Document Detail

Emergent/urgent therapeutic irradiation in pediatric oncology: patterns of presentation, treatment, and outcome.
MedLine Citation:
PMID:  9403018     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We reviewed all pediatric cases referred for emergent/urgent therapy (requiring treatment within 48 hours) to identify frequency, patterns of presentation, and efficacy of therapy. We defined five categories of emergent/urgent therapy based on irradiated site and/or signs: Group I, spinal cord compression; Group II, respiratory compromise; Group III, infradiaphagmatic distress; Group IV, intracranial signs; Group V, pain. MATERIALS AND METHODS: From 2/1/88-3/1/ 94, 104 children with 115 problems were referred by specialists at the Children's Hospital of Philadelphia. Diagnosis, nature of the emergency, and response were examined. Responses were categorized as complete resolution, improvement or stabilization, and progression. RESULTS: The 104 children represented 12% of referrals during the study period. The most common tumors were CNS PNET and gliomas (20%); and neuroblastoma (20%). Forty-five problems occurred with newly diagnosed tumors and 70 after progression. Ninety-one episodes were managed with radiation therapy and 24 with other modalities. Patients with spinal cord/cauda equina (n = 33) compression improved (55%) or stabilized (30%). Patients with respiratory compromise from thoracic (n = 14) or abdominal (n = 5) disease had a response rate of 72%. Eight patients in group III had a 66% response. In Group IV (n = 16), 63% had complete responses and 19% had stabilization. Group V (n = 15) patients had a complete or partial response of 93%. CONCLUSION: Approximately 10% of children referred for radiation therapy required emergent/urgent treatment. Eighty percent of patients achieved stabilization or showed improvement in signs and symptoms, indicating that radiotherapy is a valuable and reliable component of multimodal care in such situations.
H Bertsch; S Rudoler; M N Needle; P Malloy; L Sutton; J Belasco; A Meadows; J Goldwein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical and pediatric oncology     Volume:  30     ISSN:  0098-1532     ISO Abbreviation:  Med. Pediatr. Oncol.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1997-12-31     Completed Date:  1997-12-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7506654     Medline TA:  Med Pediatr Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  101-5     Citation Subset:  IM    
Department of Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
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MeSH Terms
Child, Preschool
Infant, Newborn
Mediastinal Diseases / radiotherapy
Neoplasms / radiotherapy*
Spinal Cord Compression / radiotherapy

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