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1.
Ann Palliat Med ; 13(2): 355-372, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38247450

ABSTRACT

BACKGROUND AND OBJECTIVE: The use of radiotherapy (RT) in the palliative and emergent settings for pediatric cancers is an under-utilized resource. Our objective was to provide an evidence-based review of the data to increase awareness of the benefit for this population along with providing guidance on pediatric specific treatment considerations for palliative care physicians, pediatric oncologists, and radiation oncologists. METHODS: A narrative review was performed querying PubMed, MEDLINE, ClinicalTrials.gov databases, and supplemented with review articles, survey studies, current and recent clinical trials. When limited data existed, well-designed retrospective and prospective studies in the adult setting were evaluated and expert opinion was provided from pediatric oncologists. KEY CONTENT AND FINDINGS: Pediatric specific treatment considerations include the use of anesthesia, impact of treatment on the developing child, and logistical challenges of RT. Treatment modality and dose selection are driven by histology and symptomatic site of pain, where we discuss detailed recommendations for hematologic, central nervous system, and solid tumors. For palliative RT, an underlying principle of searching for the lowest effective dose to balance response rate with minimal acute and late treatment related morbidity and logistical hardships is of paramount importance when caring for a pediatric patient. Lastly, we outline how to effectively communicate this option to patients and their caregivers. CONCLUSIONS: Palliative RT can be of valuable benefit in most settings for patients with pediatric cancer. There is an unmet need for prospective data to inform on dose-fractionation along with patient and caregiver reported outcomes.


Subject(s)
Neoplasms , Radiation Oncology , Adult , Humans , Child , Prospective Studies , Retrospective Studies , Neoplasms/radiotherapy , Neoplasms/pathology , Palliative Care
2.
J Pediatr Hematol Oncol ; 43(7): e972-e974, 2021 10 01.
Article in English | MEDLINE | ID: mdl-33235157

ABSTRACT

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for a global pandemic that can cause severe infections in children, especially those with comorbid conditions. Here, we report a case of a child with a newly diagnosed medulloblastoma, Fanconi Anemia, and SARS-CoV-2 infection. Through multidisciplinary care coordination and meticulous planning, we were able to safely initiate this patient's oncology care and implement a long-term model to address the patient's care. This approach could be replicated with any newly diagnosed pediatric patient that requires monitoring for signs of COVID-19 with concurrent oncology care.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , COVID-19/complications , Fanconi Anemia/drug therapy , Medulloblastoma/drug therapy , SARS-CoV-2/isolation & purification , COVID-19/transmission , COVID-19/virology , Child, Preschool , Fanconi Anemia/diagnosis , Fanconi Anemia/virology , Female , Humans , Medulloblastoma/diagnosis , Medulloblastoma/virology , Prognosis
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