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Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

School difficulties are common in children cancer survivors and may be prognostic for the success of the patient social reintegration after the disease. Here, we carry out a narrative review of the literature from 2001 to 2022 to assess the school difficulties of these patients, the predictive factors of these difficulties, and the possible long-term consequences. We punctuate this review the practical point-of-view of a teacher dedicated to our hospital, who works with children with chronic diseases such as cancer. Therefore, we expose possible barriers and solutions to improve the scholar reintegration and limit the impact of cancer on the academic achievement. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pleuropulmonary blastoma is a rare intrathoracic tumor in children. It is associated with poor prognosis and diagnosis is based on histological examination. We conducted a didactic study involving a 3-year-old child with severe acute respiratory distress associated with hemothorax; radiological and thoracoscopic examination suggested malignant pleuropulmonary process. Anatomopathological examination with radioclinical comparison allowed for the diagnosis of solid-cystic pleuropulmonary blastoma type II. Unfortunately, given the severity of the clinical features, the child died within a few weeks due to multiple organ failure. Pathologist experience is very important to recognize the disease and to start adequate treatment as soon as possible. This allows for a tumor regression rate up to 90% after neoadjuvant treatment and a 5-year survival rate of at least 53% for aggressive forms: solid and solidocystic tumors. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The solid tumors of the child are characterized, apart from their evolution, by a notable metastatic power, notably in the bone marrow. This study examined a series of 19 cases of children's solid tumors with bone marrow involvement. In the light of this study, we analyzed the different aspects of bone marrow invasion during the initial diagnosis of solid tumors, diagnosed in the pediatric oncology department of the teaching hospital Hassan II -Fez for a five-year period from June 2011 to May 2016. The study of the bone marrow in the malignant solid tumors of the child conditions the therapeutic attitude and the evaluation of the response to the treatment. The presence of medullary metastases darkens the prognosis of these tumors. The role of the laboratory of biology, apart from the standard balances, is essential for the search for extra-hematopoietic cells evoking medullary metastases. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A quick presentation by the author provides a framework to enlighten the reader on the fundamentals of his commitment to pediatric oncology and his reflection on clinical research from three examples. A research in human and social sciences highlights the wealth of collaborations between parents concerned, associations, health care teams and actors in HSS. Therapeutic trials indicate the importance of having a rigorous legislative framework for research that allows parents and to the child according to his age and maturity, to make informed and confident decisions about whether to participate or not. In genetics, the impressive advances in techniques (NGS) and knowledge, the close interplay between care and research, the notion of risk and uncertainty complicates both the transmission and understanding of information. In research even more than in care, physicians are invited to an ethics of listening which testifies to a presence, a care and a conscience in the proximity of the other, and all the more in the context of uncertainty and vulnerability that genetic research. [ABSTRACT FROM AUTHOR]

The article reports on nursing in pediatric oncology. It refers to the case history of a 5-year-old boy from South America who was transferred to a pediatric oncology unit on May 18, 2015, for intra-abdominal mass diagnosis. He felt pain and analgesic treatment was started immediately. Examinations were scheduled to define the diagnosis of the disease.

The article reports on nursing in pediatric oncology. It refers to the case history of a 5-year-old boy from South America who was transferred to a pediatric oncology unit on May 18, 2015, for intra-abdominal mass diagnosis. He felt pain and analgesic treatment was started immediately. Examinations were scheduled to define the diagnosis of the disease.

Résumé: Nous rapportons le cas d’une enfant de 7 mois présentant une mastoïdite aiguë avec otorrhée gauche. L’hémogramme avait mis en évidence une hyperleucocytose à 79 000/mm3. Un Streptococcus pneumoniae avait été isolé dans les prélèvements bactériologiques réalisés lors du drainage de l’abcès mastoïdien. Le frottis sanguin avait révélé la présence de cellules blastiques circulantes et l’os mastoïdien prélevé lors de l’intervention était infiltré par des cellules blastiques. Le diagnostic de leucémie de Burkitt avec localisation et lyse osseuse temporale gauche avait donc été posé. Un traitement selon le protocole LMB (Lymphome Malin B), (2001) de la Société française d’oncologie pédiatrique avait permis une rémission clinique et paraclinique sans rechute 30 mois après son arrêt. Le scanner de contrôle était normal avec restitution ad integrum du rocher gauche. Toute mastoïdite aiguë atypique dans sa présentation ou son évolution doit faire rechercher une affection sous-jacente de type hémopathie maligne, histiocytose ou tumeur solide. Une affection otitique peut être le mode de révélation d’une leucémie aiguë. À notre connaissance, il n’existe pas de cas de leucémie de Burkitt avec atteinte lytique temporale mastoïdienne rapporté dans la littérature chez un enfant de moins de 1 an. [ABSTRACT FROM AUTHOR]

Résumé: Les tumeurs neuroectodermiques primitives sont un ensemble de tumeurs malignes rares, très agressives. Leur localisation cervico-faciale est rare, voire exceptionnelle. Nous rapportons l’observation d’un nourrisson de 4 mois, de sexe masculin, ayant consulté pour une dyspnée supra-laryngée sévère. L’examen avait révélé une masse sous angulo-mandibulaire gauche ferme, mobile, étendue à la région parotidienne, douloureuse, avec une voussure de la paroi latérale gauche de l’oropharynx. La tomodensitométrie cervicale avait objectivé une masse bien limitée de la région carotidienne, rehaussée par le produit de contraste. L’examen anatomopathologique de cette masse vascularisée qui était développée aux dépens du nerf vague, avait montré qu’il s’agissait d’une tumeur neuroectodermique primitive. [ABSTRACT FROM AUTHOR]

Health policies promote educational activities during the care pathways for children and adolescents hospitalized in pediatric oncology services. However, the development of these activities is still limited and particularly in the physical education area. The aim of this article is to describe the implementation of a new life plan through a project of adapted physical activity in the university hospital complex of Bordeaux. It leads to broaden the educational life plan including health education for young people and teenagers affected by chronic disease. [ABSTRACT FROM AUTHOR]

Résumé: La curiethérapie est rarement utilisée en cancérologie pédiatrique, et réservée à des institutions spécialisées. Les localisations tumorales les plus fréquemment ainsi traitées sont les rhabdomyosarcomes d’origine gynécologique ou vésicoprostatiques. Les avantages balistiques de la curiethérapie en font une technique de choix en pédiatrie, puisqu’elle permet de protéger sélectivement les tissus sains. Les techniques rapportées, les modalités de la curiethérapie (bas débit de dose, haut débit de dose, débit pulsé), les doses et les indications varient en fonction des centres. Cette revue analyse les techniques, les indications en fonction des deux localisations les plus fréquentes, gynécologique et vésicoprostatique, et les résultats de cette technique qui nécessite une indispensable approche multidisciplinaire. [ABSTRACT FROM AUTHOR]

Summary: Introduction: The French-African Pediatric Oncology group (GFAOP) has contributed to a significant improvement in the prognosis of pediatric cancers in Africa through the development of therapeutic protocols adapted to local conditions. In parallel, the development of supportive care such as pain management, is now a major priority of our group. Objective: The main objective of this study was to evaluate the management of pain in children with cancer in sub-Saharan Africa. Methodology: A questionnaire was sent to both the doctor and nurse responsible for each of the 8 pilot units (PUs). Results: All physicians and 2 nurses answered the questionnaire. Human resources (3 doctors and 4 nurses per PU) were modest compared to the size of the pediatric population (71 million) and the mean number of 102 cases of cancer/year per PU. Only six physicians had received specific training in pediatric oncology. Morphine was available in only 5 of the 8 PUs; major limitations for its prescription were mainly inconsistent availability (62.5%), fear of side effects (50%), and regulations (37.5%). During the curative phase, more than half of the parents had to buy analgesics when leaving the PU. Pain assessment relied mainly on clinical evaluation (8/8), but was generally concordant with parents’ assessment. The majority of patients experienced pain at diagnosis and at a higher degree at relapse, cancer being the predominant etiology. Pain related to other causes such as medical procedures, mucositis, and neuropathic pain was detected; however, its management remained inadequate. Only 2 of 8 PUs had a written protocol for pain management. These deficiencies can be explained by limited resources, both human and financial, but also by cultural factors such as endurance against pain still advocated by many African traditions. Conclusion: In recent years, pain prevention and relief, whatever its origin, have become a priority for all medical teams, especially for children with cancer. With its profound sociocultural changes, Africa is no exception. All teams in our group are aware of the situation and hope for major improvement in pain management in the near future through increased resources and training. [Copyright &y& Elsevier]

Summary: Introduction: Laryngeal papillomatosis is a rare benign tumour of larynx generally observed in children. Material and methods: From January 2004 to December 2010, 21 patients with laryngeal papillomatosis have been recorded. Results: The mean age at the time of diagnosis was 6 years and the sex ratio was 1.11. All children were dysphonic, and 52% had laryngeal dyspnea. The tracheotomy was done in 76%. The only available treatment in our department was stripping by forceps due to direct laryngoscopy under general anaesthesia. Histological study was done systematically. Decannulation was performed in 100% of patients. Conclusion: The management of laryngeal papillomatosis raises major therapeutic difficulties. There is not an etiological treatment right now. Capricious evolution of this pathology requires regular monitoring of patients. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Although fibromatosis is considered as benign tumor, it can have significant morbidity, particularly when it occurs in the head and neck. Their propensity for infiltrative local growth with encroachment on vital structures and their tendency to recur make fibromatoses of the head and neck extremely challenging lesions. Case report: We report the case of a 10-year-old boy with desmoid fibromatosis of the upper lip. For this patient, the medical treatment has been decided to avoid a mutilating surgery. He had a good result with chemotherapy using methotrexate and vinblastine. Discussion: According to the literature, surgery is the most common treatment of fibromatosis in the head and neck region. However, particularly in children, alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations. Chemotherapy using methotrexate and vinblastine may be a reasonable choice. [ABSTRACT FROM AUTHOR]

Summary: Dermatofibrosarcoma protuberans is a malignant and locally invasive tumor. It generally affects young adults. However, in rare but not exceptional cases, children can suffer from this disease. In the literature, there are only few studies on this pathology occurring in children. The main treatment is surgical excision with large margins. We studied in our series 15 cases of dermatofibrosarcoma in children between 1995 and 2008. The data were retrospectively collected. The aim of our study is to underline the best support for this pathology in children. The mean age at the moment of diagnosis was 13years old. None of our patients underwent surgery for dermatofibrosarcoma removal before. The diagnosis was confirmed by biopsy and immunology by FISH method. In 60% of the cases, the lesion, which is very polymorphic, was on the trunk. In three cases, a skin trauma was noted in the patient''s history. Surgical management consisted in tumor''s excision with a 3cm margin laterally associated with the removal of the first unaffected anatomical layer in depth. Reconstruction was adapted to the defect''s width, depth and topography. The mean follow-up was 7.8years. There were no relapses reported in a 3-year period at least. Complications were two scars dehiscences which needed skin graft for repair and a scarring alopecia reconstructed secondarily by a skin expansion protocol. No functional sequelae were reported in our series. As dermatofibrosarcoma in children presents the same clinical aspect and evolution as in adults, we treated it the same way. This diagnosis should not be ignored in children, and should be made early to give the patient the most effective support. [Copyright &y& Elsevier]

Summary: Introduction: In children and infants, the determination of optimal dosages is essential from the beginning of treatments with vancomycin because of the high risk of inadequate serum concentrations and bacterial resistance. Bayesian pharmacokinetic methods can be used to adjust dosages according to serum vancomycin concentrations and the patients’ physiopathological characteristics. The aim of this retrospective study was to review the effective dosages of vancomycin in paediatric hematology/oncology, using a bayesian pharmacokinetic method. Patients and methods: One hundred and sixty-one patients in paediatric hematology/oncology units, aged from 1 month to 18 years, who were treated with vancomycin in continuous infusion, were selected between 2000 and 2010. The influence of initial vancomycin dosages on serum steady-state concentrations (Ssc) before bayesian adaptation was studied on the basis of dosing recommendations in children and infants (i.e., 40mg/kg/day). In addition, the Ssc before bayesian adaptation and the effective dosages determined after bayesian adaptation (Edb) were analysed according to the patients’ age, for an identical dosage of 40mg/kg/day (±10%). Results: The percentage of patients with low Ssc (i.e.,<10mg/L) was 28.6%, 16%, and 0 when treatment was initiated at less than 40mg/kg/day (±10%), at 40mg/kg/day (±10%), and at more than 40mg/kg/day (±10%), respectively. For an identical initial dosage of 40mg/kg/day (±10%), the Ssc gradually increased as the patients’ age increased. The Ssc were optimal (i.e., between 15 and 20mg/L) in adolescents and children from 6 to 12 years of age, but less than 15mg/L in children from 2 to 6 years of age and infants. The Edb gradually increased as the patients’ age decreased. Discussion and conclusions: The choice of initial dosages of vancomycin treatment must take greater account of the patient''s age in order to reduce the frequency of inadequate Ssc before titration. In the absence of nephrotoxic cofactors, we suggest an increase in initial vancomycin dosages in continuous infusion between 40 and 45mg/kg/day in children from 6 to 12 years old, between 45 and 50mg/kg/day in children from 2 to 6 years old, and between 50 and 55mg/kg/day in infants, in hematology/oncology. For teenage patients, the standard dosage (i.e., 40mg/kg/d) seems appropriate. [Copyright &y& Elsevier]

Summary: Scurvy, a disease related to ascorbic acid deficiency, remains rare in industrial countries. Ascorbic acid is a vitamin that intervenes most notably in the synthesis of collagen and catecholamines. We report the case of a 2-year-old boy hospitalized in a pediatric oncology unit because of an unusual presentation of scurvy revealed by pain and a significant increase in urinary catecholamine levels, raising fear of a neuroblastoma. [ABSTRACT FROM AUTHOR]

Abstract: Glomus tumor (GT) of limb extremities (finger, toe) is a rare tumor, especially in children. It is formed by hyperplasia of the neuro-myoarterial elements. Chronic pain is often associated. The diagnosis is made by the history and several clinical tests (Hildreth''s and Love''s tests). This diagnosis must be suspected in a child with chronic extremity pain. Magnetic resonance imaging (MRI) is the most sensitive imaging test. Complete surgical excision of the lesion is curative. We report two clinical cases of glomus tumor of limb extremities (finger and toe) in two children – aged 7 and 12 – causing severe chronic pain; the diagnosis of this condition remains a challenge. [Copyright &y& Elsevier]

Summary: Primary heart tumors are uncommon in children. The majority of them are benign, with only 10% malignant. Among malignant cardiac tumors, sarcoma (rhabdomyosarcoma, angiosarcoma, synovial sarcoma) and lymphoma (Burkitt''s lymphoma, large B-cell lymphoma, lymphoblastic lymphoma) predominate. There are few published pediatric series on malignant primary cardiac tumors. We report here 3 observations of primary malignant cardiac tumors, 2 cases of sarcoma (angiosarcoma and synovial sarcoma) and 1 case of Burkitt''s lymphoma. A precise pathological diagnosis is necessary for the proper management of these patients. For sarcoma, treatment associates surgery and chemotherapy. Surgery should be as complete as possible because of the lack of chemotherapy sensitivity of some sarcomas, mainly angiosarcoma and synovial sarcoma. Therefore, the prognosis of cardiac sarcoma remains poor. For primary cardiac lymphoma, management should not be different from lymphoma in other locations. Chemotherapy is the main treatment, and surgery has to be used only when complications occur. Prognosis depends on histology and not lymphoma location, and so is better than the prognosis for sarcoma. [Copyright &y& Elsevier]

Summary: Despite the numerous clinical trials undertaken, the prognosis of children with diffuse brain stem glioma remains very poor. This review examines the different strategies for the treatment of malignant brain stem glioma such as radiation therapy, concurrent radiochemotherapy, and classical cytotoxic drugs, with a particular focus on the novel targeted and antiangiogenic drugs recently introduced in pediatric oncology. The strategy using integrin inhibitors is discussed. [Copyright &y& Elsevier]

Summary: Granulocytic sarcoma (GS) is a rare extramedullary tumor frequently associated with acute myeloblastic leukemia (AML). We report 3 cases of pediatric granulocytic sarcomas with various locations: skin, orbit, and bowel. Cases 1 and 2 were associated with AML; case 3 was isolated. In all 3 cases, the diagnosis was delayed or initially missed. Pathology and immunohistochemistry data identified the disease. GS is treated with chemotherapy, like AML. The prognosis of GS seems better than that of isolated AML. [Copyright &y& Elsevier]

Depuis la découverte des rayons X(RX) par Röntgen, en 1895, á nos jours, l’évolution technologique de la radiothérapie n’a cessé de s’accélérer. Cependant, la philosophie est toujours restée la même: délivrer une forte dose au volume cible tout en limitant la dose aux organes á risque. Depuis le début des années 1990, avec l’aveènement de la radiothérapie conformationnelle (RC3D), différentes techniques se sont développées. Certaines sont dérivées de la RC3D comme la RC3D avec modulation d’intensité, l’ arcthérapie, la Tomothérapie™ ou les techniques d’asservissement respiratoire. Dans le domaine de la radiothérapie stéréotaxique, le GammaKnife™ est utilisé depuis une vingtaine d’annes, alors que de nouveaux concepts basés sur une approche robotique de l’irradiation (CyberKnife™) sont á présent utilisés. Aux côtés de la radiothérapie externe, la curiethérapie de nouvelle génération a, elle aussi, pu bénéficier de progrès technologiques majeurs. Dans le domaine des ions lourds, l’hadronthérapie représente une technique adaptée á des situations cliniques complexes, notamment en pédiatrie. Nous présentons ici une analyse de l’évolution technologique de la radiothérapie. [ABSTRACT FROM AUTHOR]

Summary: A report of a five-year-old male child diagnosed as a recurrent perineal giant cell fibroblasoma is described. Complete tumour removal was obtained with micrographic surgery and complete pathological analysis of the limits of the tumour with the “technique verticale modifiée” developed in our institution. The closure of the operative wound was performed with a posterior perforator thigh flap based on the descending branch of the inferior gluteal vessels. Thanks to these new surgical and pathological approaches, the complete removal of this recurring tumour was achieved with acceptable oncologic, fonctionnal and cosmetic results in this young child. [Copyright &y& Elsevier]

Abstract: Pediatric tumors still represent a formidable challenge despite the considerable therapeutical advances that have been reported for the past 30 years. This is largely related with the untowards side-effects of local therapy that are still acknowledged as the “price for cure”. In this setting, Proton therapy a sophisticated radiotherapeutical modality seems to represent a real breakthrough due to its unique ability to spare close and distant normal organs compared with modern photons techniques. We summarize in this paper current clinical and dosimetrical evidences including an update of the Orsay series on 108 children. [Copyright &y& Elsevier]

Abstract: Medulloblastoma is the most frequent childhood brain tumor (30%) but account only for less than 1% of adult brain tumor. The overall survival increased significantly during the last two decades with 80% of long survivors at five years whatever the stage. Most children who survive have significant neurocognitive sequelae. All children are included in national and international prospective studies which propose risk-adaptated radiation therapy and chemotherapy after surgery. Quality control of radiotherapy leads to reduce significantly the risk of recurrence and has an impact on survival. Risks of late toxicity should be taken into account at the time of the treatment. Due to the rarety in adult population, no prospective studies and few data about late effects are available. Adult medulloblastoma is a therapeutic challenge and their therapeutic strategies are similar to pediatric protocols. In order to improve the understanding of adult disease and to homogenize the treatment, National Cancer Institute (INCa) stimulated the creation of web conference to discuss each case prospectively and to propose a protocol of treatment. A better comprehension of biological processes and abnormal cellular signalling pathways involved in medulloblastoma pathogenesis had led toward a new prognostic classification to adapt the therapeutic strategy and gives hope of new therapeutic tools. [Copyright &y& Elsevier]

Abstract: Stereotactical radiotherapy is a very high precision procedure, limited to radiosurgery since a long time. Technologic progress permitted to develop radiotherapy in stereotactical conditions, leading to a lot of innovations. Previously indicated for cerebral pathologies, this procedure is now developed for extracerebral locations. In pediatrics, stereotactical radiotherapy is still limited, delivered precociously, due to the possibility of long-term late effects that needs to be to addressed. This review reports the different useful conditions, technical evolutions, and the current validated pediatric indications, with differences from adults, and future directions. Current state of pediatric stereotactical radiotherapy used in France is presented. [Copyright &y& Elsevier]

Copyright of Societes is the property of De Boeck Universite and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Angiogenesis is crucial for the growth of cancer. As such, it has become an established target in fighting cancer. Metronomic chemotherapy—the chronic administration of chemotherapy at relatively low, minimally toxic doses on a frequent schedule of administration at close regular intervals, with no prolonged drug-free breaks—is a potential novel approach to controlling advanced cancer disease. It is thought to work primarily through antiangiogenic mechanisms and has the property of killing resistant cancer cells while significantly reducing undesirable toxic side effects. We review the data regarding the use of metronomic chemotherapy in children with cancer and discuss its potential uses and limits. [Copyright &y& Elsevier]

Tumoral calcinosis (Ct) is a rare pathology of unknown origin. We present the clinical, imaging (including CT and MRI) , surgical and pathology findings of Ct in a 9 year-old boy who presented with an incidental finding of a large ellbow mass. The MR aspect of Ct has been reported only once and this case is the second description in a child. The association of Ct and dermatomyositis, as reported hereby, has also been described only once. With respect to treatment alternatives, we believe that it is important for radiologists to recognise this rare pathology in pediatric patients. [ABSTRACT FROM AUTHOR]

Ovarian sex cord-stromal tumors are rare tumors that originate from the nongerminal cells of ovary. Two decades ago, the identification of juvenile granulosa-cell tumors (GCT), as a specific entity inside this group, allowed a better treatment of these tumors in children. However, little data have been reported on the natural course of the disease and reliable prognostic factors have not been yet defined. We here review the clinical and genetics aspects of granulosa tumors, based on a series of 40 children. This national collaborative study involved the French Society of Children Cancer and eight clinical departments of pediatric endocrinology. We found that early diagnosis of a tumor, revealed by clinical signs of hyperoestrogeny, is an important prognostic factor. The pathophysiology of these tumors is still debatable and several cellular- and molecular-abnormal signals could be implicated in their development. The role of growth factors and oncogenes through the signaling pathway of MAP kinase is still discussed. According to our data, FSH signaling-transduction pathway, such as a constitutionally activated Gαs, could also be implicated in the induction of granulosa cell proliferation and seems to modulate the invasiveness of the tumor. Last, we have described a low-expression pattern or an extinction of an ovarian-determination gene, FOXL2, which is related to a worse prognosis of this tumor. [Copyright &y& Elsevier]

Summary: Infantile cutaneous hemangioma is a benign vascular tumour present at 10% of the infants. It forms part of the group of the vascular tumours in the classification of international society for vascular anomalies (ISSVA). Usual surgical attitude is abstention and surgery is proposed only in order to treat sequelae. But some particular situations require early surgery to avoid functional impairment, deformation or growth delay due to the lesion''s development. Using our observations, we recall the epidemiology, the physiopathology, the clinical aspects, the particularities of the facial localizations and their treatments. In these localizations the time intervenes like a fourth dimension that is going to modify, to improve or to aggravate the prognosis. Treatment requires a strategy and precocious surgery. We insist on the fact that the dogma of the therapeutic abstention remained true for a majority of children with small size hemangioma and that a precocious surgery must be proposed for some localizations in the face. [Copyright &y& Elsevier]

Summary: Blueberry Muffin baby is a rare neonatal skin disorder. Many causes are known, examples are congenital infections, hemolysis and tumors. We report on a newborn presenting with Blueberry Muffin syndrome and an adrenal mass which lead to the diagnosis of neuroblastoma. Actually, it corresponded to an acute monoblastic leukaemia with an adrenal localization and a cerebrospinal fluid involvement. Leukaemia should always be considered in such patients, even in the absence of blasts on white blood cells count and bone marrow examination, as in this patient. This observation was also unusual due to spontaneous remission. The patient is in complete remission at 1 year follow-up. [Copyright &y& Elsevier]

Summary: Background: A medical staff and an administrative staff of our paediatric oncology department have contracted a pulmonary tuberculosis. This is a rare situation and the management of this infection threat in a paediatric oncology department is not clearly defined. Recommendations tell we must treat all patients. Nevertheless, antituberculosis agent expose to increased toxic effects and immunocompromised patients have an increased risk of experiencing progression of latent mycobacterium tuberculosis infection to active tuberculosis disease. Objective: This study aims at the evaluation of a screening and a treatment strategy adapted for a paediatric oncology department. Method: From April 2004 to April 2005, 80 children with a solid tumour were screened for tuberculosis according to a screening and treatment protocol established by a multidisciplinary committee. Two risk groups were defined according to age and immunodepression status. The “high risk” group is composed of less than 2 years old children and children who underwent an haematological peripheral stem cell transplantation. All other children were included in the “low risk” group. The screening was based on clinical, biological and radiological data performed three times spaced out by 2 or 3 months. At the end of each part of screening, the multidisciplinary committee analyzed the results and discussed the utility of an antituberculosis treatment. Results: 80 children (31 boys and 49 girl) with a median age of 7,3years (0,3–24) participated to the screening. Sixty children were still undergoing anticancer treatments. Twenty belonged to the high risk group. The complete screening was performed in 32% of the patients. Three antituberculosis’ treatment were initiated: 2 for prophylaxis purpose and 1 for a tuberculosis prime-infection. A child had an additional check-up because of an abnormal chest X-ray. Our management strategy allowed us to treat significantly less patients when compared to national guidelines (3 vs 80 test Chi-2 p <0.001). No side effects of antituberculosis agents were noted. No tuberculosis has been observed in our population 28 months after the completion of the treatment. Conclusion: The proposed screening allowed us to treat a minimum of children and thus, to reduce the potential toxicity induced by antituberculosis’ treatments. [Copyright &y& Elsevier]

Chemotherapy plays a key role in the treatment of cancer in children. Thanks to its efficacy, three out of four children can now be cured. Nevertheless, 25% of paediatric cancer patients go uncured, and chemotherapy-induced long-term side effects justify the continued development of new agents and strategies to fight childhood cancer, including the investigation of off-patent drugs, which are administered on a daily basis in paediatric oncology. In this context, we review the specific characteristics of children compared to adults and the reasons for expanding pharmacological research that focuses on paediatric oncology. Such research is now encouraged and supported by European legislation and new international organisations, such as the consortium, Innovative Therapies for Children with Cancer (ITCC). [ABSTRACT FROM AUTHOR]

Abstract: School achievement of children with brain tumors is hampered by progressive neurologic and cognitive sequelae. To help the children and their family, we have created in 1997 a multidisciplinary consultation together with Necker''s hospital. Material and methods: The study describes the organization of the consultation and analyses the files of 69 children seen between September 2001 and June 2002. Results and conclusion: The authors conclude that this consultation is an irreplaceable mean to coordinate the complex rehabilitation process of a child treated for a brain tumor. [Copyright &y& Elsevier]

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A review of the world’s medical literature indicates that all treatment modalities are of interest in Ewing’s sarcoma, the second most common primary bone malignancy in children and adolescence. Chemotherapy increases survival from less than 5% to 65–70% in localized tumors and to 25–30% in primary metastatic tumors. Surgery is a major tool, whereas advances in imaging techniques have improved treatment indication and optimization. Radiotherapy remains useful, either alone or in addition to surgery, and new techniques (conformational RT and IMRT) will reduce short-term toxic effects. However, long-term toxic effects are also of major concern. Pediatric oncologists do not outweigh surgeons or radiation therapists, but they are the ones who conduct the medical orchestra, that also includes pathologists and imaging specialists. This article is a review of the data available in 2006 concerning Ewing’s sarcoma either as biologic aspects as therapeutic aspects. [ABSTRACT FROM AUTHOR]

Abstract: Malignant neonatal tumors are rare and comprise 2% of childhood malignancies. Clinical features, histologic types, prognosis were very different from those seen in older children, facing oncologists with diagnostic, therapeutic and ethical problems. Patients and methods: In a retrospective study from January 1987 to January 2004, we reviewed the management of neonates treated at the Institute Gustave Roussy for a malignant solid tumor for whom symptoms started in the first month of life. Results: Seventy-one neonates were treated, comprising 1,2% of the overall patients treated during the same period of time. Of these 71 patients, 42 (59%) presented with neuroblastomas, 12 (17%) with mesenchymal tumors, 6(8%) with cerebral tumors and 11 with various other types of tumors. Fifty-nine patients underwent surgical resection. Thirty-eight neonates received chemotherapy, administered at a 30 to 50% reduced dose. Hematologic toxicities and infections were the main therapeutic complications. Very small doses of radiotherapy were used in only 5 children. There has been no therapy-related mortality. Twenty-two of the 57 survivors have sequelae, especially patients with intraspinal neuroblastoma. The 5 year overall survival was 79%. Conclusions: Neonatal malignant solid tumors, except for cerebral tumors, have a good prognosis. The young age of patients resulted in problems of treatment tolerance. The therapeutic regimen should take into account the risk of acute iatrogenic toxicity and long term sequelae. Surgery remains the treatment of choice but chemotherapy, with dose reduction, managed by expert teams, is essential and safer in a lot of case. [Copyright &y& Elsevier]

Abstract: Retinoblastoma is the most frequent eye tumor in children, with an incidence of 1/15 000 births. Sixty per cent are unilateral: the median age at diagnosis is 2 years and most of these forms are not hereditary. Retinoblastoma is bilateral in 40%: the median age at diagnosis is 1 year. All bilateral and multifocal unilateral forms are hereditary. Hereditary retinoblastoma constitutes a cancer predisposition syndrome: a subject carrying a constitutional RB1 gene mutation has a greater than 90% risk of developing retinoblastoma, but is also at increased risk of developing secondary cancers. The 2 most frequent revealing symptoms are leucocoria and strabismus. Diagnosis is made by fundoscopy. US, MRI, CT scans may contribute to diagnosis. Management of patients with retinoblastoma must take into account the various aspects of the disease: the visual risk, the possibly hereditary nature of the disease and the life-threatening risk. Enucleation is still often necessary in unilateral disease; adjuvant treatment is decided according to the histological risk factors. Conservative treatment of at least 1 eye is possible in most of the bilateral cases: laser alone or combined with chemotherapy, cryotherapy and brachytherapy. The indication for external beam radiotherapy should be restricted to large ocular tumors and diffuse vitreous seeding because of the risk of late effects, including secondary sarcoma. Long-term follow-up and early information to retinoblastoma patients regarding the risk of second primary tumors and transmission is actually important. [Copyright &y& Elsevier]

Abstract: Objective: To report the indications and early and late catheter-related complications in a Tunisian unit of paediatric oncology. Patients and methods: This prospective study has been performed in a paediatric oncology unit of the Salah Azaïz Institute between 1989 and 2005. It concerns 58 girls and 57 boys with a median age of 7.9 years(4 months to 18 years) treated for cancer disease predominantly lymphoma (22%), sarcoma (23.2%) or leukaemia (8.5%) proposed for insertion of a central venous catheter (CVC). Results: Excluding 2 insertion failures (1.6%), we placed 123 CVC (double for 10 patients), 43 (35%) exteriorised (EC) and 80 (65%) connected to an implantable site (IS). Catheters were placed in the subclavian vein in 59.2% of cases vs 32% for internal jugular vein and 8.8% for femoral vein. Early complications included 15 cases of multiple punctures (12%), 4 cases of pneumothorax (3.2%) and 6 of arterial punctures (4.8%) originating a cervical subcutaneous haematoma in 1 patient (0.8%). Late complications were represented by infection in 7 cases (5.7%). We observed 2 cases of intracardiac catheter migration due to catheter disconnection from the IS (1.6%) and 2 cases of thrombosis (1.8%). The mean life of CVC was longer for IS (305.2 days) than for EC (64.4 days). Conclusion: Implantable sites are effective progress for venous access in children with cancer. They improved the quality of care in pediatric oncology. [Copyright &y& Elsevier]