Medical and pediatric oncology
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Med. Pediatr. Oncol. · Apr 2003
Clinical TrialCharacteristics and adequacy of intravenous morphine infusions in children in a paediatric oncology setting.
Pain management is central in the care of patients in paediatric oncology. Intravenous (i.v.) morphine infusion is an important treatment modality. The objectives of this study were to identify the characteristics of children who receive i.v. morphine infusions in a paediatric oncology setting and to describe the effectiveness, tolerability, and limiting side-effects of this treatment. ⋯ Patients who undergo major tumour surgery require extensive pain management to achieve acceptable post-operative pain relief. The routine of giving both a bolus dose and increasing the morphine dose at breakthrough pain should be encouraged. For the other patients studied, morphine infusions were considered to be adequate, but vomiting, nausea, and constipation might be reduced if prophylactic antiemetics and laxatives were given.
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Med. Pediatr. Oncol. · Apr 2003
Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse.
To report the clinical outcome in children with craniopharyngioma following primary surgery and deferred radiotherapy at relapse. ⋯ The two standard treatment options in children with craniopharyngioma are primary surgery and sub-total resection followed by radiotherapy. In certain subgroups of patients such as those with large tumors and hypothalamic extension, primary surgery is associated with a high incidence of complications and high failure rates. We recommend utilization of an individualized risk-based treatment approach, that attempts to maximize cure rates without compromising long-term functional outcome in children with craniopharyngiomas.
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Med. Pediatr. Oncol. · Mar 2003
Outcome after relapse in an unselected cohort of children and adolescents with Ewing sarcoma.
Survival after relapse in patients with Ewing sarcoma is very poor and this retrospective study attempts to identify of prognostic factors predicting survival after relapse. ⋯ These data suggest that although aggressive therapy may delay disease progression after relapse for some children, the course of the disease after relapse is usually fatal. International co-operative studies are needed to evaluate new strategies.