Care of children who are dying of cancer

Article Abstract:

Oncologists who treat children with cancer should place more emphasis on palliative care. Advances in the treatment of cancer in children have increased overall survival rates from 10% to 70%. Unfortunately, many children do not receive adequate end-of-life care. A survey of 103 parents of children who died of cancer found that many of the children suffered unnecessarily in the last month of life. In many cases, suffering was caused by pain that was not adequately controlled. In fact, more than 70% of the children had pain that was not adequately controlled.

Health aspects, Editorial, Usage, Palliative treatment, Palliative care, Cancer pain

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Results of treatment of childhood localized non-Hodgkin's lymphoma with combination chemotherapy with or without radiotherapy

Article Abstract:

Non-Hodgkin's lymphoma is a condition whose cure rate has improved dramatically, but radiotherapy and chemotherapy, the therapeutic modes used to treat the disease, have serious side effects. It is possible that radiotherapy could be omitted, since its success was established before the development of many modern chemotherapeutic agents. To investigate this possibility, 129 non-Hodgkin's lymphoma patients (average age, 10 years) who were considered to have an excellent prognosis were randomly assigned to receive either chemotherapy or chemotherapy plus radiotherapy. An excellent prognosis was determined for children with localized tumors in certain sites. Results showed that all patients were in complete remission after six weeks of induction treatment, and all completed the course of treatment. Half the group was followed for at least 38 months. The event-free survival rate was 87.9 percent for chemotherapy patients and 87.3 percent for combined therapy patients. For the whole group, there was no difference between the treatments in projected survival. The 14 treatment failures were due to disease recurrence in most cases, regardless of treatment, and their incidence was no higher than rates reported by other investigators. The most frequent toxic effect was granulocytopenia (reduced numbers of granulocytes, a type of blood cell), which reached life-threatening or severe levels in patients with combined therapy. Many fewer (19 percent) chemotherapy patients experienced this side effect. Most patients in both groups, however, were able to attend school full time during their treatment. Overall, results indicate that certain non-Hodgkin's lymphoma patients can be successfully treated with less intense methods and the omission of radiotherapy. Since the late effects of radiotherapy, such as infertility, growth retardation, and secondary cancer development, are serious, the effectiveness of chemotherapy alone in these patients is most encouraging. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Antineoplastic agents, Radiotherapy

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Treatment of children and young adults with early-stage non-Hodgkin's lymphoma

Article Abstract:

A simple regimen of nine weeks of chemotherapy only appears to be as effective in treating children with early-stage non-Hodgkin's lymphoma as eight months of chemotherapy. About 75% of these children can be cured, but prolonged chemotherapy has many side effects. Researchers assigned 67 such children and young adults to receive eight months of chemotherapy plus radiotherapy, 131 to receive eight months of chemotherapy alone and 113 to receive nine weeks of chemotherapy. Five-year remission rates were above 85% in all three groups. Patients with lymphoblastic lymphoma had the worst outcome.

Dosage and administration

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