Medical and pediatric oncology
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Med. Pediatr. Oncol. · Jan 1998
Evaluation of quality of life of childhood cancer survivors: a methodological conundrum.
QOL assessment in pediatric oncology is seriously understudied, especially compared with the adult population. The limited progress is due to the methodological complexity of the task, which should not be viewed as insurmountable. Given a precise study question, the methodological issues can be clarified simply, piece by piece. ⋯ By expanding the scope of survivorship (or cure) to include long-term clinical and general "costs" the "cost of cure" is shifted: this shift will ultimately impact estimations of cost effectiveness, with ramifications for the evaluation of hospital-wide protocols, utilization priorities, and cost policies. Outside of the hospital, the implications of QOL research are equally ubiquitous. Pediatric survivors will live an estimated 7 decades after "cure," during which time they will exist almost entirely outside the realm of health care; yet, their condition as a survivor, with or without the long-term clinical toxicities secondary to treatment, will continue to affect some or all of thei
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Med. Pediatr. Oncol. · Aug 1997
Comparative Study Clinical TrialGranulocyte-macrophage colony-stimulating factor in association with high-dose chemotherapy (VETOPEC) for childhood solid tumors: a report from the Australia and New Zealand Children's Cancer Study Group.
Combination chemotherapy with vincristine, etoposide, and high-dose, escalating cyclophosphamide (VETOPEC) is an effective regimen in pediatric patients with high-risk solid tumors. The toxicity of the regimen is predominantly haematologic. This study addressed the role of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) following each cycle of chemotherapy in decreasing neutropaenia, incidence of fever/ hospitalization, and/or increasing chemotherapy dose-intensity. ⋯ GM-CSF led to significantly more rapid neutrophil recovery following VETOPEC chemotherapy, but did not lead to any demonstrable clinical benefit, either in reducing febrile events, or in increasing chemotherapy dose intensity.
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Med. Pediatr. Oncol. · Apr 1997
Case ReportsAccidental intramuscular vincristine: lack of untoward effects and recommendations for management.
Vincristine was inadvertently injected into a thigh of three children. In each case the accident occurred as a result of the mixing of a syringe containing vincristine with a syringe of L-asparaginase which the patient was scheduled to receive on the same day. ⋯ Measures to avoid mistaken injection of vincristine for asparaginase are readily achievable and have prevented recurrences of intramuscular vincristine administration at the institutions where they have been implemented. Nonetheless, other instances of intramuscular vincristine injection are anticipated and should be rapidly recognized and quickly managed with local applications of cold and sodium bicarbonate.
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Med. Pediatr. Oncol. · Feb 1997
Comparative Study Clinical TrialAcute lymphoblastic leukemia in children: nonrandomized comparison of conventional vs. intensive chemotherapy at the National Cancer Institute of Colombia.
This study aimed to compare the therapeutic efficacy of two treatments for childhood acute lymphoblastic leukemia (ALL), and to evaluate the feasibility of intensive chemotherapy in a developing country. ⋯ IC reduces the frequency of relapses in ALL children in developing countries, when compared to previous therapy. A highly effective therapy such as m-BFM seems to be the most important predictor of outcome in children.
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Med. Pediatr. Oncol. · Aug 1996
Long-term pulmonary toxicity of multiagent chemotherapy including bleomycin and cyclophosphamide in osteosarcoma survivors.
To assess long-term pulmonary effects of multiagent chemotherapy, we studied serial pulmonary function tests (PFTs) of 35 children with osteosarcoma up to 12 years after diagnosis. ⋯ This dosage regimen of multi-agent chemotherapy for osteosarcoma patients caused a transient, but significant, decline in PFTs within 8-12 months after administration but appears to cause no significant long-term pulmonary function abnormalities.