NULL

Background: Pediatric nasopharyngeal carcinoma (NPC), is rare but mostly presented in advanced stage. Our retrospective study aimed at evaluation of treatment outcome and toxicities. Patients and methods: The records of 24 eligible patients with NPC were reviewed during the period from January 2005and January 2015. Patients received 3 courses of chemotherapy regimen that consisted of cisplatin, 5-fluorouracil, with or without methotrexate followed (in non metastatic patients) by radiation therapy or chemo-radiotherapy. OS rates were estimated using the GraphPad prism program. The log- rank test was used to examine differences in OS rates. Results: The majority of patients presented with advanced stages (III&IV) (17, 71%), and showed response to treatment (CR&PR) (15, 63%). With a median follow up of 34 months (range: 3-120), the 3-year rate for OS was 58%. Univariate and multivariate analyses revealed that disease stage significantly affected survival. Conclusion:. The used treatment protocol resulted in favorable outcome, but was associated with late effects. High precision radiotherapy (IMRT or 3DCRT) are needed to improve the cure of advanced or recurrent disease and to reduce long-term morbidities.

Background: Pediatric nasopharyngeal carcinoma (NPC), is rare but mostly presented in advanced stage. Our retrospective study aimed at evaluation of treatment outcome and toxicities. Patients and methods: The records of 24 eligible patients with NPC were reviewed during the period from January 2005and January 2015. Patients received 3 courses of chemotherapy regimen that consisted of cisplatin, 5-fluorouracil, with or without methotrexate followed (in non metastatic patients) by radiation therapy or chemo-radiotherapy. OS rates were estimated using the GraphPad prism program. The log- rank test was used to examine differences in OS rates. Results: The majority of patients presented with advanced stages (III&IV) (17, 71%), and showed response to treatment (CR&PR) (15, 63%). With a median follow up of 34 months (range: 3-120), the 3-year rate for OS was 58%. Univariate and multivariate analyses revealed that disease stage significantly affected survival. Conclusion:. The used treatment protocol resulted in favorable outcome, but was associated with late effects. High precision radiotherapy (IMRT or 3DCRT) are needed to improve the cure of advanced or recurrent disease and to reduce long-term morbidities.

Background: Pediatric nasopharyngeal carcinoma (NPC), is rare but mostly presented in advanced stage. Our retrospective study aimed at evaluation of treatment outcome and toxicities. Patients and methods: The records of 24 eligible patients with NPC were reviewed during the period from January 2005and January 2015. Patients received 3 courses of chemotherapy regimen that consisted of cisplatin, 5-fluorouracil, with or without methotrexate followed (in non metastatic patients) by radiation therapy or chemo-radiotherapy. OS rates were estimated using the GraphPad prism program. The log- rank test was used to examine differences in OS rates. Results: The majority of patients presented with advanced stages (III&IV) (17, 71%), and showed response to treatment (CR&PR) (15, 63%). With a median follow up of 34 months (range: 3-120), the 3-year rate for OS was 58%. Univariate and multivariate analyses revealed that disease stage significantly affected survival. Conclusion:. The used treatment protocol resulted in favorable outcome, but was associated with late effects. High precision radiotherapy (IMRT or 3DCRT) are needed to improve the cure of advanced or recurrent disease and to reduce long-term morbidities.

Cancer remains a major cause of death in children, but recent advances in supportive care and progress in the use of chemotherapy have considerably improved the prognosis. The need for intensive care management in pediatric oncology patients is increasing. However, studies demonstrating their outcome in the literature are still deficient, especially in developing countries. Here, we aim to report our experience in managing patients admitted to the pediatric intensive care unit (PICU) at South Egypt Cancer Institute, a tertiary university oncology center in a developing country.A review of all cancer patients admitted to the PICU at South Egypt Cancer Institute between January 2007 and December 2011 and an evaluation of prognostic factors that may correlate to their short-term outcome were performed.A total of 550 pediatric oncology patients were admitted to the PICU on 757 occasions. Hematological malignancies represented 73.6% of the cases. The median duration of PICU stay was 5 days. Sepsis and respiratory failure were the most frequent indications for PICU admission. The overall survival at the time of discharge from the PICU was 60%. Several factors were found to significantly affect the outcome of patients admitted to the PICU, including the underlying disease, the reason for admission, the intervention used, and the number of failing organs at the time of admission to the PICU.The prognosis of patients admitted to the PICU in developing countries is still behind those in developed ones. Late referral, especially of patients presenting with respiratory failure, sepsis, and multiorgan failure usually, requires urgent intervention with inotropic support, oxygen therapy, and mechanical ventilation and is significantly associated with poor outcomes, especially in patients with hematological malignancies.

Cancer remains a major cause of death in children, but recent advances in supportive care and progress in the use of chemotherapy have considerably improved the prognosis. The need for intensive care management in pediatric oncology patients is increasing. However, studies demonstrating their outcome in the literature are still deficient, especially in developing countries. Here, we aim to report our experience in managing patients admitted to the pediatric intensive care unit (PICU) at South Egypt Cancer Institute, a tertiary university oncology center in a developing country.A review of all cancer patients admitted to the PICU at South Egypt Cancer Institute between January 2007 and December 2011 and an evaluation of prognostic factors that may correlate to their short-term outcome were performed.A total of 550 pediatric oncology patients were admitted to the PICU on 757 occasions. Hematological malignancies represented 73.6% of the cases. The median duration of PICU stay was 5 days. Sepsis and respiratory failure were the most frequent indications for PICU admission. The overall survival at the time of discharge from the PICU was 60%. Several factors were found to significantly affect the outcome of patients admitted to the PICU, including the underlying disease, the reason for admission, the intervention used, and the number of failing organs at the time of admission to the PICU.The prognosis of patients admitted to the PICU in developing countries is still behind those in developed ones. Late referral, especially of patients presenting with respiratory failure, sepsis, and multiorgan failure usually, requires urgent intervention with inotropic support, oxygen therapy, and mechanical ventilation and is significantly associated with poor outcomes, especially in patients with hematological malignancies.

Cancer remains a major cause of death in children, but recent advances in supportive care and progress in the use of chemotherapy have considerably improved the prognosis. The need for intensive care management in pediatric oncology patients is increasing. However, studies demonstrating their outcome in the literature are still deficient, especially in developing countries. Here, we aim to report our experience in managing patients admitted to the pediatric intensive care unit (PICU) at South Egypt Cancer Institute, a tertiary university oncology center in a developing country.A review of all cancer patients admitted to the PICU at South Egypt Cancer Institute between January 2007 and December 2011 and an evaluation of prognostic factors that may correlate to their short-term outcome were performed.A total of 550 pediatric oncology patients were admitted to the PICU on 757 occasions. Hematological malignancies represented 73.6% of the cases. The median duration of PICU stay was 5 days. Sepsis and respiratory failure were the most frequent indications for PICU admission. The overall survival at the time of discharge from the PICU was 60%. Several factors were found to significantly affect the outcome of patients admitted to the PICU, including the underlying disease, the reason for admission, the intervention used, and the number of failing organs at the time of admission to the PICU.The prognosis of patients admitted to the PICU in developing countries is still behind those in developed ones. Late referral, especially of patients presenting with respiratory failure, sepsis, and multiorgan failure usually, requires urgent intervention with inotropic support, oxygen therapy, and mechanical ventilation and is significantly associated with poor outcomes, especially in patients with hematological malignancies.

Background Metronomic chemotherapy (mctx) combined with radiation therapy (rt) is an emerging anticancer strategy. The aim of the present study was to assess the efficacy of mctx combined with rt as salvage treatment in children with refractory or relapsed solid malignancies. Methods This prospective study enrolled patients with refractory or relapsed pediatric solid tumours from January 2013 to January 2015. Treatment consisted of 3–12 courses of mctx in all patients, followed by rt in patients who experienced local recurrence, distant metastases, or both. Each course of mctx consisted of oral celecoxib 100–400 mg twice daily (days 1–42), intravenous vinblastine 3 mg/m2 weekly (weeks 1–6), oral cyclophosphamide 2.5 mg/m2 daily (days 1–21), and oral methotrexate 15 mg/m2 twice weekly (days 21–42). Statistical methods used were the log-rank test and binary logistic regression. Results A favourable disease response (partial response or stable disease) was seen in 49 of 64 patients (76.6%), with mild acute toxicity occurring in 41 (64%). After a median follow-up of 14 months, 1-year overall survival was 62%. Pattern of disease relapse (p 0.0001), time from initial treatment to relapse (p = 0.0002), and response to treatment (p 0.0001) significantly affected survival. Age was the only factor that significantly correlated with treatment toxicity (p = 0.002; hazard ratio: 3.37; 95% confidence interval: 1.53 to 7.35) Conclusions Combining mctx with rt resulted in a favourable response rate, minimal toxicity, and 62% 1-year overall survival in patients with heavily pretreated recurrent disease. Patients with localized late recurrence or disease progression are the most likely to benefit from this regimen.

Background Metronomic chemotherapy (mctx) combined with radiation therapy (rt) is an emerging anticancer strategy. The aim of the present study was to assess the efficacy of mctx combined with rt as salvage treatment in children with refractory or relapsed solid malignancies. Methods This prospective study enrolled patients with refractory or relapsed pediatric solid tumours from January 2013 to January 2015. Treatment consisted of 3–12 courses of mctx in all patients, followed by rt in patients who experienced local recurrence, distant metastases, or both. Each course of mctx consisted of oral celecoxib 100–400 mg twice daily (days 1–42), intravenous vinblastine 3 mg/m2 weekly (weeks 1–6), oral cyclophosphamide 2.5 mg/m2 daily (days 1–21), and oral methotrexate 15 mg/m2 twice weekly (days 21–42). Statistical methods used were the log-rank test and binary logistic regression. Results A favourable disease response (partial response or stable disease) was seen in 49 of 64 patients (76.6%), with mild acute toxicity occurring in 41 (64%). After a median follow-up of 14 months, 1-year overall survival was 62%. Pattern of disease relapse (p 0.0001), time from initial treatment to relapse (p = 0.0002), and response to treatment (p 0.0001) significantly affected survival. Age was the only factor that significantly correlated with treatment toxicity (p = 0.002; hazard ratio: 3.37; 95% confidence interval: 1.53 to 7.35) Conclusions Combining mctx with rt resulted in a favourable response rate, minimal toxicity, and 62% 1-year overall survival in patients with heavily pretreated recurrent disease. Patients with localized late recurrence or disease progression are the most likely to benefit from this regimen.

NULL