Tomlinson / Kline Pediatric Oncology Nursing

Advanced Clinical Handbook
1. Auflage 2005
ISBN: 978-3-540-26784-3
Verlag: Springer Berlin Heidelberg
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 450 Seiten

Reihe: Pediatric Oncology

This comprehensive clinical handbook for nurses in pediatric hematology/oncology, authored by nurse experts from the United Kingdom and North America, contains in-depth information regarding pathophysiology, diagnosis, treatment, advanced assessment, and interventions. The book is divided into 5 sections: pediatric cancers, hematologic disorders, treatment of childhood cancer, side effects of treatment and disease, and supportive and palliative care. It is organized in a user-friendly format with quick reference guides for the nurse. With the ongoing, challenging developments faced during the clinical nursing care of children with cancer, this handbook will provide an indispensable tool for those working in this speciality.

Written for:
Pediatric oncology nurses, pediatric hematology nurses, pediatric nurses, nursing educators, nursing faculty

Keywords:
advanced practice nursing
pediatric hematology
pediatric nursing
pediatric oncology

Autoren/Hrsg.

Tomlinson, Deborah

Kline, Nancy E.

Inhaltsverzeichnis

1;Dedication;6
2;Preface;8
3;Contributors;10
4;Contents;12
5;PART I;24
5.1;Chapter 1 Leukemia;24
5.1.1;1.1 Acute Lymphoblastic Leukemia;25
5.1.2;1.2 Acute Myeloid Leukemia;39
5.1.3;1.3 Chronic Myeloid Leukemia;43
5.1.4;1.4 Juvenile Myelomonocytic Leukemia;44
5.1.5;1.5 Langerhans Cell Histiocytosis;45
5.1.6;References;46
5.2;Chapter 2 Solid Tumors;48
5.2.1;2.1 Hodgkin’s Disease;49
5.2.2;2.2 Non-Hodgkin’s Lymphoma;53
5.2.3;2.3 Ewing’s Sarcoma Family of Tumors;60
5.2.4;2.4 Osteosarcoma;64
5.2.5;2.5 Liver Tumors;68
5.2.6;2.6 Neuroblastoma;73
5.2.7;2.7 Renal Tumors;80
5.2.8;2.8 Retinoblastoma;85
5.2.9;2.9 Rhabdomyosarcoma;89
5.2.10;2.10 Non-rhabdomyosarcomatous Soft Tissue Sarcomas;94
5.2.11;2.11 Germ Cell Tumors;96
5.2.12;2.12 Rare Tumors;100
5.2.13;References;102
5.2.14;Bibliography;105
5.3;Chapter 3 Common Central Nervous System Tumors;108
5.3.1;3.1 Causes/Epidemiology;109
5.3.2;3.2 Distribution/Classification;109
5.3.3;3.3 Staging;110
5.3.4;3.4 Molecular Genetics of Brain Tumors;110
5.3.5;3.5 Diagnosis;110
5.3.6;3.6 Specialist Referral;112
5.3.7;3.7 Hydrocephalus;112
5.3.8;3.8 Treatment;112
5.3.9;3.9 Prognosis;114
5.3.10;3.10 Specific Tumors;115
5.3.11;3.11 Follow-up;123
5.3.12;3.12 The Late Effects and Rehabilitation of Survivors;123
5.3.13;3.13 Palliative Care;123
5.3.14;3.14 Future Perspectives/New Innovations;123
5.3.15;References;124
5.3.16;Bibliography;124
6;PART II;126
6.1;Chapter 4 Anemias;126
6.1.1;4.1 Anemia;127
6.1.2;4.2 Iron Deficiency Anemia;129
6.1.3;4.3 Sickle Cell Disease;132
6.1.4;4.4 Thalassemia;141
6.1.5;4.5 Hemolytic Anemia;144
6.1.6;4.6 Bone Marrow Failure Syndromes;149
6.1.7;References;153
6.2;Chapter 5 Neutropenia;157
6.2.1;5.1 Epidemiology;157
6.2.2;5.2 Etiology;158
6.2.3;5.3 Symptoms and Clinical Signs;159
6.2.4;5.4 Diagnostic Testing;159
6.2.5;5.5 Treatment;159
6.2.6;5.6 Prognosis;161
6.2.7;5.7 Follow-up;161
6.2.8;Reference;161
6.2.9;Bibliography;161
6.3;Chapter 6 Thrombocytopenia;163
6.3.1;6.1 Epidemiology;163
6.3.2;6.2 Etiology;164
6.3.3;6.3 Symptoms and Clinical Signs;164
6.3.4;6.4 Diagnostic Testing;166
6.3.5;6.5 Treatment;167
6.3.6;6.6 Prognosis;168
6.3.7;6.7 Follow-up;169
6.3.8;6.8 Future Perspectives;169
6.3.9;References;169
6.3.10;Bibliography;169
6.4;Chapter 7 BleedingDisorders;171
6.4.1;7.1 Hemophilia --- Nicole M. Sevier;171
6.4.2;7.2 Von Willebrand Disease;178
6.4.3;References;183
7;PART III;184
7.1;Chapter 8 Chemotherapy;184
7.1.1;8.1 Introduction;185
7.1.2;8.2 Chemotherapy Principles;185
7.1.3;8.3 Clinical Trials;188
7.1.4;8.4 Types of Chemotherapy Agents;188
7.1.5;8.5 Administration of Chemotherapy Agents;192
7.1.6;8.6 Routes of Administration and Practice Considerations;197
7.1.7;8.7 Safe Practice Considerations;201
7.1.8;8.8 Administration of Chemotherapy in the Home;204
7.1.9;8.9 Extravasation;207
7.1.10;8.10 Acute Hypersensitivity Reactions to Chemotherapy;212
7.1.11;References;214
7.1.12;Bibliography;215
7.2;Chapter 9 Radiation Therapy;217
7.2.1;9.1 Principles of treatment;217
7.2.2;9.2 Description of treatment;218
7.2.3;9.3 Methods of delivery;218
7.2.4;9.4 Potential side effects;220
7.2.5;9.5 Special considerations;221
7.2.6;9.6 Future Perspectives;222
7.2.7;References;222
7.3;Chapter 10 Hematopoietic Stem Cell Transplantation;223
7.3.1;10.1 Principles of Treatment;223
7.3.2;10.2 Description of Treatment;226
7.3.3;10.3 Potential Side Effects;229
7.3.4;10.4 Special Considerations;237
7.3.5;10.5 Future Perspectives;238
7.3.6;References;238
7.3.7;Bibliography;238
7.4;Chapter 11 Surgical Approaches to Childhood Cancer;242
7.4.1;11.1 Principles of Treatment;242
7.4.2;11.2 Description of Treatment;242
7.4.3;11.3 Method of Delivery;243
7.4.4;11.4 Potential Side Effects;245
7.4.5;11.5 Special Considerations;246
7.4.6;11.6 Future Perspectives;247
7.4.7;References;248
7.4.8;Bibliography;248
7.5;Chapter 12 Gene Therapy;249
7.5.1;12.1 Introduction;249
7.5.2;12.2 Principles of Treatment;250
7.5.3;12.3 Method of Delivery;251
7.5.4;12.4 Potential Side Effects;252
7.5.5;12.5 Special Considerations;252
7.5.6;12.6 Future Perspectives;253
7.5.7;References;253
7.6;Chapter 13 Complementary and Alternative Therapy;256
7.6.1;13.1 Principles of Treatment;256
7.6.2;13.2 Description of Treatment;257
7.6.3;13.3 Method of Delivery;257
7.6.4;13.4 Potential Side Effects;258
7.6.5;13.5 Special Considerations;260
7.6.6;13.6 Future Perspectives;261
7.6.7;References;261
8;PART IV;262
8.1;Chapter 14 Metabolic System;262
8.1.1;14.1 Cancer Cachexia;262
8.1.2;14.2 Obesity;264
8.1.3;14.3 Tumour Lysis Syndrome;265
8.1.4;14.4 Hypercalcaemia;270
8.1.5;14.5 Impaired Glucose Tolerance Following Bone Marrow Transplant;272
8.1.6;References;272
8.2;Chapter 15 Gastrointestinal Tract;274
8.2.1;15.1 Mucositis;275
8.2.2;15.2 Dental Caries;278
8.2.3;15.3 Nausea and Vomiting;279
8.2.4;15.4 Constipation;283
8.2.5;15.5 Diarrhoea;286
8.2.6;15.6 Typhlitis;289
8.2.7;15.7 Perirectal Cellulitis;290
8.2.8;15.8 Acute Gastrointestinal Graft Versus Host Disease;291
8.2.9;15.9 Chemical Hepatitis;293
8.2.10;References;294
8.3;Chapter 16 Bone Marrow ;296
8.3.1;16.1 Anemia;297
8.3.2;16.2 Neutropenia;298
8.3.3;16.3 Thrombocytopenia;304
8.3.4;16.4 Transfusion Issues;304
8.3.5;16.5 Disseminated Intravascular Coagulation;306
8.3.6;16.6 Septic Shock;308
8.3.7;16.7 Immune Suppression;309
8.3.8;References;311
8.4;Chapter 17 Respiratory System;314
8.4.1;17.1 Pneumocystis Pneumonia;314
8.4.2;17.2 Pneumonitis;317
8.4.3;17.3 Fibrosis;318
8.4.4;17.4 Compromised Airway;319
8.4.5;References;321
8.5;Chapter 18 Renal System;324
8.5.1;18.1 Nephrectomy;325
8.5.2;18.2 Cytotoxic Drug Excretion;329
8.5.3;18.3 Nephrotoxicity;336
8.5.4;18.4 Hemorrhagic Cystitis;342
8.5.5;References;347
8.6;Chapter 19 Cardiovascular System;349
8.6.1;19.1 Cardiotoxicity/Cardiomyopathy;349
8.6.2;19.2 Veno-occlusive Disease;354
8.6.3;References;358
8.6.4;Bibliography;358
8.7;Chapter 20 Central Nervous System;359
8.7.1;20.1 Spinal Cord Compression;359
8.7.2;20.2 Fatigue;360
8.7.3;20.3 Cognitive Deficits;363
8.7.4;20.4 Diabetes Insipidus;365
8.7.5;References;365
8.8;Chapter 21 Musculoskeletal System;368
8.8.1;21.1 Limb Salvage Procedures;368
8.8.2;21.2 Amputation;371
8.8.3;21.3 Altered Bone Density and Increased Risk of Fracture;374
8.8.4;References;375
8.9;Cahapter 22 Skin Cutaneous Toxicities;378
8.9.1;22.1 Alopecia;378
8.9.2;22.2 Altered Skin Integrity Associated with Radiation Therapy;380
8.9.3;22.3 Radiation Sensitivity and Recall;381
8.9.4;22.4 Photosensitivity;382
8.9.5;22.5 Cutaneous Reactions Associated with High-dose Cytosine Arabinoside;382
8.9.6;22.6 Nail Dystrophies;383
8.9.7;22.7 Graft Versus Host Disease;383
8.9.8;References;386
8.10;Chapter 23 Endocrine System;388
8.10.1;23.1 Hypothalamic-Pituitary Dysfunction;388
8.10.2;23.2 Growth Hormone Deficiency;389
8.10.3;23.3 Hypothalamic-Pituitary-Gonadal Axis;390
8.10.4;23.4 Thyroid Disorders;392
8.10.5;23.5 Hypothalamic-Pituitary-Adrenal Axis;392
8.10.6;23.6 Other Pituitary Hormones;393
8.10.7;References;396
8.11;Chapter 24 Ototoxicity;398
8.11.1;24.1 Incidence;398
8.11.2;24.2 Prevention and Treatment;401
8.11.3;References;404
8.12;Chapter 25 Eyes – Ocular complications;406
8.12.1;25.1 Ocular Toxicity Associated with High-dose Cytarabine Arabinoside;406
8.12.2;25.2 Cataracts;407
8.12.3;References;408
9;PART V;410
9.1;Chapter 26 Nutrition and Hydration in Children with Cancer;410
9.1.1;26.1 Introduction;410
9.1.2;26.2 Principles of Treatment;411
9.1.3;26.3 Method of Delivery;412
9.1.4;26.4 Special Considerations;413
9.1.5;References;419
9.1.6;Bibliography;419
9.2;Chapter 27 Pain in Children with Cancer;420
9.2.1;27.1 Introduction;420
9.2.2;27.2 Causes of Pain in Childhood Cancer;421
9.2.3;27.3 Assessment;421
9.2.4;27.4 Cultural Issues;425
9.2.5;27.5 Principles of Treatment;427
9.2.6;27.6 Treatment;427
9.2.7;27.7 Summary;434
9.2.8;References;435
9.2.9;Bibliography;435
9.3;Chapter 28 Blood Transfusion Therapy;436
9.3.1;28.1 Introduction;437
9.3.2;28.2 Blood Screening Guidelines;437
9.3.3;28.3 Transfusion Complications;439
9.3.4;28.4 Erythrocyte Transfusion;442
9.3.5;28.5 Platelet Transfusion Options;443
9.3.6;28.6 Granulocyte Transfusion;444
9.3.7;28.7 Albumin;445
9.3.8;28.8 Fresh Frozen Plasma (FFP);445
9.3.9;28.9 Cryoprecipitate;446
9.3.10;28.10 Intravenous Immunoglobulin (IVIG);446
9.3.11;28.11 Recombinant Human (rHu) Erythropoietin Alpha;446
9.3.12;28.12 Palliative Care Issues for Transfusion Therapy;446
9.3.13;References;447
9.3.14;Bibliography;447
9.4;Chapter 29 Growth Factors;448
9.4.1;29.1 Principles of Treatment;448
9.4.2;29.2 Method of Delivery;450
9.4.3;29.3 Future Perspectives;451
9.4.4;References;452
9.5;Chapter 30 Care of the Dying Child and the Family;454
9.5.1;30.1 Children’s Understanding of Death;454
9.5.2;30.2 Explaining Death to Children;456
9.5.3;30.3 Pediatric Palliative Care;456
9.5.4;30.4 Grief;457
9.5.5;30.5 Cultural and Spiritual Care;461
9.5.6;30.6 Bereavement;462
9.5.7;30.7 Resources;463
9.5.8;References;464
9.5.9;Bibliography;465
10;Subject Index;466

Leseproben

Chapter 9
Radiation Therapy (S. 195-196)

Joan M. O’Brien · Deborah Tomlinson

Radiotherapy has had a role in malignancies for the last century. X-rays were discovered by Von Roentgen in 1895 and were used diagnostically.The element radium was isolated by Marie and Pierre Curie in 1898. The first therapeutic report of a patient cures by radiation therapy was in 1899. However it has a diminishing role in childhood malignancies due to more effective chemotherapy regimens and the recognition of late effects of radiation treatment. Children will often be assessed on an individual level regarding the need of radiotherapy. However it is still required for around 20% of children and young people with cancer. Focus in radiation therapy (XRT) has been on methods of delivery that will minimize injury to normal tissues, to try to avoid long-term negative sequalae.

9.1 Principles of treatment

Radiotherapy causes damage to cells in a localised area. Ionising radiation both causes and treats cancer. Damage is caused by breaking strands of DNA, either double or single strands. This inhibits cell division. It may harm normal cells in the area they pass through or in the area around tumor. Radiation treatment has three main roles in the treatment of childhood and young person:

- Radical: Treatment with curative intent
- Adjuvant: "Added on" treatment
- Palliative: Treatment aimed at symptom control

Radiation is frequently used as part of a bone marrow ablative regimen. At times radiation may be used to ameliorate side effects from tumors that are threaten life or organ function, to quickly reduce the size of a mass that is impinging on the airway, or to relieve pressure on the spinal cord to decrease or prevent paralysis. Palliative radiotherapy is given to relieve pain in progressive or metastatic disease. It provides shrinkage of tumor to relieve pain and/or obstructions interfering with quality of life. The dose is monitored to ensure minimal toxicities.

9.2 Description of treatment

All radiation emits radiant energy, either in waves and particle form.

- Electrons are electromagnetic and produced from a linear accelerator. They can provide treatment to super.cial tumors and have increased absorption to bone.(X-rays are electromagnetic radiation that is produced extranuclearly, electrons are accelerated to high energy and then stopped abruptly at a tungsten target (Farah and Weichselbaum 1994)).
- Gamma rays are electromagnetic radiation produced intranuclearly from a radioactive source. They provide local and wide-.eld radiation, and are skin sparing. Gamma rays require lead or concrete to absorb them.
- Protons are high energy atoms, emitted from a machine, for the treatment of tumours needing speci.c dose localization. They are delivered by stereotaxis (a form of radiation that delivers the beam in an extremely precise manner).

9.2.1 Cell radiosensitivity

Factors that contribute to cell radiosensitivity include:
- Phase of cell cycle that cell is in: Studies have shown that cells are most radiosensitive in the M and G2 phases and most resistant in late S phase (Farah and Weichselbaum 1994). Between dose fractions, cells may move through the cell cycle to more sensitive phases. This process is called “reassortment”. This allows for a greater cell kill.