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Joseph A, Akinsete AM, Lasebikan NN, Adeneye S, Awofeso OM, Oladipo AT, Ajose AO, Ojo O, Merrell K, Ngwa W, Puthoff DS, Onitilo AA. The Landscape of Pediatric Radiation Oncology in Nigeria. JCO Glob Oncol 2024; 10:e2300219. [PMID: 38207247 DOI: 10.1200/go.23.00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/11/2023] [Accepted: 10/23/2023] [Indexed: 01/13/2024] Open
Abstract
Radiation therapy (RT) is an essential part of the multidisciplinary treatment of pediatric cancer. Over the past five decades, significant advances have been made in the delivery of RT, with better dose delivery to disease targets while minimizing exposure to nearby organs at risk. These advances have led to improved treatment outcomes, increased survival, and reduced treatment-related toxicities. Advanced treatment techniques, however, require significant investment in infrastructural and personnel resources. This review documents what is currently available regarding expertise and infrastructure for pediatric radiation oncology practice in Nigeria. It was performed to serve as a foundation for the creation and design of tailored solutions (initiatives and policies) to increase pediatric radiation availability, accessibility, and equity in Nigeria and ultimately improve pediatric cancer treatment outcomes in the region.
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Affiliation(s)
- Adedayo Joseph
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adeseye M Akinsete
- Hematology & Oncology Unit, Department of Pediatrics, College of Medicine University of Lagos, Lagos, Nigeria
| | | | - Samuel Adeneye
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Opeyemi M Awofeso
- Psychosocial Oncology & Palliative Care, Dana Farber Cancer Institute, Boston, MA
| | - Aishat T Oladipo
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Azeezat O Ajose
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwatimileyin Ojo
- Long Island Jewish Medical Center and North Shore University Hospital, New Hyde Park, NY
| | - Kenneth Merrell
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | - David S Puthoff
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| | - Adedayo A Onitilo
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
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2
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Dhar D, Vadgaonkar R, Miriyala R, Kalita H, Parab P, Mahantshetty U. "Superhero" concept to avoid anesthesia for daily radiation treatment in childhood cancer. J Cancer Res Ther 2023; 19:813-815. [PMID: 37470616 DOI: 10.4103/jcrt.jcrt_552_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Advancements in therapeutic interventions have led to significant improvement in the overall management of childhood cancer. Radiotherapy forms an important component of their treatment. Modern radiotherapy technique where an optimal therapeutic ratio can be obtained demands proper and adequate immobilization of the child. This can be technically challenging sometimes, particularly when the child is noncompliant. To address this hurdle, we have used this concept of "Superhero," where we have decorated and painted the thermoplastic masks that often used in the head and neck and cranial irradiation. We have received adequate compliance for this method, and the need for anesthesia was slackened.
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Affiliation(s)
- Debojoyti Dhar
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Rohit Vadgaonkar
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Raviteja Miriyala
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Himanshu Kalita
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Pritam Parab
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Umesh Mahantshetty
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
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3
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Bryce-Atkinson A, de Jong R, Bel A, Aznar MC, Whitfield G, van Herk M. Evaluation of Ultra-low-dose Paediatric Cone-beam Computed Tomography for Image-guided Radiotherapy. Clin Oncol (R Coll Radiol) 2020; 32:835-844. [PMID: 33067079 DOI: 10.1016/j.clon.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/11/2020] [Accepted: 09/29/2020] [Indexed: 01/01/2023]
Abstract
AIMS In image-guided radiotherapy, daily cone-beam computed tomography (CBCT) is rarely applied to children due to concerns over imaging dose. Simulating low-dose CBCT can aid clinical protocol design by allowing visualisation of new scan protocols in patients without delivering additional dose. This work simulated ultra-low-dose CBCT and evaluated its use for paediatric image-guided radiotherapy by assessment of image registration accuracy and visual image quality. MATERIALS AND METHODS Ultra-low-dose CBCT was simulated by adding the appropriate amount of noise to projection images prior to reconstruction. This simulation was validated in phantoms before application to paediatric patient data. Scans from 20 patients acquired at our current clinical protocol (0.8 mGy) were simulated for a range of ultra-low doses (0.5, 0.4, 0.2 and 0.125 mGy) creating 100 scans in total. Automatic registration accuracy was assessed in all 100 scans. Inter-observer registration variation was next assessed for a subset of 40 scans (five scans at each simulated dose and 20 scans at the current clinical protocol). This subset was assessed for visual image quality by Likert scale grading of registration performance and visibility of target coverage, organs at risk, soft-tissue structures and bony anatomy. RESULTS Simulated and acquired phantom scans were in excellent agreement. For patient scans, bony atomy registration discrepancies for ultra-low-dose scans fell within 2 mm (translation) and 1° (rotation) compared with the current clinical protocol, with excellent inter-observer agreement. Soft-tissue registration showed large discrepancies. Bone visualisation and registration performance reached over 75% acceptability (rated 'well' or 'very well') down to the lowest doses. Soft-tissue visualisation did not reach this threshold for any dose. CONCLUSION Ultra-low-dose CBCT was accurately simulated and evaluated in patient data. Patient scans simulated down to 0.125 mGy were appropriate for bony anatomy set-up. The large dose reduction could allow for more frequent (e.g. daily) image guidance and, hence, more accurate set-up for paediatric radiotherapy.
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Affiliation(s)
- A Bryce-Atkinson
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - R de Jong
- Department of Radiation Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - M C Aznar
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - G Whitfield
- Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK; The Children's Brain Tumour Research Network, The University of Manchester, Royal Manchester Children's Hospital, Manchester, UK
| | - M van Herk
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Zhao Q, Liu Y, Zhang Y, Meng L, Wei J, Wang B, Wang H, Xin Y, Dong L, Jiang X. Role and toxicity of radiation therapy in neuroblastoma patients: A literature review. Crit Rev Oncol Hematol 2020; 149:102924. [PMID: 32172225 DOI: 10.1016/j.critrevonc.2020.102924] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/13/2020] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
Abstract
Neuroblastoma is the most common extracranial solid tumor, arising from primitive sympathetic ganglion cells, in pediatric patients. The unique features of neuroblastoma include variable clinical behaviors, such as rapid progression to death and maturation to benign ganglioneuroma, followed by regression. Radiation therapy (RT) is usually administered to both the primary tumor bed and persistent metastatic sites after induction chemotherapy for high-risk neuroblastoma. RT to the tumor bed after surgical resection contributes significantly to local disease control and prevention of local relapse, confirming the role of RT. Palliative radiotherapy for metastatic neuroblastoma is also effective and safe and mainly provides symptomatic relief. The late side effects of RT in neuroblastoma patients include growth and developmental failure, hypothyroidism, gastrointestinal dysfunction, neurocognitive defects, pulmonary and cardiac abnormalities, infertility, and secondary cancers. In this article, we reviewed the role and toxicity of RT in neuroblastoma patients.
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Affiliation(s)
- Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Yang Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Yuyu Zhang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Lingbin Meng
- Department of Internal Medicine, Florida Hospital, Orlando, FL, 32803, USA.
| | - Jinlong Wei
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Bin Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Huanhuan Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, 130021, China.
| | - Lihua Dong
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
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Xiong J, Zhu K, Mao J, Cai J, He M, Li L, Wang J, Wang L. Ewing-like sarcoma/undifferentiated round cell sarcoma in an infant with APC and MSH6 variation: A case report. Medicine (Baltimore) 2019; 98:e17872. [PMID: 31702654 PMCID: PMC6855612 DOI: 10.1097/md.0000000000017872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Ewing-like sarcoma (ELS)/undifferentiated round cell sarcoma (URCS) is a rare type of soft tissue sarcomas (STS), especially in infants, with poor prognosis. It is a so-called "small round cell" sarcoma, and has many features of Ewing sarcoma, but lacks rearrangements in EWSR1. The diagnosis and treatment of this kind of STS remains challenging. BCOR genetic abnormalities have been found in some Ewing-like sarcomas. PATIENT CONCERNS This report presents an ELS case of a female infant, who was 2 months old when initially diagnosed, with the clinical stage of IIIA (G2T2N0M0). Histologic findings revealed an undifferentiated neoplasm composed of small round tumor cells with round, open chromatic nuclei, and scant cytoplasm in a sheet growth pattern. Fluorescence in situ hybridization (FISH) analysis showed absence of EWSR1 and ETV6 gene rearrangement. Molecular genetic testing found no established variants of clinical significance but variants of unknown significance in APC, KMT2D, and MSH6 were detected. Immunostaining revealed that the tumor cells were positive for TLE1 and BCOR, and negative for cytokeratin (AE1/AE3), Desmin, CD45, S100, CD31, HMB45, and SATB2. INI-1 was retained. DIAGNOSIS Ewing-like sarcoma (ELS)/undifferentiated round cell sarcoma (URCS) INTERVENTIONS:: After initial diagnosis, the patient received 4 cycles of combination chemotherapy for 2 months. Radical amputation of left upper extremity was performed 3 months after diagnosis. Postoperative chemotherapy was continued for 6 cycles. OUTCOMES The patient died of intracranial metastasis with hemorrhage in 13 months after initial diagnosis, 5 months after the last cycle of chemotherapy. LESSONS ELS in infancy is extremely rare and has a poorer prognosis than Ewing sarcoma or infantile fibrosarcoma. APC and MSH6 variation might be related with the disease progression and predict a poorer prognosis. This rare case promotes better understanding of the disease and suggests a promising role for the combination chemotherapy regimen in treating infantile ELS. Importantly, it brings to light the possibility of intracranial metastasis, which requires proactive screening for timely detection.
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Affiliation(s)
| | - Kun Zhu
- Department of Pathology, Children's Hospital of Zhejiang University School of Medicine. Hangzhou, China
| | | | | | - Min He
- Department of Surgical Oncology
| | | | | | - Larry Wang
- Pathology & Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA
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Erdmann F, Feychting M, Mogensen H, Schmiegelow K, Zeeb H. Social Inequalities Along the Childhood Cancer Continuum: An Overview of Evidence and a Conceptual Framework to Identify Underlying Mechanisms and Pathways. Front Public Health 2019; 7:84. [PMID: 31106186 PMCID: PMC6492628 DOI: 10.3389/fpubh.2019.00084] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
Inequalities in health according to social conditions are regarded as unnecessary and unjust. There is a large body of evidence on inequalities in adult cancer, observable throughout the societies on a national level as well as on a global scale. Socioeconomic influences on health matter at all ages including childhood, for which childhood cancer is the leading cause of disease related death in high-income countries (HICs). Substantial differences in the reported incidence of childhood cancers have been observed globally by socioeconomic development of a population. This is reflected in the higher incidence rates reported for HICs, particularly for acute lymphoblastic leukemia, and for cancer in infants (below 1 year), compared to low- and middle-income countries (LMICs). Considerable inequalities between populations and degree of socioeconomic development are also noted for survival from childhood cancer, with substantially lower survival rates seen in most LMICs compared to HICs. With respect to inequalities by socioeconomic position (SEP) within countries, findings of an association between SEP and childhood cancer risk are diverse and limited to studies from HICs. On the contrary, observations on social inequalities in survival within countries are accumulating and indicate that survival inequalities do not only concern resource-poor countries but also high-income populations including European countries. In turn, a childhood cancer diagnosis in itself may have implications on the parents' socioeconomic situation as well as on the later socioeconomic life after having survived the disease. The underlying mechanisms and causal pathways of these empirically demonstrated social inequalities are poorly understood, although it is of significant public health relevance for any actions or strategies to reduce childhood cancer-related inequity. We propose a conceptual framework on potential underlying mechanism and pathways specifically addressing social inequalities in childhood cancer and after childhood cancer to (i) illustrate potential pathways by which social determinants may create health inequities at different points of the childhood cancer continuum; (ii) illustrate potential pathways by which a childhood cancer diagnosis may impact the socioeconomic situation of the concerned family or the later life of a childhood survivor; and (iii) point out how major determinants may relate to each other.
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Affiliation(s)
- Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Frederiksen LE, Mader L, Feychting M, Mogensen H, Madanat-Harjuoja L, Malila N, Tolkkinen A, Hasle H, Winther JF, Erdmann F. Surviving childhood cancer: a systematic review of studies on risk and determinants of adverse socioeconomic outcomes. Int J Cancer 2018; 144:1796-1823. [PMID: 30098012 DOI: 10.1002/ijc.31789] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/20/2018] [Accepted: 07/27/2018] [Indexed: 01/03/2023]
Abstract
Substantial improvements in childhood cancer survival have resulted in a steadily increasing population of childhood cancer survivors. Whereas somatic late effects have been assessed in many studies, less is known about the impact of childhood cancer on socioeconomic outcomes in survivors. The aim of this article was to evaluate and summarise the evidence on the socioeconomic conditions of childhood cancer survivors and to identify survivors at particular risk of adverse socioeconomic outcomes. An extensive literature search of three electronic databases was conducted. Of 419 articles identified, 52 met the inclusion criteria. All the selected articles were appraised for quality, and findings were summarised in a narrative synthesis. Childhood cancer survivors were at higher risk of adverse socioeconomic outcomes with regard to educational achievement, income and social security benefits than the general population or a sibling comparison group. The risks for unemployment and a lower occupational position were significantly increased only for survivors of a central nervous system tumour. Notably, survivors of central nervous system tumours, survivors treated with cranial radiotherapy and those diagnosed at younger age independent of cancer type were determinants of particular adverse socioeconomic outcomes. Given the increasing population of childhood cancer survivors, targeted follow-up interventions and support strategies addressing not only the somatic and psychiatric late effects but also the socioeconomic difficulties that some childhood cancer survivors face is of high importance to reduce social inequity, and ensure a high quality of life after childhood cancer.
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Affiliation(s)
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laura Madanat-Harjuoja
- Finnish Cancer Registry, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Anniina Tolkkinen
- Finnish Cancer Registry, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
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Uloza V, Ulozaite N, Vaitkus S, Sarauskas V. Spontaneous regression of laryngeal carcinoma in 10 year old boy: A case report and review of literature. Int J Pediatr Otorhinolaryngol 2017; 103:10-13. [PMID: 29224746 DOI: 10.1016/j.ijporl.2017.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 09/28/2017] [Accepted: 10/03/2017] [Indexed: 11/25/2022]
Abstract
Laryngeal carcinoma is a rare pathology in children, with only 92 cases reported. Spontaneous regression of laryngeal carcinoma is even more unique clinical event, so far only observed in adults. In this report we present an extraordinary case of a 10 year old patient with laryngeal squamous cell carcinoma that underwent spontaneous regression.
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Affiliation(s)
- Virgilijus Uloza
- Lithuanian University of Health Sciences, Department of Otorhinolaryngology, Eiveniu 2, LT-5009, Kaunas, Lithuania.
| | - Nora Ulozaite
- Lithuanian University of Health Sciences, Department of Otorhinolaryngology, Eiveniu 2, LT-5009, Kaunas, Lithuania.
| | - Saulius Vaitkus
- Lithuanian University of Health Sciences, Department of Otorhinolaryngology, Eiveniu 2, LT-5009, Kaunas, Lithuania.
| | - Valdas Sarauskas
- Lithuanian University of Health Sciences, Department of Pathology, Eiveniu 2, LT-5009, Kaunas, Lithuania.
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Hiniker SM, Bush K, Fowler T, White EC, Rodriguez S, Maxim PG, Donaldson SS, Loo BW. Initial clinical outcomes of audiovisual-assisted therapeutic ambience in radiation therapy (AVATAR). Pract Radiat Oncol 2017; 7:311-318. [DOI: 10.1016/j.prro.2017.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/14/2016] [Accepted: 01/16/2017] [Indexed: 12/26/2022]
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10
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Coelho CM, Calçada R, Rodrigues S, Barragán JA, Sá AC, Macedo AP, de Fátima Monsanto M. Evaluation of administered dose using portal images in craniospinal irradiation of pediatric patients. Radiol Phys Technol 2017; 10:274-278. [PMID: 28324390 DOI: 10.1007/s12194-017-0395-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 11/29/2022]
Abstract
This study aimed to assess the administered dose based on portal imaging in craniospinal pediatric irradiation by evaluating cases in which portal images did or did not account for the total administered dose. We also intended to calculate the mean increase in total administered dose. Data were collected from General University Hospital Gregorio Marañón; we evaluated the total dose administered, total dose planned, number of portal images per treatment and corresponding monitor units of two different groups: one in which the dose from portal images is deducted from the total administered dose (D), and another in which it was not (N). We used descriptive statistics to analyze the collected data, including the mean and respective standard deviation. We used the Shapiro-Wilk and Spearman rank correlation coefficient tests and estimated the linear regression coefficients. Patients in group D received a mean dose of 29.00 ± 10.28 cGy based on the verification portal images, a quantity that was deducted from the planned dose to match the total administered dose. Patients in group N received a mean dose of 41.50 ± 30.53 cGy, which was not deducted from the planned dose, evidencing a mean increase of 41.50 ± 30.55 cGy over the total administered dose. The acquisition of the set-up verification portal images, without their inclusion in the total administered dose, reflects an average increase in total dose for craniospinal irradiation of pediatric patients. Subtraction of the monitor units used to acquire the verification images is recommended.
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Affiliation(s)
- Carina Marques Coelho
- Radiotherapy Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal.
| | - Raquel Calçada
- Radiotherapy Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal
| | - Sofia Rodrigues
- Radiotherapy Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal
| | - Juan Antonio Barragán
- Radiation Oncology Department, General University Hospital Gregorio Marañón, Doctor Esquerdo, 46, 20030, Madrid, Spain
| | - Ana Cravo Sá
- Radiotherapy Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal
| | - Ana Paula Macedo
- Mathematic Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal
| | - Maria de Fátima Monsanto
- Radiotherapy Department, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, lote 4.69.01, 1990-096, Lisbon, Portugal
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11
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Balakrishnan R, Chowdhury Q, Hussain MA, Arup MMH, Haque N, Sharmeen F, Das A, Naznin B. Early Glottic Squamous Cell Carcinoma in a 16-Year-Old: Case Report, Review of the Literature and Pediatric Head and Neck Radiotherapy Guidelines. Case Rep Oncol 2015; 8:363-8. [PMID: 26464572 PMCID: PMC4592512 DOI: 10.1159/000438899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Squamous cell carcinoma in children and adolescents is extremely rare. Less than 80 case reports have been reported in the literature since it was first reported in 1868. In this article, we intend to report a case where a 16-year-old girl who presented with complaints of change in voice was found to have early-stage vocal cord carcinoma on evaluation.
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Affiliation(s)
- Rajesh Balakrishnan
- Department of Radiotherapy and Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Qamruzzaman Chowdhury
- Department of Radiotherapy and Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh ; Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | | | | | - Nizamul Haque
- Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Fariah Sharmeen
- Department of Radiotherapy and Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Arunangshu Das
- Department of Radiotherapy and Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Bidoura Naznin
- Department of Pathology, Square Hospital, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
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12
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Yu J, Shi WE, Zhao R, Gao X, Li H. Epidemiology of brain tumors in children aged two and under: A 10-year single-institute study. Oncol Lett 2015; 9:1651-1656. [PMID: 25789017 PMCID: PMC4356287 DOI: 10.3892/ol.2015.2943] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/22/2015] [Indexed: 02/07/2023] Open
Abstract
The aim of present study was to evaluate the incidence, clinical symptoms, pathological characteristics, surgical treatment strategies and prognosis of brain tumors in children aged two and under. The current study obtained data regarding 32 consecutive infants and young children aged two years and under, who were treated for brain tumors in the Children’s Hospital of Fudan University (Shanghai, China) between 2003 and 2013. The types of tumor, clinical manifestations, location, histological features, applied treatment strategies and outcomes were retrospectively evaluated. The male to female ratio was 1.13:1, and among a total of 32 tumors, 14 (43.8%) were suptratentorial and 18 (56.3%) were infratentorial. Intracranial hypertension was the most common onset symptom, and astrocytoma was the most common tumor type (10 cases; 31.3%), followed by ependymoma (nine cases; 28.1%) and medulloblastoma (six cases; 18.8%). Surgical tumor resection was performed in 20 patients (62.5%), who experienced a mean post-operative survival time of 67.6 months. By contrast, conservative treatment with medications was administered in 12 patients (37.5%), with a mean survival time of 25.3 months. Furthermore, four patients underwent conservative therapy combined with ventriculoperitoneal shunting to relieve intracranial pressure arising from cerebrospinal fluid accumulation, resulting in a mean survival time of 10.5 months. In conclusion, the present study indicates that surgical tumor resection may improve the overall prognosis of infants and young children aged two years and under who presented with brain tumors. In addition, ventriculoperitoneal shunts may facilitate pre- and post-operative improvement in clinical symptoms by relieving intracranial pressure; however, the shunts do not appear to increase long-term survival. Furthermore, high surgical risk is an important prognostic factor in this pediatric patient population.
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Affiliation(s)
- Jianzhong Yu
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - W E Shi
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Rui Zhao
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Xiaofeng Gao
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Hao Li
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
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Iannalfi A, Fragkandrea I, Brock J, Saran F. Radiotherapy in Craniopharyngiomas. Clin Oncol (R Coll Radiol) 2013; 25:654-67. [DOI: 10.1016/j.clon.2013.07.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 11/15/2022]
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Paediatric Clinical Oncology. Clin Oncol (R Coll Radiol) 2013; 25:1-2. [DOI: 10.1016/j.clon.2012.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 09/17/2012] [Accepted: 09/18/2012] [Indexed: 11/20/2022]
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