Chan / Raney, Jr. / Raney Pediatric Oncology

1. Auflage 2010
ISBN: 978-0-387-24472-3
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, Band 4, 288 Seiten, eBook

Reihe: MD Anderson Cancer Care Series

Childhood cancer was almost always fatal before 1970. Today, 80% of ch- dren diagnosed with cancer will survive at least 5 years; 70% will be cured. However, cancer continues to be the leading cause of nonaccident-related deaths in children. More children die each year from cancer than from c- tic ?brosis, diabetes, asthma, AIDS, and congenital abnormalities combined. Nine children die from cancer every school day. Despite the fact that pediatric cancers account for only a small p- centage of the total cancer burden, more effective therapies are needed to improve mortality rates in children. Therefore, our research priority must be the development of new agents and new therapies for childhood cancer. M. D. Anderson Cancer Center has been caring for children with c- cer since its doors opened over 60 years ago. This institution has been home to several research and clinical pioneers whose innovative work has in?uenced and shaped the practice of pediatric oncology throughout the world. Notably, Drs. Wataru W. Sutow, Donald Pinkel, and Norman Jaffe have been credited with introducing curative therapies for children with leukemia and solid tumors. Cancer treatment involves far more than administering chemoth- apy and surgically excising tumors. It requires a multidisciplinary - proach to patient management, particularly in the treatment of solid - mors, which pose the biggest challenge in cancer care today. Surgery and radiotherapy as well as radiographic and pathologic assessments of response are critical factors in the treatment of children with cancer.

Zielgruppe

Research

Autoren/Hrsg.

Chan, Ka Wah

Raney, Jr., Richard B.

Raney, Jr.

Jr.,

Inhaltsverzeichnis

Acute Leukemia.- Hodgkin Lymphoma and Non-Hodgkin Lymphoma.- Brain Tumors: Diagnosis, Surgery and Radiotherapy, and Supportive Care.- Brain Tumors: Chemotherapy and Investigational Therapy.- Wilms’ Tumor.- Neuroblastoma.- Soft-Tissue Tumors.- Osteosarcoma.- Ewing’s Sarcoma.- Retinoblastoma.- Differentiated Thyroid Cancer.- Medullary Thyroid Carcinoma.- Melanoma.- Novel Therapeutic Approaches.- Supportive Care: Myelosuppression.- Supportive Care: Symptom Control.- Behavioral Medicine in Cancer Care.- The Adolescent and Young Adult Program.

Leseproben

"11 Differentiated Thyroid Cancer (p. 155-156)

Chapter Overview

Thyroid nodules are relatively common in adult women but uncommon in adult men and in children and adolescents, and children are infrequently affected by differentiated thyroid cancer. When this cancer does occur in a child, the patient’s prognosis is generally favorable and he or she can expect a near-normal life span; however, it can prove to be a lethal neoplasm, especially in older patients and when distant metastases are present. The survival duration for children and adolescents with differentiated thyroid cancer is substantially long despite the fact that the disease presents with extensive morbid characteristics. The varied presentations and activities of differentiated thyroid cancer in children require speci?c diagnostic and treatment approaches and lifelong surveillance.

Introduction

Differentiated thyroid cancer, often simply called “thyroid cancer,” is an infrequent malignancy overall but the most common endocrine malignancy. At M. D. Anderson Cancer Center, less than 10% of all patients with differentiated thyroid cancer receive the diagnosis before 20 years of age. In children, differentiated thyroid cancer occurs more commonly as the papillary rather than the follicular variant, and it affects girls more often than boys.

Unlike in young adults, differentiated thyroid cancer presents in children with extensive disease bulk, including multifocal primary lesions, bilateral cervical lymph node metastases, and tumor invasion into the soft tissues of the neck. Diffuse pulmonary metastases may also be present in a small subset of children with cervical lymph node metastases. Children with differentiated thyroid cancer generally have a good prognosis despite the initial extent of disease (Harness et al, 1992; Hung and Sarlis, 2002). Nevertheless, disease- and treatment-related morbidity and mortality do occur; thus, a thoughtful, comprehensive initial evaluation and treatment plan must be coupled with lifelong surveillance in all cases.

Radiation-Induced Differentiated Thyroid Cancer

The risk for radiation-induced differentiated thyroid cancer is well documented. During the early decades of the twentieth century, low-dose irradiation to the head and neck was often used in the treatment of benign childhood conditions such as thymic enlargement, hemangioma, ringworm, and acne. The excess relative risk for radiation-induced differentiated thyroid cancer appears to depend on radiation dose and schedule as well as the patient’s age at the time of exposure.

The average time between irradiation and diagnosis of differentiated thyroid cancer is 10 years; accordingly, some cases of radiation-induced differentiated thyroid cancer will be diagnosed before the patient is 20 years old. There is no indication that radiationinduced differentiated thyroid cancer has a different clinical presentation and course than unirradiated cases of the disease. Increasing awareness of thyroid radiosensitivity, especially in children, has led to the virtual elimination of the use of irradiation for benign conditions; thus, low-dose radiation-induced differentiated thyroid cancer is expected to subside in the future."