient/patient's family themselves.
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Hodžić, Mirsad, Zlatko Ercegović, Dželil Korkut, Mirza Moranjkić, Harun Brkić, and Selma Jakupović. "Diagnosis and Treatment of Pediatric Brain Tumors." Acta Medica Academica 49, no. 1, 2, 3 (January 28, 2021): 37. http://dx.doi.org/10.5644/ama2006-124.305.
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<p><strong>Objective</strong>. Tumors of the brain and spine make up about 20% of all childhood cancers; they are the second most common form of childhood cancer after leukemia. Brain tumors are the most common solid tumor in children. Symptoms depend on a variety of factors, including location of the tumor, age of child, and rate of tumor growth. The aim of study was to present our experience with the diagnosis and treatment of brain tumors in children.</p><p><strong>Patients and Methods</strong>. The aim of this study is to analyze clinicopathological characteristics, treatments, complications, and outcomes in children with brain tumors. This study is a retrospective analysis of 27 consecutive patients younger than 16 years and hospitalized for surgical treatment of brain tumors. Intracranial hypertension, neurological status, radiological computerized tomography (CT) or magnetic resonance imaging (MRI) findings, tumor localization, type of resection, hydrocephalus treatment, histopathology, complications, and outcome were analyzed.</p><p><strong>Results</strong>. Twenty-seven surgeries were performed in patients for brain tumors. There were 9 females and 18 males. The average patient age was 7.8 years. There were 11 (40%) children with astrocytoma; of these, there were 9 (82%) pilocytic astrocytomas and 2 (18%) ordinary histopathological subtypes of high-grade tumors.</p><p><strong>Conclusion</strong>. As with any cancer, prognosis and long-term survival vary greatly from child to child. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for a child diagnosed with a brain tumor.</p>
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Erefai, Ouassima, Amal Haimer, Faouzi Habib, Abdelmajid Soulaymani, Abdelrhani Mokhtari, and Hinde Hami. "EPID-08. Epidemiology of childhood brain tumors in Morocco." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i48. http://dx.doi.org/10.1093/neuonc/noac079.176.
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Abstract INTRODUCTION: Brain tumors are the most common solid tumors and cause of cancer-related death in children less than 15 years of age. However, little is known about these tumors in Morocco. The aim of this study is to describe the epidemiological features of pediatric brain tumors in Morocco. METHODS: This is a descriptive retrospective study of pediatric brain tumor cases, diagnosed and treated between 1994 and 2015 at Al Azhar Oncology Center in Rabat. Patient’s age and sex, habitat area, overall survival and tumor characteristics were evaluated. RESULTS: During the study period, 41 children under the age of 15 years were diagnosed with brain tumors at Al Azhar Oncology Center. Brain tumors were more common among boys than girls, with a male-female ratio of 1.9. The average age of diagnosis was 7.47 ± 3.06 years (range 2-14 years). More than half (51.22%) of the cases were diagnosed in children aged 5-9 years. Regarding the habitat area, nearly two-thirds (62.50%) of children live at least 30 kilometer (km) away from the cancer center. Medulloblastoma was the most common tumor type with 34.15% of cases. Overall, one patient develops a metastasis. Among the cases for whom the outcome was known, five children died during the study period, consisting of three girls and two boys. CONCLUSIONS: Children’s brain tumors remain a serious public health problem in Morocco, especially with the limited number of specialized pediatric cancer centers. The travel burden is a significant factor affecting access to appropriate diagnosis and treatment and can impede the provision of high-quality care for cancer patients.
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Lambert, Clare, Ran Goldman, Douglas Cochrane, Anita Dahiya, Heidi Mah, Arsh Buttar, and Sylvia Cheng. "EPID-08. FINDING THE NEEDLE IN THE HAY STACK – POPULATION-BASED STUDY OF PREDIAGNOSTIC SYMPTOMATIC INTERVAL IN CHILDREN WITH CNS TUMORS." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii320. http://dx.doi.org/10.1093/neuonc/noaa222.194.
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Abstract PURPOSE Delay in diagnosis of central nervous system (CNS) tumors in children is well documented. The aims of this study were to characterize the symptomatology of CNS tumors and the time to diagnosis in a large pediatric hospital in Canada. METHODS Retrospective chart review of children diagnosed with a CNS tumor between 2000 and 2016 in Vancouver, British Columbia, Canada was performed. Data collected included demographics, symptomatology, tumor type, age at diagnosis, known visits to healthcare professionals, neuroimaging, therapy and post treatment relapse or progression. RESULTS 148 children with complete medical records were reviewed. The average age at diagnosis was 87.8 months (standard deviation (SD) = 59.7; median = 72). 50.7% of patients had posterior fossa tumors and 49.3% had supratentorial tumors. 30% of patients were diagnosed after a single visit to a health care provider. 7.7% of children needed more than 4 visits. Median total time to diagnosis (PSI) was 62 days (range = 0-2047 days). The longest prediagnostic interval was first symptom onset to first healthcare provider visit (PSI1, median 37 days). Patients with posterior fossa tumors, presence of metastases, and symptoms of ataxia and paresis were associated with shorter PSI. CONCLUSIONS CNS tumors in children continue to pose a diagnostic challenge with significant variability in time to diagnosis. Our population-based study found that median time from symptoms to seeking medical advice by parents was over a month. It is essential to uncover the reasons for delay and address them where possible.
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Saltzman, A. F., J. C. Warncke, A. N. Colvin, A. Carrasco, J. P. Roach, J. L. Bruny, and N. G. Cost. "Development of a postoperative care pathway for children with renal tumors." Journal of Pediatric Urology 14, no. 4 (August 2018): 326.e1–326.e6. http://dx.doi.org/10.1016/j.jpurol.2018.05.002.
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Jovett Sanchez, Diana, Sally Andrea Gaspi, Ceri Jane Talan, Ana Patricia Alcasabas, and Ronnie Baticulon. "LINC-20. Impact of the COVID-19 pandemic on 30-day mortality and unplanned reoperation rates for pediatric central nervous system tumors." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i166—i167. http://dx.doi.org/10.1093/neuonc/noac079.619.
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Abstract INTRODUCTION: Unplanned reoperations and mortality within 30 days are important indicators when evaluating the quality of care provided by surgical systems. We reviewed these outcomes among children with primary central nervous system (CNS) tumors treated during the COVID-19 pandemic. METHODS: This is a retrospective study of all pediatric patients who underwent neurosurgery for primary CNS tumors at the Philippine General Hospital, the national university hospital, from January 1, 2020 until December 31, 2021. Their clinical presentation, perioperative course, and outcomes were analyzed. During this time, our hospital concurrently served as a COVID-19 referral center, thus, the workforce was restructured, and resources were reallocated to care for COVID-19 patients. RESULTS: A total of 92 pediatric patients with CNS tumors underwent 140 neurosurgical operations during the study period. Two-thirds of the patients were males, and mean age was 9.3 ± 5.0 years (range: 3 months to 18 years). Average preoperative length of stay was 3.9 ± 2.6 days. Tumor resection was performed in 73 patients (79%). Most common histologic diagnoses were medulloblastoma (20%) and low-grade glioma including pilocytic astrocytoma (20%). Overall, the 30-day mortality and unplanned reoperation rates were 12% and 22%, respectively. Eight patients died from brain herniation and/or tumor progression. Reasons for unplanned reoperations were postoperative hydrocephalus (20%), infection (9%), hematoma (7%), and tumor residual (3%). DISCUSSION: Worldwide, the COVID-19 pandemic has altered hospital protocols and shifted resources considerably. The observed high rates of death and reoperation are likely due to delays in seeking care leading to worse neurologic status at presentation, delays in performing essential surgery within the hospital, and shortage of health workers providing specialist care. It is important to periodically assess perioperative outcomes to improve the quality of surgical care given to children with CNS tumors, who remain a vulnerable population during the COVID-19 pandemic.
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Ashour, Qasim, Zahid Mohammed, and Khamees Obaid. "Nurses’ Knowledge about Care of Children with Malignant Solid Tumors at Oncology Center in Al-Hussain Medical City in Holy Karbala." Kufa Journal for Nursing Sciences 11, no. 1 (June 29, 2021): 1–8. http://dx.doi.org/10.36321/kjns.vi20211.456.
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Background: The malignant solid tumor is one of the problems facing the early childhood and the common types of malignant solid tumors are (lymphomas, nephroblastoma (Wilm’s tumors), neuroblastoma, retinoblastoma, bone tumors, Ewing’s sarcoma family of tumors and soft tissue sarcom).Aims of the study: Assessing the nurses' knowledge regarding children with malignant solid tumors and find out the relationship between the nurses' knowledge about solid tumor and their socio-demographic data.Methodology: Descriptive study dealt with object-analytical sample randomly of the 40 nurses working in the oncology center in Al-Hussain Medical City in Holy Karbala. The questionnaire was designed to gather information. And this study conducted to test a mini questionnaire questions through the period 19th / September / 2020 to 15th / March / 2021). Data was analyzed by applying descriptive statistics (repetition and percentage) and deductive statistics (Chi-Square test) SPSS version (20).Results: The study has shown that female participants in the study sample more than males, and the percentage (57.5 %) and over the sample aged more than 34 years, and the proportion (37.5%). And more sample members are graduates of the institutes, and the proportion (52%), the total score of nurse's knowledge was moderate.Conclusion: The study concludes that there is low level (33.3%) of knowledge assessment toward malignant solid tumors of children at the pre-test in the both group. The results show the implementation of the educational program at a high level of nurses knowledge post-test 1reprsented (81.24%) and post-test 2 represented (87.93 %) for the study group regarding malignant solid tumors.Recommendations: The study recommended the necessity of developing continuous educational programs to educate and train nurses regarding malignant solid tumors.
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M, Parvez, Ahmed A, Mondal B, Sadiya S, Monowara M, Paul S. K, and Rashid A. "Clinicopathologic Evaluation of Wilms’ Tumor in a Tertiary Care Children Hospital." Saudi Journal of Pathology and Microbiology 7, no. 12 (December 30, 2022): 469–72. http://dx.doi.org/10.36348/sjpm.2022.v07i12.005.
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Background and Objective: Wilms’ tumor has been recognized as the most common primary malignant tumor of kidney at childhood. It comprises 5-6% of tumors in the childhood period, and manifests with various clinical symptoms. Since there have been no sufficient studies in this field in Bangladesh, therefore, this study was conducted to investigate its histopathology and different clinical symptoms. Materials and Methods: This study was carried out on existing data from 70 children with a diagnosis of Wilms’ tumor at Bangladesh Shishu Hospital during the years 2015-2020. In this regard, personal and disease-related characteristics of patients including age, sex, tumor stage, histopathology, and involved kidney were evaluated and SPSS software and other statistical tests were used for data analysis. Results: The most common age of disease incidence was 2-4 years. In this regard, male and female ratio was 1.5. Meanwhile, the prevalence of an abdominal mass as the most common symptom was 85.0%. Left kidney was involved in 50% of cases and 58 (82.86%) of patients had a favorable histology. In addition, there was a significant correlation between site of kidney involvement and tumor histology (p<0.005). Conclusion: Considering the achieved advances in the diagnosis and treatment of Wilms’ tumor, early diagnosis with regard to clinical symptoms can have a valuable role in its effective management.
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Souweidane, Mark M., Mark D. Krieger, Howard L. Weiner, and Jonathan L. Finlay. "Surgical management of primary central nervous system germ cell tumors." Journal of Neurosurgery: Pediatrics 6, no. 2 (August 2010): 125–30. http://dx.doi.org/10.3171/2010.5.peds09112.
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The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children. Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations. Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations. The neurosurgical aspects of these proceedings are summarized here in an effort to present the agreed-upon and debated issues that may confront the pediatric neurosurgeon.
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Dwivedi, Rinu, P. Sudhapriya, P. Padmavathi, Vivek Sharma, V. V. Rameshchandra, B. C. M. Prasad, and K. V. S. Sarma. "Epidemiological analysis of central nervous system tumors in pediatric patients from a tertiary care centre in India." International Journal of Contemporary Pediatrics 6, no. 6 (October 21, 2019): 2497. http://dx.doi.org/10.18203/2349-3291.ijcp20194724.
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Background: Tumors of the nervous system are the second most common childhood cancer after leukemia. The diagnosis of CNS tumors is challenging due to non-specific symptoms in children which mimic other less serious illness.Methods: This was a retrospective analysis of case records of patients from 0-18 years of age, who were diagnosed with CNS tumors for a period of 7 years.Results: Out of total 64 patients included in this study, 32 were females and 24 were males. The mean age was 13.2 years. The most common clinical presentation in patients with brain tumors was headache (92.3%) followed by visual symptoms in the form of blurring or loss of vision (42.3%) and swaying while walking (32.6%). The overall mean symptom interval for all patients was 274.8 days (approx. 9 months) ranging from 7-1820 days. In the present study out of total 64 patients, 54 were brain tumors (35 supratentorial and 19 infratentorial) and 10 were spinal tumors. The most common tumor location was cerebellum (21.8%) followed by cerebral cortex, spine and sellar area. Based on histopathology the most common tumor type in our study was astrocytoma. There was no significant correlation of symptom interval with age and gender but was significantly associated with location and tumor grade.Conclusions: Early referral to centers with appropriate facilities will help, as many pediatric CNS tumors are low grade with better survival.
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Al-Jumaily, Usama, Rasha Al-Safi, Sabah Al-Mosawi, Homam Al-Obaidy, and Mohammed Fawzi. "Clinico-pathological spectrum of Childhood Central Nervous System Tumors in Iraq: A Single-Institutional Study." Journal of Contemporary Medical Sciences 5, no. 4 (August 28, 2019): 197–201. http://dx.doi.org/10.22317/jcms.v5i4.612.
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Objectives: The present retrospective study analyzed the spectrum of pediatric CNS tumors in a single tertiary hospital in Iraq.
Methods: Data regarding frequencies of various primary CNS tumors (diagnosed according to the World Health Organization (WHO) classification), in pediatric patients (<18 yrs. of age), were collected from a single tertiary care hospital in Iraq for a period 2014-2017.
Results: fifty-four children were diagnosed with primary CNS tumors. The most common primary pediatric CNS tumors were medulloblastoma (37%), followed by low grade gliomas (29.6%), high grade gliomas (0.011% ), CNS germinoma (0.09%), supratentorial primitive neuro-ectodermal tumors and ependymomas (0.037% for each). Rare tumors encountered were oligodendrogliomas, choroid plexus carcinoma, and pineoblastoma (0.18% for each). The most common low grade gliomas tumor was pilocytic astrocytoma.
Conclusions: This is the first study reporting the spectrum of CNS tumors in children in Iraq. Except for a higher frequency of CNS germinoma, the profile of other pediatric CNS tumors in Iraq is relatively similar to that reported in other countries.
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Kostylev, Alexandr A., Vyacheslav B. Silkov, and Margarita B. Belogurova. "Neoplasms, as one of the causes of the syndrome of palpable abdominal tumor in children." Pediatrician (St. Petersburg) 7, no. 2 (June 15, 2016): 121–26. http://dx.doi.org/10.17816/ped72121-126.
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Syndrome of palpable abdominal tumor in children is a difficult diagnostic problem. The difficulties associate with many disease entities that underlie this syndrome, often erased clinical picture and late referral to a doctor. In this article we will try to clarify the problems of diagnosis and treatment of exactly oncological diseases, as a cause of the syndrome palpable abdominal tumor. The vast majority of patients with complaints palpable education seek medical care to pediatricians or general practitioners. Prolongation of the diagnosis is often and directly associate with two factors: low oncological alertness by pediatricians (rarely by Pediatric Surgeons) and the lack of attention of parents to the initial manifestations of tumor in children. We have tried to describe the most characteristic symptoms inherent in the majority of tumors localized in the abdomen, the pelvis and the retroperitoneal space. Also there is information about on laboratory and instrumental methods of research used in the diagnosis of tumors, side by side the “routine” methods such as the complete blood count, abdominal ultrasound, in some cases, determination of specific tumor markers. There are the results of the comparative analysis and distinctive features of benign and malignant tumors of this localization are highlighted. Also the basic principles of the treatment of solid tumors in children are presented in this article. The article is focused primarily on all pediatricians, pediatric surgeons and general practitioners.
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Yaworski, A., K. Koujok, K. Cheung, Y. Ying, and H. McMillan. "P.114 Benign tumors of peripheral nerves in children at a tertiary-care pediatric hospital." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 48, s3 (November 2021): S51. http://dx.doi.org/10.1017/cjn.2021.390.
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Background: Tumors affecting peripheral nerves in children are rare. Accurate diagnosis ensures that management is appropriate and timely. Methods: We review the clinical presentation and utility of investigations of children with intrinsic tumors affecting peripheral nerves at the Children’s Hospital of Eastern Ontario (CHEO). Results: From 2009-2019, 14 cases were identified. Mean age of symptom onset was 8.2 years (range 0.3 to 17.3 years). Presenting symptoms included painless muscle wasting (2/14), focal muscle weakness (7/14), contracture (1/14), pain (1/14) or a painless, palpable mass (3/14). MRI was useful at differentiating benign pediatric nerve tumors. Peripheral nerve lipomatosis demonstrated a classic “spaghetti string” appearance. Patients with perineurioma showed evidence of enhancing, nodular lesions while intraneural ganglionic cysts display cystic lesion within the nerve. Neurofibromas appear like a “bag of worms” while schwannomas are more eccentrically positioned around the nerve. Nerve conduction studies (NCS) or electromyography (EMG) were performed in 11/14 patients. Biopsies were performed in 9 patients and surgical management in 4 patients. Conclusions: The rare nature of peripheral nerve tumors in children can pose diagnostic challenges. NCS/EMG are important to assist with localization, and MRI important at distinguishing benign tumors. Key MRI, clinical and NCS features can guide management, potentially avoiding invasive procedures.
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Roy, Prakriti, Sophie E. van Peer, Martin M. de Witte, Godelieve A. M. Tytgat, Henrike E. Karim-Kos, Martine van Grotel, Cees P. van de Ven, et al. "Characteristics and outcome of children with renal tumors in the Netherlands: The first five-year’s experience of national centralization." PLOS ONE 17, no. 1 (January 13, 2022): e0261729. http://dx.doi.org/10.1371/journal.pone.0261729.
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Around 6% of all childhood malignancies represent renal tumors, of which a majority includes Wilms tumor (WT). Although survival rates have improved over the last decades, specific patients are still at risk for adverse outcome. In the Netherlands, since 2015, pediatric oncology care for renal tumors has been centralized in the Princess Máxima Center for Pediatric Oncology. Here, we describe experiences of the first 5 years of centralized care and explore whether this influences the epidemiological landscape by comparing data with the Netherlands Cancer Registry (NCR). We identified all patients <19 years with a renal mass diagnosed between 01-01-2015 and 31-12-2019 in the Princess Máxima Center. Epidemiology, characteristics and management were analyzed. We identified 164 patients (including 1 patient who refused consent for registration), in our center with a suspicion of a renal tumor. The remaining 163 cases included WT (n = 118)/cystic partially differentiated nephroblastoma (n = 2)/nephrogenic rests only (n = 6) and non-WT (n = 37). In this period, the NCR included 138 children, 1 17-year-old patient was not referred to the Princess Máxima Center. Central radiology review (before starting treatment) was performed in 121/163 patients, and central pathology review in 148/152 patients that underwent surgery. Treatment stratification, according to SIOP/EpSSG protocols was pursued based on multidisciplinary consensus. Preoperative chemotherapy was administered in 133 patients, whereas 19 patients underwent upfront surgery. Surgery was performed in 152 patients, and from 133 biomaterial was stored. Centralization of care for children with renal tumors led to referral of all but 1 new renal tumor cases in the Netherlands, and leads to referral of very rare subtypes not registered in the NCR, that benefit from high quality diagnostics and multidisciplinary decision making. National centralization of care led to enhanced development of molecular diagnostics and other innovation-based treatments for the future.
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Coven, Scott L., Joseph R. Stanek, Ethan Hollingsworth, and Jonathan L. Finlay. "Delays in diagnosis for children with newly diagnosed central nervous system tumors." Neuro-Oncology Practice 5, no. 4 (March 9, 2018): 227–33. http://dx.doi.org/10.1093/nop/npy002.
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Abstract Background United States studies documenting time interval from symptom onset to definitive diagnosis for childhood central nervous system (CNS) tumors are more than a quarter-century old. The purpose of this study is to establish an accurate and contemporary Ohio baseline of the diagnostic interval for children with newly diagnosed CNS tumors. Methods Medical records were retrospectively reviewed for 301 children with newly diagnosed CNS tumors from January 2004 to August 2015 at Nationwide Children’s Hospital. We obtained comprehensive data on 171 patients (56.8%). Records were reviewed for age, gender, tumor type, presenting symptoms, number of health care visits prior to diagnosis, time interval (in months) from onset of symptoms to definitive diagnosis, and any associated genetic syndromes. Results Of the 171 patients with newly diagnosed CNS tumors, 25 children (14.6%) had a known cancer predisposition syndrome (all with neurofibromatosis type 1). Among the remaining 146 children, the median and mean time intervals from symptom onset to definitive diagnosis were 42 days and 138 days (range < 1 to 2190 days), respectively. Conclusions We have documented and quantified the contemporary delays in diagnosis of childhood brain tumors in central Ohio to serve as a benchmark for our future planned interventions to reduce the time interval from symptom onset to diagnosis through adaptation of the United Kingdom HeadSmart program throughout the state of Ohio and ultimately throughout the United States.
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Kabir, SM Rashed Zahangir, Md Waheed Akhtar, and Farida Yasmin. "Pediatric Germ Cell Tumors: An Experience of 7 Years in a Tertiary Hospital of Bangladesh." Dhaka Shishu (Children) Hospital Journal 35, no. 2 (October 12, 2020): 119–22. http://dx.doi.org/10.3329/dshj.v35i2.49692.
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Introduction: Germ cell tumors are a group of tumors with different clinical presentation and histological and biological characteristics. Malignant germ cell tumors occur at all ages with a trend of bimodal distribution in infancy and adolescence.
Objective: To evaluate the demographic characteristics, distribution of different types of germ cell tumor, treatment modalities and outcome of germ cell tumor in children in a tertiary care hospital of Bangladesh.
Methods: In this retrospective study, data regarding age and sex distribution, location, types of tumors, management of germ cell tumor in children were retrieved from the medical records of pediatric oncology department in NICRH, Dhaka from 2008 to 2014.
Results: Out of total 87 patients female were 50 and male 37. Most of the patients were up to 5 years of age. The gonadal germ cell tumors (80%) were more than extragonadal tumor (20%) in both male and female patients. The most common germ cell tumor was dysgerminoma (32%) followed by yolk sac tumor (29.8%) and teratoma (19.5%). Yolk Sac Tumor (51.4%) was the most common in male and dysgerminoma (56%) the commonest in female. Out of 87, seventy two (82.7%) received chemotherapy following surgery. Among those 72 patients who received chemotherapy 49 (68 %) patients completed their treatment. Until the last follow up 71.4% patients remained alive and tumor free.
Conclusion: Germ cell tumors are the most variable tumor of all childhood malignancies that has difference in age, sex, location and histological subtypes. Gonadal tumors have better prognosis than extragonadal tumors in both the sex.
DS (Child) H J 2019; 35(2) : 119-122
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Kieran, Mark W., David Walker, Didier Frappaz, and Michael Prados. "Brain Tumors: From Childhood Through Adolescence Into Adulthood." Journal of Clinical Oncology 28, no. 32 (November 10, 2010): 4783–89. http://dx.doi.org/10.1200/jco.2010.28.3481.
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The transition from childhood to adulthood through adolescence has been clearly identified as a time of great physical, psychological, emotional, social, and sexual change. Clinical care is currently divided into adult or pediatric care; adolescent patients require specific expertise that most clinical practices do not have. When illness coincides with the adolescent transition, the health system is severely challenged. Health systems historically have varied widely in the age they choose for allocating an individual to the adult model of health care. Tumors of the CNS complicate the difficult adjustments required in adolescents and young adults by virtue of their morbidity, complex treatment, and prognosis. Some brain tumors are unique to children, some occur predominantly in adults, and others peak in adolescence. Delays in the diagnosis of brain tumors can occur at any age but are particularly common in adolescence because of difficulties of accessing health systems, the difficulties of discriminating pathologic from typical adolescent behavioral characteristics, and changing endocrine function. Coming to terms with the cancer diagnosis; coping personally, socially, and financially with cancer treatments; accepting the risk of a shortened life span; confronting acquired disability; and coping with complex rehabilitation and adjusted plans for life are challenges for which there are no established specialist health models. This article will discuss the changing brain tumor profile of children, adolescents, and adults, with a focus on our limited understanding of the adolescent/young adult transition period.
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Thurman, Cara B., Maura Abbott, Jinfang Liu, and Elaine Larson. "Risk for Health Care–Associated Bloodstream Infections in Pediatric Oncology Patients With Various Malignancies." Journal of Pediatric Oncology Nursing 34, no. 3 (December 30, 2016): 196–202. http://dx.doi.org/10.1177/1043454216680596.
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This was a retrospective cohort study to identify the rates, predictors, and outcomes of health care–associated bloodstream infections (HA-BSI) among children with solid tumors, lymphoma, lymphoid leukemia, and myeloid leukemia. The study population included 4500 children ≤18 years old at a pediatric hospital in New York City from 2006 to 2014. A total of 147 HA-BSI cases were identified; using multivariable logistic regression modeling, children with a hematologic diagnosis (lymphoma, lymphoid leukemia, myeloid leukemia) were at greater risk for HA-BSI than those with a solid tumor diagnosis (all P values <.0001). The odds of mortality for patients with HA-BSI were 6.98 (95% confidence interval 3.02-16.10) times that of those without HA-BSI. Although malignancy type was identified as risk factor for HA-BSI, there was no significant difference in overall mortality from HA-BSI by tumor type ( P = .51).
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Jokic, Radoica, Zoran Radovanovic, Jelena Antic, Aleksandar Komarcevic, Ivana Lukic, and Ivan Varga. "Surgical treatment for breast tumors in children." Srpski arhiv za celokupno lekarstvo 147, no. 9-10 (2019): 571–77. http://dx.doi.org/10.2298/sarh190204031j.
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Introduction/Objective. Fibroadenoma, often called ?breast mice tumors? due to their mobility, are the most common breast tumors in pediatric population. Considering that some tumors have a potential for rapid growth, breast tissue damage, and that an ideal diagnostic tool has yet to be found, complete mass extirpation might be the treatment of choice. The aim of the study was to present our clinical experience in treating children with breast masses. Methods. A retrospective review (2011?2018) of patients treated for breast tumors at the Institute for Child and Youth Health Care of Vojvodina in Novi Sad was conducted. Results. In this study 29 girls (mean age 15.8 ? 1.8) were included. The majority of masses were located in the upper outer (27.6%) or lower inner (24.1%) breast quadrant. The mean mass diameter was 39.7 mm. It has been observed that the mean mass diameter in the group of girls with positive family history for breast diseases was significantly lower (p < 0.05) than in those with negative family history (27.5 vs. 43.2 mm). There were no proven malignant tumors and all tumors have been completely extirpated. The mean postoperative stay was 1.5 ? 1.02 days. Conclusion. An appropriate radical operative technique dependent on mass size and localization is still the ?gold standard? for treating breast masses in pediatric patients. Cooperation with experts in the field of oncologic breast surgery enables implementing these operative techniques in clinical practice of pediatric surgeons.
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Khairkar, Praveen, Anand Kakani, and Amit Agrawal. "Neuropsychiatric presentations of pediatrics brain tumors: cases series." Romanian Neurosurgery 30, no. 4 (December 1, 2016): 493–97. http://dx.doi.org/10.1515/romneu-2016-0078.
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Abstract Brain tumors constitute the second most common tumors in the pediatric age group after the leukemias. Symptoms and signs depend on growth rate of tumor, its location in the central nervous system, the extent of peri-tumoral vasogenic edema and the age of the child. Most common neuropsychiatric problems reported in children with brain tumor(s) include adjustment problems, anxiety disorder, neurocognitive deficits and depressive disorder as reported by very few case reports and isolated observational data. To the best of our knowledge no similar data or reports are as yet published from India on the similar lines. We wish to report case series of neuropsychiatric presentations in different types of brain tumors observed at our rural tertiary care multi-speciality hospital.
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Shah, Irfanullah, Muhammad Aslam Shaikh, and Khalid Mehmood. "Prevalence of Tumors in the Posterior Cerebral Fossa in Children and Adults, as well as their Histological Kinds: a Cross-Sectional Study." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 30, 2022): 690–92. http://dx.doi.org/10.53350/pjmhs22161690.
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Aim: To determine the prevalence of posterior fossa tumors in children and adults, as well as their histological kinds. Study design: A cross-sectional study Place and duration: From February 2012 to January 2019, the Department of Neurosurgery at Riyadh Care Hospital Methodology: We undertook a descriptive analysis of patients with posterior fossa space-occupying lesions. The neurosurgical intervention was done in all of the instances due to the critical location. Specimens were sent for histological evaluation after surgery. The data from these patients, as well as histology reports, were examined. The data was analyzed using SPSS version 21. Results: Males made up 57.14 percent (n=48) of the 84 patients, while children made up 41.66 percent (n=35). The most common tumor was schwannoma, seen in 34.52 percent (n=29) of cases, 72.41 percent of adults, and 27.58 % of children. In 22.61 %, 15.47 %, and 14.28 % of cases, meningioma, pilocytic astrocytoma (PCA), and Meduloblastoma were found, respectively. Metastasis was only seen in adults, and malignant round blue cell tumors were only found in children. Astrocytoma and schwannoma were prevalent in adults. Children were more likely to develop Meduloblastoma, Pilocytic astrocytoma, and malignant round blue cell tumors. Conclusion: High-grade Astrocytoma and Schwannoma are dominantly present in adults. Malignant round blue cell tumor, Pilocytic astrocytoma Medulloblastoma is more prevalent in children. Metastasis was only observed in adults. Because of their location, risk of excision, and involvement of the brain stem structures and fourth ventricle, posterior fossa tumors are widely known for their significant morbidity and mortality. Early diagnosis is now possible due to modern diagnostic and therapy technologies, which help to lower mortality rates and improve postoperative prognosis. Keywords: posterior cerebral fossa tumors, children, adults
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Dinikina, Yu V., O. V. Shadrivova, M. B. Belogurova, Yu E. Melekhina, S. M. Ignatyeva, T. S. Bogomolova, E. G. Boychenko, S. A. Kuleva, A. S. Kolbin, and N. N. Klimko. "Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis." Oncohematology 14, no. 1 (April 10, 2019): 40–48. http://dx.doi.org/10.17650/1818-8346-2019-14-1-40-48.
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We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In theregister of patients with IA (1997–2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors – 33.5 %, neuroblastoma – 33.5 %, osteosarcoma – 11.0 %, Wilms tumor – 11.0 %, hemangioblastoma – 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit – 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation – 22.2 %, concomitant bacterial infection – 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs – 88.9 %. The predominant clinical sign was fever – 66.7 %, cough and respiratory failure were seen less frequently – 33.4 % and33.4 %, respectively. The etiologicalagents of IA were Aspergillus fumigatus – 33.3 %, Aspergillus nidulans – 33.3 % and Aspergillus ustus – 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly – 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12-week survival in children and adolescents with IA in case of solid tumors was 77.8 %.
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O'Dorisio, M. S., P. Navalkele, T. M. O'Dorisio, and C. F. Lynch. "Neuroendocrine tumors in children and young adults: Incidence, survival, and prevalence in the United States." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e22120-e22120. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e22120.
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e22120 Background: Neuroendocrine tumors (NET) arising from the diffuse endocrine system are thought to be quite rare in children and young adults. However, a surprising number of young people have been referred to our neuroendocrine tumor clinic and the NCI has targeted NET as a high priority for development of new diagnostic and therapeutic options. This analysis of the SEER database was undertaken to determine the incidence, prevalence, and survival of NET in young people. Their incidence, prevalence, and survival were compared with neuroblastoma, a related pediatric malignancy arising in the neural crest. Methods: The SEER data were obtained from 9 standard SEER registries for the diagnosis years of 1975 to 2004 using SEER*Stat version 6.4.4. ICD-9 codes related to neuroendocrine tumors and to neuroblastoma were characterized as to patient age, gender, racial and ethnic background, stage, grade, histology, incidence, survival, and prevalence. Results: Neuroendocrine tumors occur more often in females among children and young adults with the most common sites being bronchial, ovarian, and breast. The overall incidence of neuroendocrine tumors was lower than for neuroblastoma in the age range 0–30 years. However, the 30 year limited prevalence of neuroendocrine tumors in the 9 SEER registries was 698 compared to 881 for neuroblastoma. This extrapolated to over 7000 children and young adults with neuroendocrine tumors across the United States. Survival rate of young people with neuroendocrine tumors declined from 84% in 1975–1986 to 80% in the 1987–2004 era. Conclusions: These results indicate that neuroendocrine tumors constitute an unrecognized cancer threat to children and young adults. Survival of children and young adults with neuroendocrine tumors has decreased over the past 30 years in the United States. We recommend the establishment of centers of care for children and young adults diagnosed with neuroendocrine tumors with the expectation that earlier diagnosis coupled with targeted therapies will decrease the incidence of metastatic disease and improve survival. No significant financial relationships to disclose.
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Rajagopal, Revathi, Daniel C. Moreira, Lane Faughnan, Huiqi Wang, Sameen Naqvi, Meenakshi Devidas, and Ibrahim Qaddoumi. "OTHR-06. Knowledge gap among health care providers in childhood central nervous system tumors: Result from an international multicenter survey." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i148. http://dx.doi.org/10.1093/neuonc/noac079.545.
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Abstract BACKGROUND: Central nervous system (CNS) tumors in children are associated with a longer delay in diagnosis. One of the contributing factors is the lack of awareness regarding childhood CNS tumors presentation among health care providers. To evaluate the knowledge gap among health care providers, we conducted a cross-sectional survey that was distributed globally. METHODS: The survey was disseminated to health care practitioners via electronic mail in November 2018 and it was closed in March 2020. The participants were asked to complete a pre-test survey, requested to view a CNS tumor education seminar, and subsequently complete a post-test survey. The survey had nine questions focusing on CNS tumor symptoms, pre-diagnosis symptom interval (PSI), and imaging indication. The knowledge gap was evaluated with pre-test and post-test scores. RESULTS: 889 pre-test and 392 post-test responses were received. The majority of the respondents were from Asia, with a percentage of 73.1% and 87.5% in pre-test and post-test respectively. For the pre-test, the median score for accurate answers was 40.0% (range:13.1-92.9%). Interestingly, a high rate of correctness was achieved in the post-test with a median score of 77.1% (14.9-98.2%). In the pre-test, only 18.7% of the participants responded precisely that Cushing’s triad is a less common symptom and just 15.0% recognized that older children >10 years old are at risk for late diagnosis. Surprisingly, 21.9% falsely reported that patients with malignant tumors experience the longest PSI, and 54.5% of the respondents wrongly selected medulloblastoma as the commonest CNS tumor. Overall, the pre-test scores among pediatricians and professionals with >10 years of experience did not demonstrate improved knowledge when compared to other specialties. CONCLUSIONS: The survey analysis showed a significant knowledge gap regarding childhood CNS tumors among health care providers. Therefore, raising professional awareness is very important and can be achieved through targeted educational strategies.
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Nuijts, Myrthe, Inge Stegeman, Tom Seeters, Carlien Bennebroek, Nicole Naus, Giorgio Porro, Michelle van Egmond-Ebbeling, Saskia Imhof, and Antoinette Schouten van Meeteren. "OTHR-05. Visual impairment in children with a newly diagnosed brain tumor: a Dutch prospective nationwide cohort study." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i147—i148. http://dx.doi.org/10.1093/neuonc/noac079.544.
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Abstract PURPOSE: Visual impairment is a serious adverse effect in children with a brain tumor. To date, visual impairment is often underestimated and unrecognized, while early detection of visual impairment is important to potentially preserve the visual function. Our aim was to assess the prevalence and type of abnormal ophthalmological findings in an unselected cohort of children with a newly diagnosed brain tumor and to identify potential oncological and clinical risk factors. PATIENTS AND METHODS: In this prospective nationwide cohort study, we included children, aged 0-18 years, with a newly diagnosed brain tumor in the Netherlands between May 2019 and August 2021. A comprehensive ophthalmological examination (including orthoptic evaluation, visual acuity, visual fields and funduscopy) was performed at diagnosis. Multivariable logistic regression analyses were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of the risk factors. RESULTS: In total, 170 children were included (43.5% female; median age [interquartile range], 8.3 [3.9 – 13.0] years; 48.2% infratentorial tumors, 31.2% midline tumors and 20.6% cerebral hemispheres tumors). Overall, 101 children (59.4%) presented with visual symptoms at diagnosis. The most common findings on ophthalmological examination were papilledema (52.4%), gaze deficits (33.5%), visual field defects (28.1%), nystagmus (24.8%), strabismus (19.9%) and decreased visual acuity (8.6%). The risk of papilledema was associated with older age in years (OR 1.2, 95% CI 1.1 – 1.3) and hydrocephalus (OR 14.8, 95% CI 5.4 – 40.0). Visual field defects were detected more frequently in children with a tumor located in the cerebral hemisphere (OR 4.5, 95% CI 1.3 – 15.3) or midline (OR 7.0, 95% CI 2.2 – 21.9). CONCLUSIONS: More than 50% of the children had abnormal ophthalmological findings at brain tumor diagnosis. These findings emphasize the necessity of standardized ophthalmological surveillance and the importance of awareness of health care providers of ophthalmological abnormalities in this patient group.
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Madlener, Sibylle, and Johannes Gojo. "Liquid Biomarkers for Pediatric Brain Tumors: Biological Features, Advantages and Perspectives." Journal of Personalized Medicine 10, no. 4 (November 27, 2020): 254. http://dx.doi.org/10.3390/jpm10040254.
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Tumors of the central nervous system are the most frequent solid tumor type and the major cause for cancer-related mortality in children and adolescents. These tumors are biologically highly heterogeneous and comprise various different entities. Molecular diagnostics are already well-established for pediatric brain tumors and have facilitated a more accurate patient stratification. The availability of targeted, biomarker-driven therapies has increased the necessity of longitudinal monitoring of molecular alterations within tumors for precision medicine-guided therapy. Nevertheless, diagnosis is still primarily based on analyses of the primary tumor and follow-up is usually performed by imaging techniques which lack important information on tumor biology possibly changing the course of the disease. To overcome this shortage of longitudinal information, liquid biopsy has emerged as a promising diagnostic tool representing a less-invasive source of biomarkers for tumor monitoring and therapeutic decision making. Novel ultrasensitive methods for detection of allele variants, genetic alterations with low abundance, have been developed and are promising tools for establishing and integrating liquid biopsy techniques into clinical routine. Pediatric brain tumors harbor multiple molecular alterations with the potential to be used as liquid biomarkers. Consequently, studies have already investigated different types of biomarker in diverse entities of pediatric brain tumors. However, there are still certain pitfalls until liquid biomarkers can be unleashed and implemented into routine clinical care. Within this review, we summarize current knowledge on liquid biopsy markers and technologies in pediatric brain tumors, their advantages and drawbacks, as well as future potential biomarkers and perspectives with respect to clinical implementation in patient care.
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Mukherjee, Bijoya. "STUDY ON OVARIAN TUMORS IN PEDIATRIC AND ADOLESCENT GIRLS IN A TERTIARY CARE CENTRE." International Journal of Advanced Research 10, no. 02 (February 28, 2022): 508–14. http://dx.doi.org/10.21474/ijar01/14232.
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Background of study: International treatment guidelines dedicated to children and adolescents are not yet established, hence need for such studies like ours is required to throw light on demographic variations of ovarian tumors and developing specific guidelines for their management. Materials and Methods: It is a descriptive longitudinal study undertaken in the Department of Obstetrics &Gynaecology from Feb 2018 to July 2019. According to prevalence in our setup, 50 cases of adolescent girls and children were taken for study and subjected to thorough clinical assessment and investigations. After proper diagnosis, surgery was performed in all cases and depending upon histopathology and cytology, adjuvant chemotherapy was given in selected cases. Patients were followed up till 6 months after discharge. Results: The most common symptom was found to be abdominal pain (42%) , most common sign abdominal mass (38%). Out of 50 cases, 12% were found to be malignant, all of germ cell origin. Epithelial tumors were found to be the most common ovarian tumors(52%) up to 20 years of age, out of which benign tumors had 48% epithelial origin. However, up to 10 years of age, germ cell tumors were found to be the most common (75%). Only 1 malignant case expired, belonging to mixed germ cell variety of advanced stage. Conclusion: Ovarian neoplasm is highly challenging, especially in adolescents and children due to the need for fertility preservation. Early detection, optimal therapy and intense follow up with psychological support to patients and families are the mainstay of treatment.
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Vernon-Levett, Paula, and Maggie Geller. "Posterior Fossa Tumors in Children: A Case Study." AACN Clinical Issues: Advanced Practice in Acute and Critical Care 8, no. 2 (May 1997): 214–26. http://dx.doi.org/10.1097/00044067-199705000-00006.
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Massie, A. McCauley, Jonathan Ebelhar, Kristen E. Allen, Nicholas P. DeGroote, Karen Wasilewski-Masker, and Katharine E. Brock. "Defining and timing of palliative opportunities in children with central nervous system tumors." Neuro-Oncology Practice 8, no. 4 (March 12, 2021): 451–59. http://dx.doi.org/10.1093/nop/npab020.
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Abstract Background Children with brain and central nervous system (CNS) tumors experience substantial challenges to their quality of life during their disease course. These challenges are opportunities for increased subspecialty palliative care (PC) involvement. Palliative opportunities have been defined in the pediatric oncology population, but the frequency, timing, and factors associated with palliative opportunities in pediatric patients with CNS tumors are unknown. Methods A single-institution retrospective review was performed on children ages 0-18 diagnosed with a CNS tumor who died between January 1, 2012 and November 30, 2017. Nine palliative opportunities were defined prior to data collection (progression, relapse, admission for severe symptoms, intensive care admission, bone marrow transplant, phase 1 trial, hospice, do-not-resuscitate (DNR) order). Demographic, disease, treatment, palliative opportunity, and end-of-life data were collected. Opportunities were evaluated over quartiles from diagnosis to death. Results Amongst 101 patients with a median age at death of eight years (interquartile range [IQR] = 8.0, range 0-22), there was a median of seven (IQR = 6) palliative opportunities per patient, which increased closer to death. PC consultation occurred in 34 (33.7%) patients, at a median of 2.2 months before death, and was associated with having a DNR order (P = .0028). Hospice was involved for 72 (71.3%) patients. Conclusion Children with CNS tumors suffered repeated events warranting PC yet received PC support only one-third of the time. Mapping palliative opportunities over the cancer course promotes earlier timing of PC consultation which can decrease suffering and resuscitation attempts at the end-of-life.
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Kowalczyk, Bartłomiej, Andrzej Szafrański, and Anna Kuźnik-Buziewicz. "Principles of orthopedic treatment for malignant bone tumors in children." Chirurgia Narządów Ruchu i Ortopedia Polska 87, no. 1 (March 31, 2022): 13–19. http://dx.doi.org/10.31139/chnriop.2022.87.1.3.
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Primary bone sarcomas are not frequent entities, but constitute important issue especially in pediatric population. Advances in chemotherapy and diagnostic modalities allowed limb saving resections of malignant bone tumors became leading surgical option. To be successful the treatment of primary bone tumors should be conducted in dedicated centers by experienced team of specialists. Nevertheless, the rules of such treatment should be known widely to improve diagnosis, medical care over oncologic patient and communication between specialists. In this review paper the authors present current rules of surgical approach to bony malignancies in children and adolescents.
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Moreira, Daniel C., Revathi Rajagopal, Regina M. Navarro-Martin del Campo, Ana C. Polanco, Ana Patricia Alcasabas, Luis A. Arredondo-Navarro, Danny Campos, et al. "Bridging the Gap in Access to Care for Children With CNS Tumors Worldwide." JCO Global Oncology, no. 6 (September 2020): 583–84. http://dx.doi.org/10.1200/go.20.00047.
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Miltenburg, Dartene, Deon F. Louw, and Garnette R. Sutherland. "Epidemiology of Childhood Brain Tumors." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 23, no. 2 (May 1996): 118–22. http://dx.doi.org/10.1017/s031716710003883x.
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ABSTRACT:Background: Brain tumors comprise more than 20% of all childhood malignancies, and constitute the greatest number of solid pediatric cancers. Incidence rates reported have varied from 2.4 to 3.5/100, 000 children, reflecting the impact of modern imaging techniques, the application of diverse investigative methodologies, and the accessibility of the community to health care. Methods: Material from patients < 18 years of age was collated from the Manitoba Cancer Foundation Tumor Registry, the personal records of Winnipeg pediatric neurologists, and autopsy data. Patient data were also obtained from hospital charts and operating room log books. Histological sections were examined and classified according to the American Cancer Society by a single neuropathologist. The chi-square test was used for statistical evaluation. Results: During the seven-year study period, the diagnosis of brain tumor was made in 89 pediatric patients, of which 88 were diagnosed premortem. The overall average annual incidence rate for both sexes was 4.03/100, 000 child-years, higher than that previously reported. The male and female average annual incidence rates were 4.2 and 3.7/100, 000 child-years, respectively. Tumor type and location were relatively unremarkable, with an expected peak of medulloblastoma occurring in young males. The yearly incidence of tumor occurrence was fairly stable, and the geographic distribution of cases within Manitoba, homogeneous. Conclusion: The highest incidence rates of pediatric brain tumors have been recorded in countries possessing sophisticated universal health care systems, possibly reflecting their efficacy in disease surveillance.
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Crowell, Cameron, Bruce Crooks, Simon Walling, Kelly Boileau, Lynette Bowes, Robert Rutledge, Ketan Kulkarni, Daniel McNeely, and Craig Erker. "RARE-01. ASSESSING THE SYMPTOM DIAGNOSTIC INTERVAL FOR CHILDREN WITH CENTRAL NERVOUS SYSTEM TUMOURS." Neuro-Oncology 23, Supplement_1 (June 1, 2021): i40. http://dx.doi.org/10.1093/neuonc/noab090.162.
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Abstract Background Diagnostic delays in pediatric neuro-oncology is a subject of distress for families and providers. We aimed to evaluate the symptom diagnostic interval (SDI) and influencing variables for children with CNS tumors. Methods This retrospective study analyzed 210 patients diagnosed from 2001–2018 and managed at the tertiary care facility in Halifax, Canada. SDI was defined as time from first symptom until tissue diagnosis or, if not available, imaging diagnosis. Non-parametric tests were used to compare SDI between groups. Results Median SDI was 12.4 weeks (IQR 4.3–30), longer than 7 other studies of 1308 children reporting medians of 4.5–10 weeks (p < 0.01). Most common tumors and their median SDI included low-grade glioma (LGG) (n=97, 46%; 17.9 weeks), medulloblastoma (n=31, 15%; 8.7 weeks), high-grade glioma (HGG) and DIPG (n=23, 11%; 5.6 weeks), and ependymoma (n=13, 6%; 13.6 weeks). The most common initial reported symptom included headache (n=63; 30%), nausea/vomiting (n=27, 18%), seizure (n=24, 12%), and visual impairment (n=13, 6.3%). Patients aged 0–3 years had a shorter SDI than patients 10 years and older (SDI 8.7 vs 14.6 weeks; p = 0.03). Tumor category showed longer SDI for LGG versus HGG (p = 0.003), DIPG (p = 0.02), medulloblastoma (p = 0.03) and other embryonal tumors (p = 0.03). Longer SDI was not associated with increased risk of disease progression for LGG (p = 0.93), medulloblastoma (p = 0.89), or ependymoma (p = 0.5). No difference in SDI was found with regard to diagnosis era, ethnicity, socioeconomic status, or distance to the tertiary care facility. Conclusion SDI at our centre is longer than previously reported studies. SDI is linked to tumor biology and its relevance within specific tumor groups deserves further investigation given it doesn’t appear to predict tumor progression/recurrence, yet families and providers feel distress when delays in diagnosis are perceived.
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Belogurova, Margarita Borisovna, Elmira Gosmanovna Boichenko, and Svetlana Aleksandrovna Kulyova. "Children's oncology in St. Petersburg: achievements and prospects of development." Pediatrician (St. Petersburg) 6, no. 4 (December 15, 2015): 5–12. http://dx.doi.org/10.17816/ped645-12.
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The statistics (incidence, mortality, survival) characterizing a problem and the oncological care to children with malignant tumors in St. Petersburg are presented in the article. It is proved that intensification in the therapeutic regimens according to immunohistochemical features, age, extending of tumor significantly raised survival rates, having approached them to the world. The five-year survival of children treated in the 90th of the last century in St. Petersburg, was 60,9 %, at the beginning of the 2000th increase of survival to 69,3 % with approach to European survival (71,8 %) is noted. Improvement of indicators of survival, first of all, should be explained with progress in therapy of the most widespread localizations - leukemias and central nervous system tumors. Thanks to an intensification of treatment it was succeeded to improve considerably results of treatment of children with acute leukemia: the survival from 10-15 % in the 70-80th reached 80 %. Traditionally good results were observed at Hodgkin’s lymphoma: the 5-year overall survival was 94% with event-free survival of 87 %. Using of the European protocol for treatment of Wilm’s tumor (SIOP 93-01) increased survival of children with a unilateral tumor to 94,4 % at the overall survival more than 80 %. Improvement of overall survival in children was influenced also by introduction in practice protocols of BFM (Berlin-Frankfurt-Münster) for treatment non-Hodgkin’s lymphoma thanks to what 5-year event-free survival increased from 30 to 81 %. Now the perspective in children’s oncology are development of molecular and genetic diagnostics with search the germ mutations at a hereditary cancer syndrome, definition of a range of somatic mutations in genes at sporadic malignant tumors at children.
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Yoshihashi, Manabu. "AS2-2 NEUROCOGNITIVE AND PSYCHOSOCIAL DISORDERS IN CHILDREN WITH BRAIN TUMORS." Neuro-Oncology Advances 1, Supplement_2 (December 2019): ii2. http://dx.doi.org/10.1093/noajnl/vdz039.004.
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Abstract The survival rate of children with brain tumors has been improving in the recent times. However, treatment outcomes should also include improved functional prognosis, considering motor dysfunction and sensory disorders, such as vision, and neurocognitive and psychosocial disorders, such as impaired intelligence, memory disorders, impaired attention, and impaired social behavior. In children with brain tumors, neurocognitive and psychosocial disorders easily occur due to various factors such as effect of the tumor, complications such as hydrocephalus, and impact of surgical treatment or radiotherapy. In addition, neurocognitive and psychosocial disorders are associated with decreasing quality of life (QoL) of pediatric patients with brain tumors. When assessing neurocognitive and psychosocial disorders, objective assessments such as a neuropsychological assessment that includes an academic achievement test and an intelligence test, and subjective assessments such as observing behaviors need to be included. However, limited pediatric neuropsychological tests available in Japan. Little evidence is available on the direct intervention methods that aim to improve neurocognitive and psychosocial disorders. Medical management for epilepsy, hydrocephalus, and endocrine disorders is performed while carefully considering cognitive function even in patients with neurocognitive and psychosocial disorders. Patients’ symptoms and QoL can be improved through cognitive rehabilitation, environmental adjustments such as an intervention in their educational environment, and family support. To integrate these medical and social models, a multidisciplinary team approach is required. There is limited data on the assessment and intervention methods available for neurocognitive and psychosocial disorders of children with brain tumors. Currently, only a few facilities are equipped to provide expert treatment. The Neuropsychological Assessment Subcommittee (Brain Tumor Committee, the Japanese Children’s Cancer Group (JCCG)) aims to standardize the evaluation of neurocognitive and psychosocial disorders and intervention methods. These will be presented in line with the medical care provided at our hospital.