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title:Palliative Radiotherapy in the Management of Advanced Pediatric Malignancies

Author:Prashant Kumbhaj, Rameshwaram Sharma, Aseemrai bhatnagar, Peeyush Kumar Saini

Keywords:Palliative Radiotherapy, Paediatric Malignancies

Type:Original Article

Abstract:Purpose: To evaluate the role of palliative radiotherapy in the management of advanced pediatric malignancies. Methods: Patients coming to the department of radiotherapy S.M.S Hospital were included in the study. Out of 40 patients 36 pediatric patients were selected between Nov 2010 to Nov 2012. 4 Patients were excluded from the study. Inclusion Criteria (1) Advanced Pediatric Malignancy (2) Age 1 to 20 yrs (3) Consents of parents (4) Symptomatic Patients.Exclusion Criteria (1) Early stage Disease (2)Asymptomatic Patients(3)Age <1 yrs and >20 yrs(4)No Consent All of theses 36 children received palliative external beam radiotherapy by cobalt 60. . The two dose schedules were used (1) 625cGy in 3 fractions (2) 30 Gy in 10 fractions. Results: There were 26 boys and 10 girls in the age group of 1 to 19 years, with a median age of 14 years (range of 1-19 years). Predominant symptoms were swelling, pain, bleeding, and weakness of limbs. The median duration of symptoms was 80 days (range of 4-40 days). The histological diagnosis was malignant round cell tumors (17); retinoblastoma (6); neuroblastoma (5); and Ewing's sarcoma (8). All patients presented with advanced stages of disease. Out of 36 patients 18 (50%) had disseminated disease at presentation. Some patients underwent surgery and chemotherapy and all patients received palliative radiotherapy. Three patients showed complete resolution, 18 patients showed good, while 14 patients had little, 1 did not have any relief in their symptoms. At the completion of treatment, 16 patients had partial response, 8 patients had progressive disease, 10 had stable disease and 2 patients had complete response. Conclusions: So the role of radiotherapy is very important as palliative modality in children with locally advanced lesions.

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