Single Centre Review of Hepatoblastoma Over 20 Years in New Zealand (original) (raw)
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Distress and biopsychosocial needs of Brazilian adolescents and young adults patients with cancer
Pediatric Blood & Cancer, 2017
Background/Objectives: A cancer diagnosis can negatively affect the biopsychosocial functioning of adolescents and young adults (AYA).This study aims to describe levels of, and relationships between, distress and biopsychosocial unmet needs in a sample of Brazilian AYA patients with cancer. Design/Methods: A study was conducted among 122 AYA patients with cancer aged 18 to 35 years, treated at a Brazilian public hospital. They were assessed using the Distress Thermometer, the Hospital Anxiety and Depression Scale and the Functional Assessment of Cancer Therapy - General. Descriptive statistics were obtained for all measures, item level frequencies were examined to identify common unmet needs and relationships between distress and unmet needs were explored. Results: AYA patients were mostly were male (50.8%), single (54.1%), white (52.5%), diagnosed with, central nervous system (31.1%), hematologic (23%) or genitourinary (15.6%) cancers, at an advanced disease stage (41.8%). AYA reported greater distress (50%), being commonly related to practical (60.7%), emotional (73.8%) and physical (86.1%) problems. Financial (32%), worry (56.6%), nervousness (50%), sadness (31.1%), pain (47.5%), fatigue (39.3%), memory concentration (35.2%), and sleep (32%)were the highest scored. However, 25.4% reported clinical symptoms of anxiety and 9.8% of depression. AYA patients reported poor levels of quality of life that is at 50th percentile of the US norm. Distress, symptoms of anxiety/depression and quality of life were significantly associated with biopsychosocial problems reported (p<.001). Higher levels of distress was predicted by symptoms of anxiety (B=0.2; p<.001), depression (B=0.2; p<.001), emotional (B=0.8; p<.001) and physical (B=0.3; p<.01) problems. Conclusions: Brazilian AYA patients reported high levels and numbers of unmet needs and substantial distress. Strong associations were found between increased distress and more unmet needs. Findings suggest the need for psychosocial intervention for Brazilian cancer patients that target helping them cope with biopsychosocial distress. Further, this preliminary data highlight opportunities to re-orientate services to better meet AYA needs.
Pediatric hematology and oncology, 2017
Cisplatin and carboplatin are effective antineoplastic agents. They are also considered to be potentially highly ototoxic. To date, no long-term follow-up data from well-documented cohorts with substantial numbers of childhood cancer survivors (CCS) with platinum-related hearing loss are available. Therefore, in this study, we studied the reversibility of ototoxicity from discontinuation of treatment onwards in a national cohort of platinum-treated survivors with hearing loss at the end of cancer treatment. Of the 168 CCS with follow-up audiograms, we longitudinally evaluated the course of hearing function in 61 CCS who showed hearing impairment at discontinuation of treatment according to the Münster criteria (>20 dB at ≥4-8 kHz). Survivors were treated with platinum (median total cumulative dose cisplatin: 480 mg/m(2) and median total cumulative dose carboplatin: 2520 mg/m(2)). Median follow-up time was 5.5 years (range: 1.0-28.8 years). The results showed that none of these su...
Hepatic late adverse effects after antineoplastic treatment for childhood cancer
Reviews, 1996
Background Survival rates have greatly improved as a result of more effective treatments for childhood cancer. Unfortunately the improved prognosis has resulted in the occurrence of late, treatment-related complications. Liver complications are common during and soon after treatment for childhood cancer. However, among long-term childhood cancer survivors the risk of hepatic late adverse effects is largely unknown. To make informed decisions about future cancer treatment and follow-up policies it is important to know the risk of, and associated risk factors for, hepatic late adverse effects. Objectives To evaluate the existing evidence on the association between antineoplastic treatment for childhood cancer and hepatic late adverse effects. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 2), MEDLINE (1966 to June 2009) and EMBASE (1980 to June 2009). In addition, we searched reference lists of relevant articles and conference proceedings. Selection criteria All studies except case reports, case series and studies including less than 10 patients that examined the association between antineoplastic treatment for childhood cancer (aged 18 years or less at diagnosis) and hepatic late adverse effects (one year or more after the end of treatment).
The Management and Outcomes of Neuroblastoma in South Africa
Stellenbosch : Stellenbosch University, 2021
This thesis is presented in fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) in the Department of Paediatrics and Child Health, Stellenbosch University. By submitting this thesis electronically, I declare that the entirety of the work contained therein is my own original work, that I am the authorship owner thereof (unless to the extent explicitly otherwise stated), and in the case of multi-authored published papers, constitutes work for which the candidate was the lead author. The contribution of the candidate to multi-authored papers is outlined in the introduction to each included paper as appropriate. I have not previously in its entirety, or in part, submitted the thesis for obtaining any qualification at this or any other university. Opinions expressed and conclusions arrived at, are those of the author and are not necessarily to be attributed to the funders.
International journal of radiation oncology, biology, physics, 2018
Our aim was to review the advances in radiation therapy for the management of pediatric cancers made by the Children's Oncology Group (COG) radiation oncology discipline since its inception in 2000. The various radiation oncology disease site leaders reviewed the contributions and advances in pediatric oncology made through the work of the COG. They have presented outcomes of relevant studies and summarized current treatment policies developed by consensus from experts in the field. The indications and techniques for pediatric radiation therapy have evolved considerably over the years for virtually all pediatric tumor types, resulting in improved cure rates together with the potential for decreased treatment-related morbidity and mortality. The COG radiation oncology discipline has made significant contributions toward the treatment of childhood cancer. Our discipline is committed to continuing research to refine and modernize the use of radiation therapy in current and future p...
Acta medica Lituanica
Hematopoietic stem cell transplantation (HSCT) is a complex procedure that is curative for several fatal pediatric malignancies and non-malignant diseases. Despite its complexity, potential toxicity, and high costs HSCT has become a standard procedure worldwide for several decades. Pediatric HSCT programs encounter several specific challenges. The rarity and heterogeneity of primary diseases, result in an almost 10-fold inferior number of pediatric HSCT as compared to adults. In contrast to the adult programs, where autologous HSCT is more common, allogeneic HSCT (that is more complex) prevails in pediatric setting which is underpinned by a higher number of inborn disorders transplanted in early childhood.In Lithuania, the pediatric HSCT program (EBMT CIC* 508) was launched at Vilnius University Hospital Santaros Klinikos in February 2002. Currently, this is the only specialized pediatric HSCT center in Lithuania and in the Baltic countries. Since 2011 it is a reference center for L...
Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma
International Journal of Radiation Oncology Biology Physics, 2006
Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse. Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10 -20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated. Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3% ؎ 5.4% and 68.0% ؎ 6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p ؍ 0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p ؍ 0.05). Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials.