from Part VI - Oncology
Published online by Cambridge University Press: 08 January 2010
Short- and long-term outcomes of children with malignancies have improved considerably during the last four decades. According to the review by Ries et al. (1991), the survival rate for cancer cases diagnosed before 15 years of age has improved from around 50% in the early 1970s to 75% a decade later. This favorable trend has been observed not only in hematologic malignancies but also in many solid tumors such as Wilms' tumor and hepatoblastoma. This progress is due to many factors including advances in medical expertise, surgical techniques, and most importantly innovation and refinement of adjuvant chemotherapy. With growing numbers of surviving patients, the long-term side effects of chemotherapy are now viewed with increasing concern and may lead us to reconsider therapeutic strategies in the future, possibly promoting further integration of genetic and tumor markers into tailored management protocols.
Children with cancers represent a unique population for studying genetic and environmental mechanisms of cancer etiology, and also genetic factors or tumor markers associated with survival. Identifying mechanisms and/or markers encourages the development of prevention, screening or pre-emptive treatment strategies. However, less is known about children's cancers compared to adults and additional research is necessary; the relatively small number of children with cancer and the lack of co-ordinated studies has led, for too long, to fragmentation and duplication of research effort. Large collaborative trials in pediatric cancer research are a priority.
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