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Pediatric (Non-CNS) Tumors

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Handbook of Evidence-Based Radiation Oncology

Abstract

This chapter will discuss Wilms’ tumor, neuroblastoma, rhabdomyosarcoma, Ewing’s sarcoma, pediatric Hodgkin’s disease, and retinoblastoma. The number one cause of death in children is accidents (44%), followed by cancer (10%), congenital abnormalities (8%), homicide (5%), and heart disease (4%). Of childhood cancers, leukemias are the most common (∼30%, the majority of which are ALL) followed by CNS neoplasms (∼20%), lymphomas (∼15%, Hodgkin’s > NHL > Burkitt’s lymphoma), neuroblastoma (∼8%), Wilms’ tumor (∼6%), osteosarcoma (∼3%), rhabdomyosarcoma (∼3%), non­r­ha­b­domyo­sarcoma soft-tissue sarcomas (∼3%), Ewing’s sarcoma (∼2%), retinoblastoma (∼2%), and others. Of pediatric CNS neoplasms, gliomas are most common (low-grade astrocytomas ∼35–50%, brainstem gliomas ∼15%, malignant astrocytomas ∼10%, optic pathway gliomas ∼5%), followed by medulloblastoma (∼20%), ependymomas (∼10%), craniopharyngioma (∼5–10%), and germ cell tumors (<5%). These are discussed in (Chapter 2). Whenever possible, we recommend that children be enrolled in cooperative group protocols.

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References

Wilms’Tumor

  • D’Angio GJ, Breslow N, Beckwith JB, et al. Treatment of Wilms’ tumor. Results of the Third National Wilms’ Tumor Study. Cancer 1989;64:349-360.

    Google Scholar 

  • D’Angio GJ, Evans A, Breslow N, et al. The treatment of Wilms’ tumor: results of the Second National Wilms’ Tumor Study. Cancer 1981;47:2302-2311.

    Article  PubMed  Google Scholar 

  • D’Angio GJ, Evans AE, Breslow N, et al. The treatment of Wilms’ tumor: Results of the national Wilms’ tumor study. Cancer 1976;38:633-646.

    Article  PubMed  Google Scholar 

  • Dome JS, Cotton CA, Perlman EJ, et al. Treatment of anaplastic histology Wilms’ tumor: Results from the fifth National Wilms’ Tumor Study. JCO 2006;24(15):2352-2358.

    Article  Google Scholar 

  • Green DM, Breslow NE, Beckwith JB, et al. Comparison between single-dose and divided-dose administration of dactinomycin and doxorubicin for patients with Wilms’ tumor: a report from the National Wilms’ Tumor Study Group. J Clin Oncol 1998;16:237-245.

    PubMed  CAS  Google Scholar 

  • Green DM, Breslow NE, Beckwith JB, et al. Treatment with nephrectomy only for small, stage I/favorable histology Wilms’ tumor: a report from the National Wilms’ Tumor Study Group. J Clin Oncol 2001;19:3719-3724.

    PubMed  CAS  Google Scholar 

  • Grundy PE, Breslow NE, Li S, et al. Loss of heterozygosity for chromosomes 1p and 16q is an adverse prognostic factor in favorable histology Wilms tumor: A report from the National Wilms Tumor Study Group. J Clin Oncol 2005;23:7312-7321.

    Article  PubMed  CAS  Google Scholar 

  • Thomas PR, Tefft M, Compaan PJ, et al. Results of two radiation therapy randomizations in the third National Wilms’ Tumor Study. Cancer 1991;68:1703-1707.

    Article  PubMed  CAS  Google Scholar 

Neuroblastoma

  • Castleberry RP, Kun LE, Shuster JJ, et al. Radiotherapy improves the outlook for patients older than 1 year with Pediatric Oncology Group stage C neuroblastoma. J Clin Oncol 1991;9:789-795.

    PubMed  CAS  Google Scholar 

  • Haas-Kogan DA, Swift PS, Selch M, et al. Impact of radiotherapy for high-risk neuroblastoma: a Children’s Cancer Group study. Int J Radiat Oncol Biol Phys 2003;56:28-39.

    Article  PubMed  Google Scholar 

  • Kun LE. Childhood Cancer. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 913-938.

    Google Scholar 

  • London WB, Castleberry RP, Matthay KK, et al. Evidence for an age cutoff greater than 365 days for Neuroblastoma risk group stratification in the Children’s Oncology Group. J Clin Oncol 2005;23:6459-6465.

    Article  PubMed  CAS  Google Scholar 

  • Mansur DB, Michaelski JM. Neuroblastoma, In: Halperin EC, Perez CA, Brady LW. Principes and practice of radiation oncology. 5th ed. Philadelphia: Lippincott, Williams, and Wilkins; 2008. pp. 1859-1871.

    Google Scholar 

  • Matthay KK, Haas-Kogan D, Constine LS. Neuroblastoma. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation oncology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. pp. 179-222.

    Google Scholar 

  • Matthay KK, Reynolds CP, Seeger RC, et al. Long-term results for children with high-risk neuroblastoma treated on a randomized trial of myeloablative therapy followed by 13-cis-retinoid acid: A Children’s Oncology Group Study. J Clin Oncol 2009;27:1007-1013.

    Article  PubMed  CAS  Google Scholar 

  • Matthay KK, Villablanca JG, Seeger RC, et al. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children’s Cancer Group. N Engl J Med 1999;341:1165-1173.

    Google Scholar 

  • Monclair T, Brodeur GM, Ambro PF, et al. The International Neuroblastoma Risk Group (INRG) staging system: An INRG Task Force Report. J Clin Oncol 2008;27:298-303.

    Article  PubMed  Google Scholar 

  • Nitschke R, Smith EI, Shochat S, et al. Localized neuroblastoma treated by surgery: a Pediatric Oncology Group Study. J Clin Oncol 1988;6:1271-1279.

    PubMed  CAS  Google Scholar 

  • Perez CA, Matthay KK, Atkinson JB, et al. Biologic variables in the outcome of stages I and II neuroblastoma treated with surgery as primary therapy: a children’s cancer group study. J Clin Oncol 2000;18:18-26.

    PubMed  CAS  Google Scholar 

  • Schmidt ML, Lal A, Seeger RC, et al. Favorable prognosis for patients 12 to 18 months of age with stage 4 nonamplified MYCN neuroblastoma: A Children’s Cancer Group Study. J Clin Oncol 2005;23:6474-6480.

    Article  PubMed  CAS  Google Scholar 

  • Spierer M, Tereffe W, Wolden S. Neuroblastoma and Wilms’ Tumor. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1273-1298.

    Google Scholar 

  • Strother D, van Hoff J, Rao PV, et al. Event-free survival of children with biologically favourable neuroblastoma based on the degree of initial tumour resection: results from the Pediatric Oncology Group. Eur J Cancer 1997;33:2121-2125.

    Article  PubMed  CAS  Google Scholar 

  • Wolden S. Neuroblastoma. In:Gunderson LL, Tepper JE, editors. Clinical ­radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007 pp. 1637-1643.

    Google Scholar 

Rhabdomyosarcoma

  • Arndt CA, Stoner JA, Hawkins DS, et al. Vincristine, actinomycin, and cyclophosphamide compared with vincristine, actinomycin, and cyclophosphamide alternating with vincristine, topotecan, and cyclophosphamide for intermediate-risk rhabdomyosarcoma: children’s oncology group study D9803. J Clin Oncol. 2009;27(31):5182-5188.

    Article  PubMed  CAS  Google Scholar 

  • Bloch LE, Pappo AS. Pediatric soft tissue sarcomas. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007. pp 1593-1603.

    Google Scholar 

  • Breitfeld PP, Lyden E, Raney RB, et al. Ifosfamide and etoposide are superior to vincristine and melphalan for pediatric metastatic rhabdomyosarcoma when administered with irradiation and combination chemotherapy: a report from the Intergroup Rhabdomyosarcoma Study Group. J Pediatr Hematol Oncol 2001;23:225-233.

    Article  PubMed  CAS  Google Scholar 

  • Breneman JC, Donaldson SS. Rhabdomyosarcoma. In: Halperin EC, Perez CA, Brady LW. Principes and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1872-1885.

    Google Scholar 

  • Crist W, Gehan EA, Ragab AH, et al. The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 1995;13:610-630.

    PubMed  CAS  Google Scholar 

  • Crist WM, Anderson JR, Meza JL, et al. Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. J Clin Oncol 2001;19:3091-3102.

    PubMed  CAS  Google Scholar 

  • Friedmann AM, Tarbell NJ, Constine LS. Rhabdomyosarcoma. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation onco­logy. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. pp. 319-346.

    Google Scholar 

  • Kun LE. Childhood Cancer. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 913-938.

    Google Scholar 

  • Maurer HM, Beltangady M, Gehan EA, et al. The Intergroup Rhabdomyosarcoma Study-I. A final report. Cancer 1988;61:209-220.

    CAS  Google Scholar 

  • Maurer HM, Gehan EA, Beltangady M, et al. The Intergroup Rhabdomyosarcoma Study-II. Cancer 1993;71:1904-1922.

    Article  PubMed  CAS  Google Scholar 

  • Wharam Jr. MD. Pediatric Bone and Soft Tissue Tumors. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1251-1272.

    Google Scholar 

Ewing’S sarcoma

  • Donaldson SS, Torrey M, Link MP, et al. A multidisciplinary study investigating radiotherapy in Ewing’s sarcoma: end results of POG no. 8346. Pediatric Oncology Group. Int J Radiat Oncol Biol Phys 1998;42:125-135.

    Google Scholar 

  • Dunst J, Jurgens H, Sauer R, et al. Radiation therapy in Ewing’s sarcoma: an update of the CESS 86 trial. Int J Radiat Oncol Biol Phys 1995;32:919-930.

    Article  PubMed  CAS  Google Scholar 

  • Evans RG, Nesbit ME, Gehan EA, et al. Multimodal therapy for the management of localized Ewing’s sarcoma of pelvic and sacral bones: a report from the second intergroup study. J Clin Oncol 1991;9:1173-1180.

    PubMed  CAS  Google Scholar 

  • Grier HE, Krailo MD, Tarbell NJ, et al. Addition of ifosfamide and etoposide to standard chemotherapy for Ewing’s sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med 2003;348:694-701.

    Article  PubMed  CAS  Google Scholar 

  • Marcus KJ, Tarbell NJ. Ewing’s Sarcoma. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation oncology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. pp. 271-290.

    Google Scholar 

  • Marcus KJ, Marcus Jr RB. Ewing Tumor. In: Halperin EC, Perez CA, Brady LW. Principes and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1886-1891.

    Google Scholar 

  • Nesbit ME, Jr., Gehan EA, Burgert EO, Jr., et al. Multimodal therapy for the management of primary, nonmetastatic Ewing’s sarcoma of bone: a long-term follow-up of the First Intergroup study. J Clin Oncol 1990;8:1664-1674.

    PubMed  Google Scholar 

  • Paulussen M, Ahrens S, Dunst J, et al. Localized Ewing tumor of bone: final results of the cooperative Ewing’s Sarcoma Study CESS 86. J Clin Oncol 2001;19:1818-1829.

    PubMed  CAS  Google Scholar 

  • Paulussen M, Craft AW, Lewis I, et al. Results of the EICESS-92 Study: Two randomized trials of Ewing’s Sarcoma treatment – Cyclophosphamide compared with ifosfamide in standard-risk patients and assessment of benefit of etoposide added to standard treatment in high-risk patients. J Clin Oncol 2008;27:4385-4393.

    Article  Google Scholar 

  • Schuck A, Ahrens S, Paulussen M, et al. Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. Int J Radiat Oncol Biol Phys 2003;55:168-177.

    Article  PubMed  Google Scholar 

  • Schuck A. Pediatric sarcomas of bone. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007. pp. 1605-1612.

    Google Scholar 

  • Wharam Jr. MD. Pediatric Bone and Soft Tissue Tumors. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1251-1272.

    Google Scholar 

Pediatric Hodgkin’s Lymphoma

  • Asselin B, Hudson M, Mandell LR, et al. Pediatric Leukemias and Lymphomas. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1215-1251.

    Google Scholar 

  • Donaldson SS, Link MP, Weinstein HJ, et al. Final results of a prospective clinical trial with VAMP and low-dose involved-field radiation for children with low-risk Hodgkins disease. J Clin Oncol 2007;25:332-337.

    Article  PubMed  CAS  Google Scholar 

  • Greene FL, American Joint Committee on Cancer., American Cancer Society. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag; 2002.

    Google Scholar 

  • Hudson MM, Constine LS. Hodgkin’s Disease. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation oncology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. pp. 223-260.

    Google Scholar 

  • Hudson MM, Krasin N, Link MP, et al. Risk-adapted, combined-modality therapy with VAMP/COPP and response-based, involved-field radiation for unfavorable pediatric Hodgkins disease. J Clin Oncol 2004;22:4541-4550.

    Article  PubMed  CAS  Google Scholar 

  • Hudson MM, Asselin BL, Constine LS. Lymphomas in children. In: Halperin EC, Perez CA, Brady LW. Principes and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1892-1912.

    Google Scholar 

  • Hudson MM, Constine LS. Pediatric hodgkin’s lymphomas. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007. pp. 1657-1663.

    Google Scholar 

  • Nachman JB, Sposto R, Herzog P, et al. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 2002;20:3765-3771.

    Article  PubMed  Google Scholar 

  • Ruhl U, Albrecht M, Dieckmann K, et al. Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD 95 trial. Int J Radiat Oncol Biol Phys 2001;51:1209-1218.

    Article  PubMed  CAS  Google Scholar 

  • Ruhl U, Albrecht MR, Lueders H, et al. The German multinational GPOH-HD 95 trial: Treatment results and analysis of failures in pediatric Hodgkins disease using combination chemotherapy with and without radiation. Int J Radiat Oncol Biol Phys 2004;60:S131.

    Google Scholar 

Retinoblastoma

  • Abramson DA, McCormick B, Schefler AC. Retinoblastoma. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1463-1482.

    Google Scholar 

  • Freire JE, Kolton MM, Brady LW. Eye and Orbit. In: Halperin EC, Perez CA, Brady LW. Principes and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 778-799.

    Google Scholar 

  • Halperin EC, Kirkpatrick JP. Retinoblastoma. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation oncology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. pp. 135-178.

    Google Scholar 

  • Kun LE. Childhood Cancer. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 913-938.

    Google Scholar 

  • Lavey RS. Retinoblastoma. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007. pp. 1625-1636.

    Google Scholar 

  • Reese AB, Ellsworth RM. The evaluation and current concept of retinoblastoma therapy. Trans Am Acad Ophthalmol Otolaryngol 1963;67:164.

    PubMed  CAS  Google Scholar 

Further Reading

  • Bleyer WA. The U.S. pediatric cancer clinical trials programmes: international implications and the way forward. Eur J Cancer 1997;33:1439-1447.

    Google Scholar 

  • Faria P, Beckwidth JB, Mishra K, et al. Focal versus diffuse anaplasia in Wilms Tumor: New definitions with prognostic significance. A Report from the National Wilms Tumor Study Group. Am J Surg Pathol 1996;20:909-920.

    CAS  Google Scholar 

  • George RE, London WB, Cohn SL, et al. Hyperdiploidy plus nonamplified MYCN confers a favorable prognosis in children 12 to 18 months old with disseminated neuroblastoma: A Pediatric Oncology Group Study. J Clin Oncol 2005;23:6466-6473.

    Article  PubMed  CAS  Google Scholar 

  • Halperin EC. Wilms’ Tumor. In: Halperin EC, Constine LS, Tarbell NJ, et al., editors. Pediatric radiation oncology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. pp. 379-422.

    Google Scholar 

  • Kalapurakal J, Thomas PRM. Wilms’ Tumor. In: Perez CA, Brady LW, Halperin EC, et al., editors. Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1850-1858.

    Google Scholar 

  • Kalapurakal J, Thomas PRM. Wilms’ Tumor. In: Gunderson LL, Tepper JE, editors. Clinical ­radiation oncology, 2nd ed. Philadelphia: Churchill Livingston; 2007. pp 1613-1623.

    Google Scholar 

  • Kun LE. Childhood Cancer. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, ­technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 913-938.

    Google Scholar 

  • Spierer M, Tereffe W, Wolden S. Neuroblastoma and Wilms’ Tumor. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 1273-1298.

    Google Scholar 

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Authors and Affiliations

  1. Radiation Oncology, University of California San Francisco, San Francisco, CA, USA

    Stuart Y. Tsuji MD, PhD, Linda W. Chan MD & Daphne A. Haas-Kogan MD

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  1. Stuart Y. Tsuji MD, PhD
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  2. Linda W. Chan MD
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  3. Daphne A. Haas-Kogan MD
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Editors and Affiliations

  1. Div. Radiation Oncology, Oregon Clinic, SW. Barnes Rd. 9205, Portland, 97225, Oregon, USA

    Eric K. Hansen

  2. Department of Radiation Oncology, University of California, San Francisco, Divisadero Street, Suite H-1031 1600, San Francisco, 94143, California, USA

    Mack Roach

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Tsuji, S.Y., Chan, L.W., Haas-Kogan, D.A. (2010). Pediatric (Non-CNS) Tumors. In: Hansen, E., Roach, M. (eds) Handbook of Evidence-Based Radiation Oncology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92988-0_41

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