Introduction

Abstract

Over the past two decades, substantial advances have been made in the treatment of many of the common childhood malignancies. In the 1960s, patients cured of acute lymphocytic leukemia (ALL) were indeed rarities. Now over 90% of newly diagnosed children with ALL will attain remission and 60% will be long-term survivors. Survival rates for Wilms’ tumor, childhood lymphoma, primary bone malignancies, and rhabdomyosarcoma have all improved dramatically over the past 20 years, due in large measure to the development of effective adjuvant chemotherapy regimens. The roles of surgery and radiotherapy have become better delineated. No longer is extensive surgical resection and radical radiotherapy considered mandatory for all children with solid tumors. Rather, mutilating surgery can often be avoided in favor of less radical resection, the judicious use of radiation, and chemotherapy.