Epidemiology Etiology

Overall, STSs are rare with an annual incidence of around 2-3 100,000 persons of all ages. STS incidence increases exponentially with age, but peaks as a percent of all cancers in 5- to 10-year-olds. At a rate of 8.2 cases per million, STS ties as the fifth most common cancer in 15- to 19-year-olds (7.7 of all tumors) in the 20- to 24-year-olds there are 17.9 cases per million - 6.6 of all tumors and the seventh most common. Although rates continue to increase with age and reach 62.3 per...

Special considerations for chemotherapy in cNS tumors

Drugs that penetrate the BBB have the capacity to produce neurotoxicity as a dose-limiting side effect, which may compound other treatment-related neurotoxicities (e.g., methotrexate and RT). The use of chemotherapy, especially in high doses, in patients with CNS tumors carries additional hazards linked primarily to the infectious risks of ventricular- or lumbar-peritoneal shunts, central venous lines, and frequent episodes of fever, which cause difficulties in discriminating between shunt...

References

Bleyer WA O'Leary M, Barr R, Ries LAG (eds) (2006) Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age, including SEER Incidence and Survival, 1975-2000. National Cancer Institute, NIH Pub. No. 06-5767, Bethesda MD also available at www.seer.cancer.gov publications 2. Brown J, Shvartsman HS, Deavers MT, et al (2004b) The activity of taxanes in the treatment of sex cord-stromal ovarian tumors. J Clin Oncol 22 3517-3523 3. Raney RB Jr, Sinclair L, Uri A, et al (1987)...

Secreting tumors NGGcTs

MAKEI 86 and 89 studies utilized chemotherapy with PVB (cisplatin + vinblastine + bleomycin) after sur gery and before CrSp RT (36 Gy CrSp RT with 14 Gy tumor boost), followed by postradiation chemotherapy with etoposide and ifosfamide. Subsequently, MAKEI 89 used preoperative PVB (cisplatin + etoposide + bleomycin) followed by tumor resection, followed by further chemotherapy with PIV (cisplatin + ifosfamide + vinblastine) and RT (30 Gy CrSp, tumor boost of 20 Gy). Twenty-seven patients were...

Of Adolescent Young Adult Oncology as an Entity

From time immemorial, adolescents have been criticized for their behavior. Socrates complained that children today are tyrants they contradict their parents, gobble their food, and tyrannize their teachers. Homer declared thou knowst the over-eager vehemence of youth, how quick in temper, and in judgment weak. Shakespeare suggested that teenagers be put into suspended animation until of age 17 . Some characteristics of adolescents, including ambivalence, rebellion, desire for freedom from...

General Surgical Guidelines

The absolute diagnosis of an ovarian malignancy can only be made by microscopic pathologic evaluation of a surgically obtained specimen. Detailed surgical approach recommendations are included in the Appendix. The importance of appropriate initial staging cannot be overemphasized, as a small percentage of patients have apparent early-stage disease but have positive lymph nodes on final review. This can then affect the stage, recommended treatment, and overall prognosis. Although the occasional...

Rhabdomyosarcoma

RMS is a distinct entity and clearly differs from NRSTS in regard to its natural history and its higher sensitivity to chemotherapy and radiotherapy 6 . During the past 30 years the 5-year overall survival (OS) rates of pediatric RMS has improved dramatically from 25-30 to approximately 70 1, 12-14 . These results are due largely to the development of Table 11.3 Rhabdomyosarcoma the histological subtypes and their more frequent characteristics. RMS Rhabdomyosarcoma Table 11.3 Rhabdomyosarcoma...

General Treatment Consideration

Hodgkin lymphoma is highly curable in the adolescent and young adult patient population. The challenge faced by oncologists today is to find the balance between maximizing cure and minimizing the late effects in this population. Adolescents with Hodgkin lymphoma are not treated as a distinct patient population and are routinely placed on either pediatric or adult treatment regimens, without a strong foundation for the decision. Several studies, however, have reported a poorer outcome in...