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  1. Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

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    Yimei Li

    Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

  2. Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report.

    Science.gov (United States)

    Chow, Eric J; Anderson, Lynnette; Baker, K Scott; Bhatia, Smita; Guilcher, Gregory M T; Huang, Jennifer T; Pelletier, Wendy; Perkins, Joanna L; Rivard, Linda S; Schechter, Tal; Shah, Ami J; Wilson, Karla D; Wong, Kenneth; Grewal, Satkiran S; Armenian, Saro H; Meacham, Lillian R; Mulrooney, Daniel A; Castellino, Sharon M

    2016-05-01

    Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies, solid tumors, and, increasingly, nonmalignant diseases. Given improvements in care, there are a growing number of long-term survivors of pediatric HCT. Compared with childhood cancer survivors who did not undergo transplantation, HCT survivors have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pretransplantation treatment exposures and organ dysfunction, the transplantation conditioning regimen, and any post-transplantation graft-versus-host disease (GVHD). In response, the Children's Oncology Group (COG) has created long-term follow-up guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those who were treated with HCT. Guideline task forces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other health care professionals, and patient advocates systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided herein is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those who underwent transplantation for nonmalignant diseases, and those with a history of chronic GVHD. PMID

  3. Current calibration, treatment, and treatment planning techniques among institutions participating in the Children's Oncology Group

    International Nuclear Information System (INIS)

    Purpose: To report current technology implementation, radiation therapy physics and treatment planning practices, and results of treatment planning exercises among 261 institutions belonging to the Children's Oncology Group (COG). Methods and Materials: The Radiation Therapy Committee of the newly formed COG mandated that each institution demonstrate basic physics and treatment planning abilities by satisfactorily completing a questionnaire and four treatment planning exercises designed by the Quality Assurance Review Center. The planning cases are (1) a maxillary sinus target volume (for two-dimensional planning), (2) a Hodgkin's disease mantle field (for irregular-field and off-axis dose calculations), (3) a central axis blocked case, and (4) a craniospinal irradiation case. The questionnaire and treatment plans were submitted (as of 1/30/02) by 243 institutions and completed satisfactorily by 233. Data from this questionnaire and analyses of the treatment plans with monitor unit calculations are presented. Results: Of the 243 clinics responding, 54% use multileaf collimators routinely, 94% use asymmetric jaws routinely, and 13% use dynamic wedges. Nearly all institutions calibrate their linear accelerators following American Association of Physicists in Medicine protocols, currently 16% with TG-51 and 81% with TG-21 protocol. Treatment planning systems are relied on very heavily for all calculations, including monitor units. Techniques and results of each of the treatment planning exercises are presented. Conclusions: Together, these data provide a unique compilation of current (2001) radiation therapy practices in institutions treating pediatric patients. Overall, the COG facilities have the equipment and the personnel to perform high-quality radiation therapy. With ongoing quality assurance review, radiation therapy compliance with COG protocols should be high

  4. Late effects on the urinary bladder in patients treated for cancer in childhood: a report from the Children's Oncology Group.

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    Ritchey, Michael; Ferrer, Fernando; Shearer, Patricia; Spunt, Sheri L

    2009-04-01

    Childhood cancer survivors who have had pelvic or central nervous system surgery or have received alkylator-containing chemotherapy or pelvic radiotherapy as part of their cancer therapy may experience urinary bladder late effects. This article reviews the medical literature on long-term bladder complications in survivors of childhood cancer and outlines the Children's Oncology Group Long-Term Follow-up (COG LTFU) Guidelines related to bladder function. An overview of the treatment of bladder late effects and recommended counseling for survivors with these complications are presented. PMID:18985721

  5. Reconsidering Physical Activity Restrictions for Mononephric Survivors of Childhood Cancer: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Okada, Maki; Hockenberry, Marilyn J; Koh, Chester J; Meeske, Kathleen A; Rangan, Kasey E; Rodgers, Cheryl; Rosenthal, Yael; Ruccione, Kathleen S; Freyer, David R

    2016-07-01

    Although traditional recommendations for mononephric childhood cancer survivors are to avoid contact sports in order to protect the remaining kidney, review of available evidence suggests that the majority of renal loss is caused by accidents not involving sports. An interdisciplinary team performed a review of the English literature published from 1999 to 2012 within the PubMed, Cochrane, Google Scholar, and National Guidelines Clearinghouse databases. The level of evidence and proposed recommendations were graded according to an established rubric and GRADE criteria. Our review found that kidney loss is most commonly caused by nonsports activities such as motor vehicle accidents and falls, implying that restrictions on sports-related activity in mononephric pediatric survivors are not well supported. This favors encouraging ordinary sports and related activities without restriction in mononephric childhood cancer survivors because the known benefits of exercise outweigh the exceedingly low risk of renal loss. Accordingly, activity recommendations for mononephric patients have been revised in the most current version of the Children's Oncology Group Long-term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers. This has important implications for this and similar populations who may now undertake individual and organized sports without undue regard for their mononephric status. PMID:26589357

  6. Family history of cancer and risk of pediatric and adolescent Hodgkin lymphoma: A Children's Oncology Group study.

    Science.gov (United States)

    Linabery, Amy M; Erhardt, Erik B; Richardson, Michaela R; Ambinder, Richard F; Friedman, Debra L; Glaser, Sally L; Monnereau, Alain; Spector, Logan G; Ross, Julie A; Grufferman, Seymour

    2015-11-01

    Family history of lymphoid neoplasm (LN) is a strong and consistently observed Hodgkin lymphoma (HL) risk factor, although it has been only marginally examined in pediatric/adolescent patients. Here, healthy control children identified by random digit dialing were matched on sex, race/ethnicity and age to HL cases diagnosed at 0-14 years at Children's Oncology Group institutions in 1989-2003. Detailed histories were captured by structured telephone interviews with parents of 517 cases and 783 controls. Epstein-Barr virus (EBV) RNA detection was performed for 355 available case tumors. Two analytic strategies were applied to estimate associations between family cancer history and pediatric/adolescent HL. In a standard case-control approach, multivariate conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (CIs). In a reconstructed cohort approach, each relative was included as a separate observation, and multivariate proportional hazards regression was used to produce hazard ratios (HRs) and 95% CIs. Using the latter, pediatric/adolescent HL was associated with a positive family history (HR = 1.20, 95% CI: 1.06-1.36), particularly early-onset cancers (HR = 1.30, 95% CI: 1.06-1.59) and those in the paternal lineage (HR = 1.38, 95% CI: 1.16-1.65), with a suggested association for LN in first-degree relatives (HR = 3.61, 95% CI: 0.87-15.01). There were no discernable patterns for EBV+ versus EBV- HL. The clustering of LN within pedigrees may signal shared genetic susceptibility or common environmental exposures. Heritable genetic risk variants have only recently begun to be discovered, however. These results are consistent with other studies and provide a compelling rationale for family-based studies to garner information about genetic susceptibility to HL. PMID:25940226

  7. Prognostic implications of the IDH1 synonymous SNP rs11554137 in pediatric and adult AML: a report from the Children's Oncology Group and SWOG

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    Ho, Phoenix A.; Kopecky, Kenneth J.; Alonzo, Todd A.; Gerbing, Robert B.; Miller, Kristen L.; Kuhn, Julia; Zeng, Rong; Ries, Rhonda E.; Raimondi, Susana C; Hirsch, Betsy A.; Oehler, Vivian; Hurwitz, Craig A.; Franklin, Janet L.; Gamis, Alan S.; Petersdorf, Stephen H.

    2011-01-01

    IDH1 SNP rs11554137 was recently reported in association with poor prognosis in normal karyotype adult acute myeloid leukemia (AML). We aimed to determine the prevalence, clinical associations, and prognostic significance of SNP rs11554137 in unselected pediatric and adult AML patients. Diagnostic marrow specimens from 527 AML patients treated on the pediatric trial Children's Oncology Group-AAML03P1 (N = 253) or adult SWOG trials (N = 274) were analyzed for the presence of the SNP. SNP rs115...

  8. Analysis of NF-B Pathway Proteins in Pediatric Hodgkin Lymphoma: Correlations with EBV Status and Clinical Outcome—A Children's Oncology Group Study

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    Horton, Terzah M.; Sheehan, Andrea M.; Dolores López-Terrada; Hutchison, Robert E.; Sonia Narendra; Meng-Fen Wu; Hao Liu

    2012-01-01

    Constitutively active nuclear factor-κB (NF-κB) is integral to the survival of Hodgkin/Reed-Sternberg cells (H/RS) in Hodgkin lymphoma (HL). To investigate NF-κB pathway proteins in pediatric HL, we utilized a tissue microarray compiled from 102 children enrolled in the Children's Oncology Group intermediate-risk clinical trial AHOD0031 (56 male, 78 Caucasian, median age 15 years (range 1–20 years), 85 nodular sclerosing subtype, 23 Epstein-Barr virus (EBV) positive, and 24 refractory/relapse...

  9. Effectiveness of high-dose methotrexate in T-cell lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma: a randomized study by the Children's Oncology Group (POG 9404)

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    Asselin, Barbara L; Devidas, Meenakshi; Wang, Chenguang; Pullen, Jeanette; Borowitz, Michael J.; Hutchison, Robert; Lipshultz, Steven E.; Camitta, Bruce M.

    2011-01-01

    The Pediatric Oncology Group (POG) phase 3 trial 9404 was designed to determine the effectiveness of high-dose methotrexate (HDM) when added to multi-agent chemotherapy based on the Dana-Farber backbone. Children with T-cell acute lymphoblastic leukemia (T-ALL) or advanced lymphoblastic lymphoma (T-NHL) were randomized at diagnosis to receive/not receive HDM (5 g/m2 as a 24-hour infusion) at weeks 4, 7, 10, and 13. Between 1996 and 2000, 436 patients were enrolled in the methotrexate randomiz...

  10. A comparison of discharge strategies after chemotherapy completion in pediatric patients with acute myeloid leukemia: a report from the Children's Oncology Group.

    Science.gov (United States)

    Miller, Tamara P; Getz, Kelly D; Kavcic, Marko; Li, Yimei; Huang, Yuan-Shun V; Sung, Lillian; Alonzo, Todd A; Gerbing, Robert; Daves, Marla; Horton, Terzah M; Pulsipher, Michael A; Pollard, Jessica; Bagatell, Rochelle; Seif, Alix E; Fisher, Brian T; Gamis, Alan S; Aplenc, Richard

    2016-07-01

    While most children receive acute myeloid leukemia (AML) chemotherapy as inpatients, there is variability in timing of discharge after chemotherapy completion. This study compared treatment-related morbidity, mortality and cumulative hospitalization in children with AML who were discharged after chemotherapy completion (early discharge) and those who remained hospitalized. Chart abstraction data for 153 early discharge-eligible patients enrolled on a Children's Oncology Group trial were compared by discharge strategy. Targeted toxicities included viridans group streptococcal (VGS) bacteremia, hypoxia and hypotension. Early discharge occurred in 11% of courses post-Induction I. Re-admission occurred in 80-100%, but median hospital stay was 7 days shorter. Patients discharged early had higher rates of VGS (adjusted risk ratio (aRR) = 1.67, 95% CI = 1.11-2.51), hypoxia (aRR = 1.92, 95% CI = 1.06-3.48) and hypotension (aRR = 4.36, 95% CI = 2.01-9.46), but there was no difference in mortality. As pressure increases to shorten hospitalizations, these results have important implications for determining discharge practices in pediatric AML. PMID:26727639

  11. Local Control With Reduced-Dose Radiotherapy for Low-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group D9602 Study

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    Breneman, John, E-mail: john.breneman@uchealth.com [Department of Radiation Oncology, University of Cincinnati and Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Meza, Jane [Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, NE (United States); Donaldson, Sarah S. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Raney, R. Beverly [Children' s Cancer Hospital and Division of Pediatrics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Children' s Ambulatory Blood and Cancer Center, Dell Children' s Medical Center of Central Texas, Austin, TX (United States); Wolden, Suzanne [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, RI (United States); Rodeberg, David A. [Department of Surgery, East Carolina University, Greenville, NC (United States); Meyer, William [Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Walterhouse, David [Division of Hematology/Oncology, Children' s Memorial Medical Center, Chicago, IL (United States); Hawkins, Douglas S. [Department of Pediatrics, Seattle Children' s Hospital, University of Washington, Seattle, WA (United States)

    2012-06-01

    Purpose: To analyze the effect of reduced-dose radiotherapy on local control in children with low-risk rhabdomyosarcoma (RMS) treated in the Children's Oncology Group D9602 study. Methods and Materials: Patients with low-risk RMS were nonrandomly assigned to receive radiotherapy doses dependent on the completeness of surgical resection of the primary tumor (clinical group) and the presence of involved regional lymph nodes. After resection, most patients with microscopic residual and uninvolved nodes received 36 Gy, those with involved nodes received 41.4 to 50.4 Gy, and those with orbital primary tumors received 45 Gy. All patients received vincristine and dactinomycin, with cyclophosphamide added for patient subsets with a higher risk of relapse in Intergroup Rhabdomyosarcoma Study Group III and IV studies. Results: Three hundred forty-two patients were eligible for analysis; 172 received radiotherapy as part of their treatment. The cumulative incidence of local/regional failure was 15% in patients with microscopic involved margins when cyclophosphamide was not part of the treatment regimen and 0% when cyclophosphamide was included. The cumulative incidence of local/regional failure was 14% in patients with orbital tumors. Protocol-specified omission of radiotherapy in girls with Group IIA vaginal tumors (n = 5) resulted in three failures for this group. Conclusions: In comparison with Intergroup Rhabdomyosarcoma Study Group III and IV results, reduced-dose radiotherapy does not compromise local control for patients with microscopic tumor after surgical resection or with orbital primary tumors when cyclophosphamide is added to the treatment program. Girls with unresected nonbladder genitourinary tumors require radiotherapy for postsurgical residual tumor for optimal local control to be achieved.

  12. Local Therapy for Rhabdomyosarcoma of the Hands and Feet: Is Amputation Necessary? A Report From the Children's Oncology Group

    International Nuclear Information System (INIS)

    Purpose: To evaluate the outcome of children with rhabdomyosarcoma (RMS) of the hand or foot treated with surgery and/or local radiotherapy (RT). Methods and Materials: Forty-eight patients with nonmetastatic RMS of the hand or foot were enrolled on Intergroup Rhabdomyosarcoma Study III, IV-Pilot, and IV. Patients received multiagent chemotherapy with surgery and/or RT. Twenty-four patients (50%) underwent surgery without local RT, of whom 4 had complete resection and 20 had an amputation. The remaining 24 patients (50%) underwent local RT, of whom 2 required RT for microscopic residual disease after prior amputation. Median follow-up for surviving patients was 9.7 years. Results: Actuarial 10-year local control was 100%; 10-year event-free survival and overall survival rates were 62% and 63%, respectively. Poor prognostic factors for recurrence included gross residual (Group III) disease and nodal involvement (p = 0.01 and 0.05, respectively). More patients in the RT group had alveolar histology, Group III disease, and nodal involvement, as compared with the surgery group. There was no difference in 10-year event-free survival (57% vs. 66%) or overall survival (63% vs. 63%) between patients who underwent surgery or local RT. Among relapsing patients, there were no long-term survivors. No secondary malignancies have been observed. Conclusions: Despite having high-risk features, patients treated with local RT achieved excellent local control. Complete surgical resection without amputation is difficult to achieve in the hand or foot. Therefore, we recommend either definitive RT or surgical resection that maintains form and function as primary local therapy rather than amputation in patients with hand or foot RMS.

  13. A Pilot Study of Intensified PEG-Asparaginase in High-risk Acute Lymphoblastic Leukemia: Children's Oncology Group Study AALL08P1.

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    Rodriguez, Vilmarie; Kairalla, John; Salzer, Wanda L; Raetz, Elizabeth A; Loh, Mignon Lc; Carroll, Andrew J; Heerema, Nyla A; Wood, Brent L; Borowitz, Michael J; Burke, Michael J; Asselin, Barbara L; Devidas, Meenakshi; Winick, Naomi J; Carroll, William L; Hunger, Stephen P; Dreyer, ZoAnn E

    2016-08-01

    AALL08P1 was designed to determine whether biweekly intensified pegaspargase (I-PEG) was feasible and safe in pediatric patients with newly diagnosed high-risk B-precursor lymphoblastic leukemia when given with Children's Oncology Group hemiaugmented BFM therapy. High-risk average (HR-Avg) patients received standard pegaspargase dosing (6 doses), whereas high-risk high (HR-High) patients received I-PEG biweekly from the start of Consolidation until day 1 of Maintenance. Feasibility and safety were defined in advance as ≥65% of patients tolerating at least 8 doses of I-PEG and 90% requiring ≤49 weeks from day 1 of Consolidation to the initiation of Maintenance. Targeted toxicities included allergic reactions, anaphylaxis, pancreatitis, thrombosis, bleeding, central nervous system events, and sepsis. AALL08P1 enrolled 104 patients; 54 were classified as HR-Avg and 30 as HR-High after completion of induction therapy. Only 53% (16/30) of the HR-High patients received ≥8 total doses of I-PEG and 50% (15/30) took ≤49 weeks from start of Consolidation to the initiation of Maintenance. I-PEG did not significantly increase grade 2 to 5 targeted toxicities. I-PEG was not feasible or safe as defined in AALL08P1. Complete assessment of this regimen was limited due to removal of patients from I-PEG regimen and early closure of the study. PMID:27299599

  14. Local Control and Outcome in Children with Localized Vaginal Rhabdomyosarcoma: A Report from the Soft Tissue Sarcoma Committee of the Children’s Oncology Group

    Science.gov (United States)

    Walterhouse, David O.; Meza, Jane L.; Breneman, John C.; Donaldson, Sarah S.; Hayes-Jordan, Andrea; Pappo, Alberto S.; Arndt, Carola; Raney, R. Beverly; Meyer, William H.; Hawkins, Douglas S.

    2012-01-01

    Background The local control approach for girls with non-resected vaginal rhabdomyosarcoma (RMS) enrolled onto Intergroup RMS Study Group (IRSG)/Children’s Oncology Group (COG) studies has differed from that used at other primary sites by delaying or eliminating radiotherapy (RT) based on response achieved with chemotherapy and delayed primary resection. Procedures We reviewed locoregional treatment and outcome for patients with localized RMS of the vagina on the two most recent COG low-risk RMS studies. Results Forty-one patients with localized vaginal RMS were enrolled: 25 onto D9602 and 16 onto Subset 2 of ARST0331. Only four of the 39 with non-resected tumors received RT. The 5-year cumulative incidence of local recurrence was 26% on D9602, and the 2-year cumulative incidence of local recurrence was 43% on ARST0331. Increased local failure rates appeared to correlate with chemotherapy regimens that incorporated lower cumulative doses of cyclophosphamide. Estimated 5-year and 2-year failure free survival rates were 70% (95% CI: 46%, 84%) on D9602 and 42% (95% CI: 11%, 70%) on ARST0331, respectively. Conclusions To prevent local recurrence, we recommend a local control approach for patients with non-resected RMS of the vagina that is similar to that used for other primary sites and includes RT. We recognize that potential long-term effects of RT are sometimes unacceptable, especially for children less than 24 months of age. However, when making the decision to eliminate RT, the risk of local recurrence must be considered especially when using a chemotherapy regimen with a total cumulative cyclophosphamide dose of ≤ 4.8 g/m2. PMID:21298768

  15. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

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    Servaes, Sabah [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Khanna, Geetika [Washington University School of Medicine, Pediatric Radiology, St. Louis Children' s Hospital, Mallinckrodt Institute for Radiology, 510 S. Kingshighway, Campus Box 8131-MIR, St. Louis, MO (United States); Naranjo, Arlene [University of Florida, Department of Biostatistics, Gainesville, FL (United States); Geller, James I. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cincinnati, OH (United States); Ehrlich, Peter F. [University of Michigan, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Gow, Kenneth W. [Seattle Children' s Hospital, Pediatric Surgery, Seattle, WA (United States); Perlman, Elizabeth J. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Pathology, Chicago, IL (United States); Dome, Jeffrey S. [Children' s National Medical Center, Center for Cancer and Blood Disorders, Washington, DC (United States); Gratias, Eric; Mullen, Elizabeth A. [Harvard University, Dana Farber Cancer Institute and Boston Children' s Hospital, Boston, MA (United States)

    2014-08-19

    CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P = 0.73), while specificity was 86.5% and 83.8% (P = 1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P = 0.22), and specificity was 90.4% and 92.3% (P = 1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco-regional staging of pediatric renal tumors. (orig.)

  16. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    International Nuclear Information System (INIS)

    CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P = 0.73), while specificity was 86.5% and 83.8% (P = 1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P = 0.22), and specificity was 90.4% and 92.3% (P = 1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco-regional staging of pediatric renal tumors. (orig.)

  17. Randomized use of cyclosporin A (CsA) to modulate P-glycoprotein in children with AML in remission: Pediatric Oncology Group Study 9421

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    Becton, David; Dahl, Gary V.; Ravindranath, Yaddanapudi; Chang, Myron N.; Behm, Fred G.; Raimondi, Susana C; Head, David R.; Stine, Kimo C.; Lacayo, Norman J.; Sikic, Branimir Ivan; Arceci, Robert J.; Weinstein, Howard

    2006-01-01

    Relapse is a major obstacle in the cure of acute myeloid leukemia (AML). The Pediatric Oncology Group AML Study 9421 tested 2 different strategies to improve event-free survival (EFS) and overall survival (OS). Patients were randomized to receive standard-dose DAT (daunorubicin, cytarabine, and thioguanine) or high-dose DAT during induction. To interfere with P-glycoprotein (P-gp)-dependent drug efflux, the second randomization tested the benefit of cyclosporine (CsA) added to consolidation c...

  18. Influence of Noncompliance With Radiation Therapy Protocol Guidelines and Operative Bed Recurrences for Children With Rhabdomyosarcoma and Microscopic Residual Disease: A Report From the Children's Oncology Group

    International Nuclear Information System (INIS)

    Purpose: Postoperative radiation therapy (RT) is recommended for patients with rhabdomyosarcoma having microscopic disease. Sometimes RT dose/volume is reduced or omitted in an attempt to avoid late effects, particularly in young children. We reviewed operative bed recurrences to determine if noncompliance with RT protocol guidelines influenced local-regional control. Methods and Materials: All operative bed recurrences among 695 Group II rhabdomyosarcoma patients in Intergroup Rhabdomyosarcoma Study Group (IRS) I through IV were reviewed for deviation from RT protocol. Major/minor dose deviation was defined as >10% or 6-10% of the prescribed dose (40-60 Gy), respectively. Major/minor volume deviation was defined as tumor excluded from the RT field or treatment volume not covered by the specified margin (preoperative tumor volume and 2- to 5-cm margin), respectively. No RT was a major deviation. Results: Forty-six of 83 (55%) patients with operative bed recurrences did not receive the intended RT (39 major and 7 minor deviations). RT omission was the most frequent RT protocol deviation (19/46, 41%), followed by dose (17/46, 37%), volume (9/46, 20%), and dose and volume deviation (1/46, 2%). Only 7 operative bed recurrences occurred in IRS IV (5% local-regional failure) with only 3 RT protocol deviations. Sixty-three (76%) patients with recurrence died of disease despite retrieval therapy, including 13 of 19 nonirradiated children. Conclusion: Over half of the operative bed recurrences were associated with noncompliance; omission of RT was the most common protocol deviation. Three fourths of children die when local-regional disease is not controlled, emphasizing the importance of RT in Group II rhabdomyosarcoma.

  19. Survival and secondary tumors in children with medulloblastoma receiving radiotherapy and adjuvant chemotherapy: results of Children's Oncology Group trial A9961

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    PACKER, ROGER J.; Zhou, Tianni; Holmes, Emi; Vezina, Gilbert; Gajjar, Amar

    2012-01-01

    The purpose of the trial was to determine the survival and incidence of secondary tumors in children with medulloblastoma receiving radiotherapy plus chemotherapy. Three hundred seventy-nine eligible patients with nondisseminated medulloblastoma between the ages of 3 and 21 years were treated with 2340 cGy of craniospinal and 5580 cGy of posterior fossa irradiation. Patients were randomized between postradiation cisplatin and vincristine plus either CCNU or cyclophosphamide. Survival, pattern...

  20. Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group

    Science.gov (United States)

    Bhatia, Smita; Landier, Wendy; Shangguan, Muyun; Hageman, Lindsey; Schaible, Alexandra N.; Carter, Andrea R.; Hanby, Cara L.; Leisenring, Wendy; Yasui, Yutaka; Kornegay, Nancy M.; Mascarenhas, Leo; Ritchey, A. Kim; Casillas, Jacqueline N.; Dickens, David S.; Meza, Jane; Carroll, William L.; Relling, Mary V.; Wong, F. Lennie

    2012-01-01

    Purpose Systemic exposure to mercaptopurine (MP) is critical for durable remissions in children with acute lymphoblastic leukemia (ALL). Nonadherence to oral MP could increase relapse risk and also contribute to inferior outcome in Hispanics. This study identified determinants of adherence and described impact of adherence on relapse, both overall and by ethnicity. Patients and Methods A total of 327 children with ALL (169 Hispanic; 158 non-Hispanic white) participated. Medication event-monitoring system caps recorded date and time of MP bottle openings. Adherence rate, calculated monthly, was defined as ratio of days of MP bottle opening to days when MP was prescribed. Results After 53,394 person-days of monitoring, adherence declined from 94.7% (month 1) to 90.2% (month 6; P < .001). Mean adherence over 6 months was significantly lower among Hispanics (88.4% v 94.8%; P < .001), patients age ≥ 12 years (85.8% v 93.1%; P < .001), and patients from single-mother households (80.6% v 93.1%; P = .001). A progressive increase in relapse was observed with decreasing adherence (reference: adherence ≥ 95%; 94.9% to 90%: hazard ratio [HR], 4.1; 95% CI,1.2 to 13.5; P = .02; 89.9% to 85%: HR, 4.0; 95% CI, 1.0 to 15.5; P = .04; < 85%: HR. 5.7; 95% CI, 1.9 to 16.8; P = .002). Cumulative incidence of relapse (± standard deviation) was higher among Hispanics (16.5% ± 4.0% v 6.3% ± 2.2%; P = .02). Association between Hispanic ethnicity and relapse (HR, 2.6; 95% CI, 1.1 to 6.1; P = .02) became nonsignificant (HR, 1.8; 95% CI, 0.6 to 5.2; P = .26) after adjusting for adherence and socioeconomic status. At adherence rates ≥ 90%, Hispanics continued to demonstrate higher relapse, whereas at rates < 90%, relapse risk was comparable to that of non-Hispanic whites. Conclusion Lower adherence to oral MP increases relapse risk. Ethnic difference in relapse risk differs by level of adherence—an observation currently under investigation. PMID:22564992

  1. Prospective, longitudinal assessment of quality of life in children from diagnosis to 3 months off treatment for standard risk acute lymphoblastic leukemia: Results of Children's Oncology Group study AALL0331.

    Science.gov (United States)

    Mitchell, Hannah-Rose; Lu, Xiaomin; Myers, Regina M; Sung, Lillian; Balsamo, Lyn M; Carroll, William L; Raetz, Elizabeth; Loh, Mignon L; Mattano, Leonard A; Winick, Naomi J; Devidas, Meenakshi; Hunger, Stephen P; Maloney, Kelly; Kadan-Lottick, Nina S

    2016-01-15

    Standard risk acute lymphoblastic leukemia (SR-ALL) has high cure rates, but requires 2-3 years of therapy. We aimed to (i) prospectively evaluate health-related quality of life (HRQOL) during and after SR-ALL therapy, and (ii) identify associated predictors. Parents of 160 SR-ALL patients enrolled on Children's Oncology Group (COG) therapeutic trial AALL0331 at 31 sites completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (physical, emotional and social functioning) and Family Assessment Device-General Functioning (FAD-GF) at 1, 6 and 12 months after diagnosis, and 3 months post-therapy. Mean PedsQL scores in physical, emotional and social functioning were impaired 1 month after diagnosis but steadily improved. Three months post-therapy, impaired physical and social functioning was observed in 27.8 and 25.8% of patients, respectively. In repeated-measures analysis, problematic family functioning predicted emotional (OR = 1.85, 95% CI 1.03-3.34) and social (OR = 1.99, 95% CI 1.21-3.27) impairment. Larger household size was associated with social impairment (OR = 1.21, 95% CI 1.02-1.45). Adverse neurological event(s) during therapy predicted post-therapy physical (OR = 5.17, 95% CI 1.61-16.63) and social (OR = 8.17, 95% CI 1.19-56.16) impairment. HRQOL 1 month after diagnosis was not predictive of HRQOL 3 months after therapy completion. In conclusion, children with SR-ALL experience considerable impairment in HRQOL at the end of induction, but rapidly improve. However, many still experience physical and social impairment 3 months post-therapy, suggesting a role for continued family and physical functioning support. Longer follow-up is needed to determine if post-therapy deficits change over time. PMID:26235006

  2. Bloodstream infections in children with cancer: a multicentre surveillance study of the Italian Association of Paediatric Haematology and Oncology. Supportive Therapy Group-Infectious Diseases Section.

    Science.gov (United States)

    Viscoli, C; Castagnola, E; Giacchino, M; Cesáro, S; Properzi, E; Tucci, F; Mura, R M; Alvisi, P; Zanazzo, G; Surico, G; Bonetti, F; De Sio, L; Izzi, G; Di Cataldo, A; Ziino, O; Massolo, F; Nardi, M; Santoro, N; Binda, S

    1999-05-01

    A one-year prospective, multicentre surveillance study on aetiology, main clinical features and outcome of bloodstream infections in children with cancer was conducted in 18 paediatric haematology centres belonging to the Italian Association for Paediatric Haematology and Oncology. A total of 191 bloodstream infections were reported during the study period. Of them, 123 (64%) occurred in neutropenic and 68 (36%) in non-neutropenic patients. Gram-positive cocci caused 45% (85/191) of the episodes, gram-negative rods 41% (78/191), and fungi 9% (18/191). The remaining 5% (10/191) of the episodes were poly-microbial infections. A total of 204 pathogens were isolated (46% gram-positive cocci; 44% gram-negative rods; and 10% fungi). The aetiologic distribution was similar among neutropenic and non-neutropenic patients. A correlation between the infection and the presence of an indwelling central venous catheter was found in 20% (23/114) of the episodes among neutropenic patients and in 55% (23/62) among non-neutropenic patients. Gram-negative micro-organisms were isolated in an unusually high proportion of catheter-related infections (48%). The overall mortality rate from any cause within 30 days from the first positive blood culture was 11%, and was higher among patients who were neutropenic at the onset of the infection than among those who were not neutropenic (15 versus 4%, P = 0.03). In addition, the mortality was significantly higher in recipients of bone marrow transplantation than in patients with acute leukaemia or solid tumour (21, 11 and 6%, respectively) and was also higher in fungaemias and poly-microbial infections (22 and 30%) than in single gram-positive and gram-negative bacteraemias (11 and 6%). PMID:10505037

  3. Equivalence of intrathecal chemotherapy and radiotherapy as central nervous system prophylaxis in children with acute lymphatic leukemia: a pediatric oncology group study

    International Nuclear Information System (INIS)

    The efficacy of intrathecal (i.t.) chemoprophylaxis was compared with cranial radiotherapy plus i.t. methotrexate (MTX) in a Southwest Oncology Group (SWOG) study accessing 408 patients from September 10, 1974, to October 29, 1976. Randomization was stratified by prognostic groups (PGs) based on age and white blood cell count at diagnosis. All received induction therapy with vincristine and prednisone (Pred); maintenance therapy consisted of daily 6-mercaptopurine and weekly MTX. Consolidation for arm 1 employed cyclophosphamide and L-asparaginase followed by biwekly 5-day courses of parenteral MTX. The first dose of each course of MTX was given i.t. in triple chemoprophylaxis (MTX, hydrocortisone, and cytosine arabinoside). During maintenance, i.t. chemoprophylaxis was bimonthly and 28-day Pred ''pulses'' were given every 3 mo. Arm 2 i.t. chemoprophylaxis was initiated on achievement of remission, and arm 3 i.t. on treatment day 1; both continued 1 yr. Arm 4 induction included two doses of L-asparaginase. On achievement of remission, CNS prophylaxis (radiotherapy, 2400 rad plus i.t. MTX) was given. For all, therapy was discontinued after 3 yr of continuous complete remission. Survival and the incidence of extramedullary relapse were similar for the treatment employing either i.t. chemoprophylaxis or radiotherapy plus i.t. MTX upon achievement of remission. The study indicates that i.t. chemoprophylaxis may be substituted for cranial radiotherapy when utilizing effective systemic regimens. Additionally, chemoprophylaxis may be reduced from 3 to 1 yr in patients with good prognostic factors

  4. Caregiving demands and well-being in parents of children treated with outpatient or inpatient methotrexate infusion: A report from the Children’s Oncology Group

    OpenAIRE

    Kelly, Katherine Patterson; Wells, Diane Keegan; Chen, Lu; Reeves, Elaine; Mass, Ellen; Camitta, Bruce; Hinds, Pamela S.

    2014-01-01

    Parent well-being is affected by their child’s oncology treatment regimen and associated caregiving demand. Parental caregiving demands and well-being were evaluated in 161 parents from 47 sites whose child was randomized to receive either a 4-hour (outpatient) or 24-hour (inpatient) methotrexate infusion during consolidation treatment for acute lymphoblastic leukemia (ALL). A majority of patients randomized to the 4-hour infusion (66.3%) received the infusion as an inpatient. The most freque...

  5. Rasburicase in the prevention of laboratory/clinical tumour lysis syndrome in children with advanced mature B-NHL: A Children’s Oncology Group Report

    OpenAIRE

    Galardy, Paul; Hochberg, Jessica; Perkins, Sherrie L.; Harrison, Lauren; Goldman, Stanton; Cairo, Mitchell S

    2013-01-01

    Laboratory (LTLS) and clinical (CTLS) tumour lysis syndrome (TLS) are frequent complications in newly diagnosed children with advanced mature B cell non-Hodgkin lymphoma (B-NHL). Rasburicase, compared to allopurinol, results in more rapid reduction of uric acid in paediatric patients at risk for TLS. However, the safety and efficacy of rasburicase for the treatment or or prevention of TLS has not been prospectively evaluated. Children with newly diagnosed stage III–IV, bone marrow+ and/or cen...

  6. About the Community Oncology and Prevention Trials Research Group | Division of Cancer Prevention

    Science.gov (United States)

    The Community Oncology and Prevention Trials Research Group supports clinical oncology trials in cancer prevention and control in community settings. The group also supports investigator-initiated research projects in supportive, palliative and end-of-life care, and coordinates clinical oncology research projects with other NCI programs to be done in the community setting. |

  7. Outcome After First Relapse in Children With Acute Lymphoblastic Leukemia : A Report Based on the Dutch Childhood Oncology Group (DCOG) Relapse ALL 98 Protocol

    NARCIS (Netherlands)

    van den Berg, H.; de Groot-Kruseman, H. A.; Damen-Korbijn, C. M.; de Bont, E. S. J. M.; Schouten-van Meeteren, A. Y. N.; Hoogerbrugge, P. M.

    2011-01-01

    Background. We report on the treatment of children and adolescents with acute lymphoblastic leukemia (ALL) in first relapse. The protocol focused on: (1) Intensive chemotherapy preceding allogeneic stem cell transplantation (SCT) in early bone marrow relapse; (2) Rotational chemotherapy in late rela

  8. Outcome after first relapse in children with acute lymphoblastic leukemia: a report based on the Dutch Childhood Oncology Group (DCOG) relapse all 98 protocol

    NARCIS (Netherlands)

    Berg, H. van den; Groot-Kruseman, H.A. de; Damen-Korbijn, C.M.; Bont, E.S. de; Schouten-van Meeteren, A.Y.; Hoogerbrugge, P.M.

    2011-01-01

    BACKGROUND: We report on the treatment of children and adolescents with acute lymphoblastic leukemia (ALL) in first relapse. The protocol focused on: (1) Intensive chemotherapy preceding allogeneic stem cell transplantation (SCT) in early bone marrow relapse; (2) Rotational chemotherapy in late rela

  9. Reasons for non-completion of health related quality of life evaluations in pediatric acute myeloid leukemia: a report from the Children's Oncology Group.

    Directory of Open Access Journals (Sweden)

    Donna L Johnston

    Full Text Available BACKGROUND: Health related quality of life (HRQL assessments during therapy for pediatric cancer are important. The objective of this study was to describe reasons for failure to provide HRQL assessments during a pediatric acute myeloid leukemia (AML clinical trial. METHODS: We focused on HRQL assessments embedded in a multicenter pediatric AML clinical trial. The PedsQL 4.0 Generic Core Scales, PedsQL 3.0 Acute Cancer Module, PedsQL Multidimensional Fatigue Scale, and Pediatric Inventory for Parents were obtained from parent/guardian respondents at a maximum of six time points. Children provided self-report optionally. A central study coordinator contacted sites with delinquent HRQL data. Reasons for failure to submit the HRQL assessments were evaluated by three pediatric oncologists and themes were generated using thematic analysis. RESULTS: There were 906 completed and 1091 potential assessments included in this analysis (83%. The median age of included children was 12.9 years (range 2.0 to 18.9. The five themes for non-completion were: patient too ill; passive or active refusal by respondent; developmental delay; logistical challenges; and poor knowledge of study processes from both the respondent and institutional perspective. CONCLUSIONS: We identified reasons for non-completion of HRQL assessments during active therapy. This information will facilitate recommendations to improve study processes and future HRQL study designs to maximize response rates.

  10. Motexafin-Gadolinium and Involved Field Radiation Therapy for Intrinsic Pontine Glioma of Childhood: A Children's Oncology Group Phase 2 Study

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Kristin A., E-mail: bradley@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Zhou Tianni [Department of Preventive Medicine, University of Southern California, Los Angeles, California (United States); McNall-Knapp, Rene Y. [Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Jakacki, Regina I. [Division of Pediatric Hematology/Oncology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Levy, Adam S. [Division of Pediatric Hematology/Oncology, Children' s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York (United States); Vezina, Gilbert [Department of Radiology, Children' s National Medical Center, George Washington University School of Medicine, Washington, DC (United States); Pollack, Ian F. [Department of Neurosurgery, Children' s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2013-01-01

    Purpose: To evaluate the effects on 1-year event-free survival (EFS) and overall survival (OS) of combining motexafin and gadolinium (MGd), a potent radiosensitizer, with daily fractionated radiation therapy in children with newly diagnosed intrinsic pontine gliomas. Methods and Materials: Patients with newly diagnosed intrinsic pontine glioma were treated with MGd daily for 5 consecutive days each week, for a total of 30 doses. Patients received a 5- to 10-min intravenous bolus of MGd, 4.4 mg/kg/day, given 2 to 5 h prior to standard dose irradiation. Radiation therapy was administered at a daily dose of 1.8 Gy for 30 treatments over 6 weeks. The total dose was 54 Gy. Results: Sixty eligible children received MGd daily, concurrent with 6 weeks of radiation therapy. The estimated 1-year EFS was 18% {+-} 5%, and the estimated 1-year OS was 53% {+-} 6.5%. The most common grade 3 to 4 toxicities were lymphopenia, transient elevation of liver transaminases, and hypertension. Conclusions: Compared to historical controls, the addition of MGd to a standard 6-week course of radiation did not improve the survival of pediatric patients with newly diagnosed intrinsic pontine gliomas.

  11. Motexafin-Gadolinium and Involved Field Radiation Therapy for Intrinsic Pontine Glioma of Childhood: A Children's Oncology Group Phase 2 Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effects on 1-year event-free survival (EFS) and overall survival (OS) of combining motexafin and gadolinium (MGd), a potent radiosensitizer, with daily fractionated radiation therapy in children with newly diagnosed intrinsic pontine gliomas. Methods and Materials: Patients with newly diagnosed intrinsic pontine glioma were treated with MGd daily for 5 consecutive days each week, for a total of 30 doses. Patients received a 5- to 10-min intravenous bolus of MGd, 4.4 mg/kg/day, given 2 to 5 h prior to standard dose irradiation. Radiation therapy was administered at a daily dose of 1.8 Gy for 30 treatments over 6 weeks. The total dose was 54 Gy. Results: Sixty eligible children received MGd daily, concurrent with 6 weeks of radiation therapy. The estimated 1-year EFS was 18% ± 5%, and the estimated 1-year OS was 53% ± 6.5%. The most common grade 3 to 4 toxicities were lymphopenia, transient elevation of liver transaminases, and hypertension. Conclusions: Compared to historical controls, the addition of MGd to a standard 6-week course of radiation did not improve the survival of pediatric patients with newly diagnosed intrinsic pontine gliomas.

  12. Evolution and accomplishments of the radiation therapy oncology group

    International Nuclear Information System (INIS)

    Purpose: The Radiation Therapy Oncology Group (RTOG) recently completed its first quarter century as a cooperative clinical cancer research organization. It is timely and appropriate to document its origins, evolution, and accomplishments. Methods and Materials: The historical review of the RTOG called upon written and oral documentation. Results: The RTOG is the most enduring product of the Committee for Radiation Therapy Studies (CRTS). Although not one of the original 17 clinical trials groups developed by the National Cancer Institute in 1956, the RTOG has pursued trials suggested by laboratory findings including the oxygen effect, intrinsic radiosensitivity, proliferation kinetics of normal and tumor cells, and interactions with other cytotoxic agents. Improvements in survival have been demonstrated for patients with carcinoma of the esophagus and cervix, and nonsmall cell carcinomas of the lung. The national and international radiation oncology communities have benefited from standards and quality control/assurance guidelines for established and new modalities. A growing number of institutions in North America participate in RTOG trials. Conclusion: The RTOG is an important clinical research resource, which has contributed to improved outcome for patients with many forms of cancer. It has become increasingly productive and widely adopted and endorsed by oncologists throughout North America

  13. Vesicular monoamine transporter protein expression correlates with clinical features, tumor biology, and MIBG avidity in neuroblastoma: a report from the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Temple, William; Mendelsohn, Lori; Nekritz, Erin; Gustafson, W.C.; Matthay, Katherine K. [UCSF School of Medicine, Department of Pediatrics, San Francisco, CA (United States); UCSF Benioff Children' s Hospital, San Francisco, CA (United States); Kim, Grace E. [UCSF School of Medicine, Department of Pathology, San Francisco, CA (United States); Lin, Lawrence; Giacomini, Kathy [UCSF School of Pharmacy, Department of Bioengineering and Therapeutic Sciences, San Francisco, CA (United States); Naranjo, Arlene; Van Ryn, Collin [University of Florida, Children' s Oncology Group Statistics and Data Center, Gainesville, FL (United States); Yanik, Gregory A. [University of Michigan, CS Mott Children' s Hospital, Ann Arbor, MI (United States); Kreissman, Susan G. [Duke University Medical Center, Durham, NC (United States); Hogarty, Michael [University of Pennsylvania, Children' s Hospital of Philadelphia and Perelman School of Medicine, Philadelphia, PA (United States); DuBois, Steven G. [UCSF School of Medicine, Department of Pediatrics, San Francisco, CA (United States); UCSF Benioff Children' s Hospital, San Francisco, CA (United States); UCSF School of Medicine, San Francisco, CA (United States)

    2016-03-15

    Vesicular monoamine transporters 1 and 2 (VMAT1 and VMAT2) are thought to mediate MIBG uptake in adult neuroendocrine tumors. In neuroblastoma, the norepinephrine transporter (NET) has been investigated as the principal MIBG uptake protein, though some tumors without NET expression concentrate MIBG. We investigated VMAT expression in neuroblastoma and correlated expression with MIBG uptake and clinical features. We evaluated VMAT1 and VMAT2 expression by immunohistochemistry (IHC) in neuroblastoma tumors from 76 patients with high-risk metastatic disease treated in a uniform cooperative group trial (COG A3973). All patients had baseline MIBG diagnostic scans centrally reviewed. IHC results were scored as the product of intensity grading (0 - 3+) and percent of tumor cells expressing the protein of interest. The association between VMAT1 and VMAT2 scores and clinical and biological features was tested using Wilcoxon rank-sum tests. Patient characteristics were typical of high-risk neuroblastoma, though the cohort was intentionally enriched in patients with MIBG-nonavid tumors (n = 20). VMAT1 and VMAT2 were expressed in 62 % and 75 % of neuroblastoma tumors, respectively. VMAT1 and VMAT2 scores were both significantly lower in MYCN amplified tumors and in tumors with high mitotic karyorrhectic index. MIBG-avid tumors had significantly higher VMAT2 scores than MIBG-nonavid tumors (median 216 vs. 45; p = 0.04). VMAT1 expression did not correlate with MIBG avidity. VMAT1 and VMAT2 are expressed in the majority of neuroblastomas. Expression correlates with other biological features. The expression level of VMAT2 but not that of VMAT1 correlates with avidity for MIBG. (orig.)

  14. Vesicular monoamine transporter protein expression correlates with clinical features, tumor biology, and MIBG avidity in neuroblastoma: a report from the Children's Oncology Group

    International Nuclear Information System (INIS)

    Vesicular monoamine transporters 1 and 2 (VMAT1 and VMAT2) are thought to mediate MIBG uptake in adult neuroendocrine tumors. In neuroblastoma, the norepinephrine transporter (NET) has been investigated as the principal MIBG uptake protein, though some tumors without NET expression concentrate MIBG. We investigated VMAT expression in neuroblastoma and correlated expression with MIBG uptake and clinical features. We evaluated VMAT1 and VMAT2 expression by immunohistochemistry (IHC) in neuroblastoma tumors from 76 patients with high-risk metastatic disease treated in a uniform cooperative group trial (COG A3973). All patients had baseline MIBG diagnostic scans centrally reviewed. IHC results were scored as the product of intensity grading (0 - 3+) and percent of tumor cells expressing the protein of interest. The association between VMAT1 and VMAT2 scores and clinical and biological features was tested using Wilcoxon rank-sum tests. Patient characteristics were typical of high-risk neuroblastoma, though the cohort was intentionally enriched in patients with MIBG-nonavid tumors (n = 20). VMAT1 and VMAT2 were expressed in 62 % and 75 % of neuroblastoma tumors, respectively. VMAT1 and VMAT2 scores were both significantly lower in MYCN amplified tumors and in tumors with high mitotic karyorrhectic index. MIBG-avid tumors had significantly higher VMAT2 scores than MIBG-nonavid tumors (median 216 vs. 45; p = 0.04). VMAT1 expression did not correlate with MIBG avidity. VMAT1 and VMAT2 are expressed in the majority of neuroblastomas. Expression correlates with other biological features. The expression level of VMAT2 but not that of VMAT1 correlates with avidity for MIBG. (orig.)

  15. Comprehensive rehabilitation of post-oncologic children in Belarus

    International Nuclear Information System (INIS)

    Full text: The incidence of child disability resulting from malignant tumors has been constantly high at fourth place, characterized by considerable severity and duration. The high degree and length of disability induced by oncological diseases in children subsequently lead to the formation of high, sometimes lifelong, social disadaptation. At the same time the recent improvements in effectiveness of treatment of malignant tumors in children have contributed to a significant improvement (over 70%) in the long-term survival rate among children, which is clearly linked with the introduction of modern treatment methods. According to data of the Childhood cancer subregistry of Belarus, a total of 6,485 cases of malignant tumors were registered in children aged 0-19 years over the period 1986 through 2005, of which 4,288 were alive as of January 1, 2006. The above data are indicative of the need for a comprehensive medical, psychological, professional and overall social rehabilitation of children who have been treated for oncological diseases. Development of a program of comprehensive rehabilitation for such children should be inherently linked with the existing principles of rehabilitation. An early startup and complex character of the rehabilitation process are particularly critical to the success. An early startup of medical, social, psychological and pedagogical rehabilitation measures helps prevent the establishment of a disability-minded personality, which, in case of positive treatment, leads to social deficiency of the child, enduring into the adulthood. The child's personality is formed under the pressure of oncologically-induce fears, excessive care by the relatives, preferential treatment, etc. which highly impacts on his/her abilities to be a full-fledged and rightful member of the society, thereby thwarting the medical outcomes. Therefore, rehabilitation of children who have survived oncological diseases should not be limited to their functional disorders

  16. Anti-CD13 antibodies in children with extensive chronic graft-versus-host disease and their relation to soluble CD13 after allogeneic blood and marrow transplantation from a Children's Oncology Groups Study, ASCT0031

    OpenAIRE

    Cuvelier, Geoff D.E.; Kariminia, Amina; Fujii, Hisaki; Aslanian, Soudabeh; Wall, Donna; Goldman, Fred; Grupp, Stephan A.; Dunn, Sandra E.; Krailo, Mark; Shapiro, Linda H.; Gilman, Andrew; Schultz, Kirk R.

    2010-01-01

    Our group previous demonstrated a strong association between elevated plasma soluble CD13 enzyme activity and newly diagnosed extensive chronic graft-versus-host disease (cGVHD) in children. Since cytotoxic anti-CD13 antibodies have been documented after blood and marrow transplant in association with cytomegalovirus infection and cGVHD, we hypothesized soluble CD13 contributes to cGVHD pathogenesis by induction of CD13 reactive antibodies and that anti-CD13 antibodies could be additional bio...

  17. Ethnic group and survival from childhood cancer: report from the UK Children's Cancer Study Group

    OpenAIRE

    Stiller, C A; Bunch, K. J.; Lewis, I. J.

    2000-01-01

    Survival following cancer was analysed in relation to ethnic group among children diagnosed in Britain during 1981–1996 and treated at paediatric oncology centres by members of the UK Children's Cancer Study Group. Survival was analysed for 11 diagnostic groups: acute lymphoblastic leukaemia (ALL), acute non-lymphocytic leukaemia, Hodgkin's disease, non-Hodgkin's lymphoma, astrocytoma, primitive neuroectodermal tumour, neuroblastoma, Wilms' tumour, osteosarcoma, Ewing's sarcoma and rhabdomyos...

  18. Keep in Mind Quality of Life: Outcome of a Ten-Year Series of Post-Transplantation Early Relapses in Childhood Acute Lymphoblastic Leukemia-A Report from the Grand Ouest Oncology Study Group for Children in France.

    Science.gov (United States)

    Haro, Sophie; Tavenard, Aude; Rialland, Fanny; Taque, Sophie; Guillerm, Gaelle; Blouin, Pascale; Esvan, Maxime; Pellier, Isabelle; Gandemer, Virginie

    2016-05-01

    Relapses of acute lymphoblastic leukemia (ALL) early after hematopoietic stem cell transplantations in children are uncommon but associated with a very poor prognosis. Whereas there are no current recommendations for the management of these relapses, the children's quality of life is an important issue. We studied the outcomes, including 1-year overall survival, complete remission, and quality of life, of 19 children with ALL who relapsed within the first year after their transplantation treated in the 5 participating centers between 2000 and 2011 Patients were distributed as follows: supportive care only (group A), outpatient treatment (mainly steroid and vincristine, group B), or intensive inpatient treatment (group C). There were no significant differences in 1-year overall survival (31.5% for the entire cohort) or remission rate for time between transplantation and relapse (treatment group. However, time spent in hospital (for treatment and complications) significantly differed between treatment groups B and C (20.8% ± 13.0 versus 59.1% ± 32.9, respectively; P treatment groups. Our sample size-limited data indicate, in a prepersonalized medicine era, that children treated with steroid and vincristine have the same prognosis as those treated with intensive therapy, but they may benefit from improved quality of life. Nevertheless, new therapeutic strategies are required and future prospective trials would help to establish recommendations. PMID:26845034

  19. Radiation oncology training in the United States: report from the Radiation Oncology Resident Training Working Group organized by the Society of Chairman of Academic Radiation Oncology Programs (SCAROP)

    International Nuclear Information System (INIS)

    Purpose: In response to the major changes occurring in healthcare, medical education, and cancer research, SCAROP addressed issues related to post-graduate education that could enhance existing programs and complement the present system. Methods and Materials: SCAROP brought together a Working Group with a broad range of representatives organized in subcommittees to address: training, curriculum, and model building. Results: The Working Group emphasized the importance of training physicians with the necessary clinical, scientific, and analytical skills, and the need to provide expert radiation oncology services to patients throughout the United States. Opportunities currently exist for graduates in academic medicine, although there may be limited time and financial resources available to support academic pursuits. Conclusions: In the face of diminishing resources for training and education and the increased scope of knowledge required, a number of models for resident training are considered that can provide flexibility to complement the present system. This report is intended to initiate dialogue among the organizations responsible for radiation oncology resident education so that resident training can continually evolve to meet the needs of cancer patients and take advantage of opportunities for progress through innovative cancer care and research

  20. Group Therapy with Patients in the Waiting Room of an Oncology Clinic.

    Science.gov (United States)

    Arnowitz, Edward; And Others

    1983-01-01

    Describes a therapy group for cancer patients, conducted by cotherapists in an oncology waiting room. Group members provided mutual support and shared concerns and coping methods. Medical staff members became more involved and were more able to address the affective needs of the patients and their families. (JAC)

  1. Group Counseling for Navy Children.

    Science.gov (United States)

    Mitchum, Nancy Taylor

    1991-01-01

    Conducted six-session group counseling program for Navy children (n=22) enrolled in public schools whose fathers were on deployment. Pretest and posttest scores on the Coopersmith Self-Esteem Inventory suggest that participation in the group counseling unit positively affected self-esteem of Navy children whose fathers were on deployment. Found…

  2. Postgraduate Training in Clinical Oncology. Report on a WHO Working Group (The Hague, The Netherlands, December 6-8, 1978).

    Science.gov (United States)

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    The 1978 report of the Working Group of Postgraduate Training in Clinical Oncology, convened by the World Health Organization (WHO) Regional Office for Europe in collaboration with the government of The Netherlands, is presented. The groups analyzed models of postgraduate training in clinical oncology and evaluated their suitability in relation to…

  3. Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

    Directory of Open Access Journals (Sweden)

    Vivek Arora

    2010-11-01

    Full Text Available Vivek Arora, Shannon Philp, Kathryn Nattress, Selvan Pather, Christopher Dalrymple, Kenneth Atkinson, Sofia Smirnova, Stephen Cotterell, Jonathan CarterSydney Gynecological Oncology Group, Royal Prince Alfred Hospital, University of Sydney, Sydney, AustraliaPurpose: Patient satisfaction with the provision of hospital oncology services can have a significant impact on their overall treatment experience.Aims: To assess patient satisfaction with the inpatient hospital services in the gynecological oncology setting using the IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC.Methods: A modified version of the IN-PATSAT32 questionnaire with additional 16 items was administered to 52 adult surgical inpatients admitted with the Sydney Gynecological Oncology Group. All participants were provided with an information leaflet regarding the survey and written consent obtained.Results: A high response rate (100% from patients with varied social, ethnic, and educational backgrounds confirmed the acceptability of the survey. Standard of medical care provided, frequency of doctors’ visits, exchange of information with doctors, friendliness of the staff, and state of the room ranked highly (>95% on the patient satisfaction scales. Problems were identified with ease of access to and within the hospital, quality of food, and exchange of information with other hospital staff.Conclusions: Overall the satisfaction with inpatient care was rated very highly in most areas. Deficiencies in certain elements of provision of medical care to the patients were identified and steps have been taken to improve upon these shortcomings.Keywords: patient satisfaction, EORTC, IN-PATSAT32, gynecological oncology, survey

  4. Non-oncology physician visits after diagnosis of cancer in children

    OpenAIRE

    Heins, M.J.; Lorenzi, M.F.; Korevaar, J. C.; McBride, M. L.

    2016-01-01

    Background: Children diagnosed with cancer often require extensive care for medical, psychosocial and educational problems during and after therapy. Part of this care is provided by family physicians and non-cancer specialists, but their involvement in the first years after diagnosis has barely been studied. Studying non-oncology physician visits may provide insight into the roles of different health care providers. Methods: We included 757 children diagnosed with cancer under age 15 between ...

  5. A Phase II Study of Preradiotherapy Chemotherapy Followed by Hyperfractionated Radiotherapy for Newly Diagnosed High-Risk Medulloblastoma/Primitive Neuroectodermal Tumor: A Report From the Children's Oncology Group (CCG 9931)

    International Nuclear Information System (INIS)

    Purpose: To verify feasibility and monitor progression-free survival and overall survival in children with high-risk medulloblastoma and noncerebellar primitive neuroectodermal tumors (PNETs) treated in a Phase II study with preradiotherapy chemotherapy (CHT) followed by high-dose, hyperfractionated craniospinal radiotherapy (CSRT). Methods and Materials: Eligibility criteria included age >3 years at diagnosis, medulloblastoma with either high M stage and/or >1.5 cm2 postoperative residual disease, and all patients with noncerebellar PNET. Treatment was initiated with five alternating monthly cycles of CHT (A [cisplatin, cyclophosphamide, etoposide, and vincristine], B [carboplatin and etoposide], A, B, and A) followed by hyperfractionated CSRT (40 Gy) with a boost to the primary tumor (72 Gy) given in twice-daily 1-Gy fractions. Results: The valid study group consisted of 124 patients whose median age at diagnosis was 7.8 years. Eighty-four patients (68%) completed the entire protocol according to study guidelines (within 9 months), and the median time to complete CSRT was 1.6 months. Major reasons for failure to complete CHT included progressive disease (17%) and toxic death (2.4%). The 5-year progression-free survival and overall survival rates were 43% ± 5% and 52% ± 5%, respectively. No significant differences were detected in subset analysis related to response to CHT, site of primary tumor, postoperative residual disease, or M stage. Conclusions: The feasibility of this intensive multimodality protocol was confirmed, and response to pre-RT CHT did not impact on survival. Survival data from this protocol can not be compared with data from other studies, given the protocol design.

  6. Radiation therapy oncology group: 3-D CRT quality assurance guidelines

    International Nuclear Information System (INIS)

    Purpose: Guidelines to conduct multi-institutional three-dimensional conformal radiation therapy (3-D CRT) clinical trials are needed as the modality emerges from a single institution procedure to a research tool in multi-institution clinical group trials. The guidelines are used (1) to ensure that participating institutions have the proper equipment and appropriate techniques to administer 3D CRT; (2) to define a standard data set to be submitted to a review center for each treated patient to assess protocol compliance; and (3) to establish a quality assurance (QA) review process of the submitted data. Materials and Methods: Computer hardware and software components have been implemented which allow the digital data transfer (via either the Internet or magnetic tape), display, manipulation, and storage of a 3D CRT protocol patient treatment planning and image data set for QA review. Each participating institution is required to complete a 3D CRT Facility Questionnaire and submit it to the RTOG 3-D QA Center prior to enrolling patients on a 3-D CRT protocol. In addition, a protocol 'dry run' test has been designed to demonstrate each participating institutions' ability to submit a protocol compliant data set prior to placing patients on a 3D CRT study. This dry run test involves the digital transfer of all protocol required data and the supporting hard copy documentation excepting simulation or portal films/images. Results: The 3D CRT Facility Questionnaire includes descriptions of: (1) linac model, collimation system and energies to be used; (2) isocenter accuracy for gantry, collimator, and couch rotations; (3) type of immobilization repositioning system and patient motion studies if required by protocol (set-up uncertainty, organ movement); and (4) treatment verification system(s). The 3-D RTP system must have the following capabilities: (1) ability to handle at least 40 axial CT slices; (2) beam's-eye-view (BEV) display; (3) calculate 3-D dose matrices; (4

  7. Laser therapy and phototherapy in complex treatment of children's oncological diseases

    Science.gov (United States)

    Tsigankin, V. I.; Balakirev, S. A.; Atroshchenko, V. I.; Belousov, N. N.; Ivanov, Andrei V.

    1996-01-01

    The application of the laser therapy and phototherapy with utilization of High Intensive Impulse Laser Therapeutic Unit and High Intensive Impulse Light Therapeutic Unit has created new side prospects in treatment of side-effects and complications when treating oncological diseases and a great number of non-tumoral diseases of adults as well as children. The application of the laser therapy and phototherapy in complex treatment of children's oncological diseases has shown that this method has a significant antiinflammatory and anaesthetic effect as well as powerful regenerative influence on tissues. Its application decreases considerably the duration of treatment of complications when treating children's malignant tumors and enables to keep to scheduled terms of complex treatment.

  8. Distribution of ABO blood group in children with acute leukemias

    Directory of Open Access Journals (Sweden)

    Meliha Sakić

    2012-12-01

    Full Text Available Introduction: This study is the fi rst study about the distribution ABO blood types at children with acute leukemia in Federation of Bosnia and Herzegovina. The aim of the study is to point out distribution of blood type groups at children with acute leukemia (ALMethods: The number of children in this study was the following: 145 children with acute leukemia and 27 of children with acute myeloblastic leukemia (AML. All of the children were treated at Hemato- Oncology Unitof Pediatric Clinic in Sarajevo, in the period January 2000 until December 2010. Age of children was between 1 month and 15 years.Results: The results showed that different blood types were registered in 93. 1% of children who got ill and treated from acute leukemia for the mentioned period. At 6. 9 % of children, none of the blood types wereregistered. It was noticed that 40.9 % children who have registered blood type O, 37% blood type A,16% blood type B and 6.5% blood type AB had AL, too. It has been observed that children with following bloodtypes had AML: O, 47.8%, A, 47.7% and AB, 30.4%.Conclusion: Signifi cance ABO types distribution was confi rmed for children with ALL, p<0, 05. The analysis of the distribution of ABO types based on gender showed that signifi cance was confi rmed at females with both ALL and AML (p<0.05.

  9. Minimal Disease Assessment in the Treatment of Children and Adolescents with Intermediate-Risk (Stage III/IV) B-Cell Non-Hodgkin Lymphoma: A Children’s Oncology Group Report

    OpenAIRE

    Shiramizu, Bruce; Goldman, Stanton; Kusao, Ian; Agsalda, Melissa; Lynch, James; Smith, Lynette; Harrison, Lauren; Morris, Erin; Gross, Thomas G.; Sanger, Warren; Perkins, Sherrie; Cairo, Mitchell S

    2011-01-01

    Children/adolescents with mature B-cell non-Hodgkin lymphoma (B-NHL) have an excellent prognosis but relapses still occur. While chromosomal aberrations and/or clonal immunoglobulin (Ig) gene rearrangements may indicate risk of failure, a more universal approach was developed to detect minimal disease (MD). Children/adolescents with intermediate-risk B-NHL were treated with French-British-American/Lymphome Malins de Burkitt 96 (FAB/LMB96) B4 modified chemotherapy and rituximab. Specimens from...

  10. Strategy of medical, psychological and social rehabilitation for children with haematological and oncological diseases

    Directory of Open Access Journals (Sweden)

    N. N. Volodin

    2015-06-01

    Full Text Available Advances in the treatment of children with hematological and oncological diseases have led to accumulation of disabled children with severe organic and functional disorders that require the development of medical, neurocognitive, physical and psycho-social rehabilitation of these patients. On the basis of literature and own data about late effects and long-term results of treatment the concept of multidisciplinary rehabilitation, providing individual development, rehabilitation, education and social adaptation of sick children has been formulated.

  11. Phase 2 trial design in neuro-oncology revisited: a report from the RANO group.

    Science.gov (United States)

    Galanis, Evanthia; Wu, Wenting; Cloughesy, Timothy; Lamborn, Kathleen; Mann, Bhupinder; Wen, Patrick Y; Reardon, David A; Wick, Wolfgang; Macdonald, David; Armstrong, Terri S; Weller, Michael; Vogelbaum, Michael; Colman, Howard; Sargent, Daniel J; van den Bent, Martin J; Gilbert, Mark; Chang, Susan

    2012-05-01

    Advances in the management of gliomas, including the approval of agents such as temozolomide and bevacizumab, have created an evolving therapeutic landscape in glioma treatment, thus affecting our ability to reliably use historical controls to comparatively assess the activity of new therapies. Furthermore, the increasing availability of novel, targeted agents--which are competing for a small patient population, in view of the low incidence of primary brain tumours--draws attention to the need to improve the efficiency of phase 2 clinical testing in neuro-oncology to expeditiously transition the most promising of these drugs or combinations to potentially practice-changing phase 3 trials. In this report from the Response Assessment in Neurooncology (RANO) group, we review phase 2 trial designs that can address these challenges and capitalise on scientific and clinical advances in brain tumour treatment in neuro-oncology to accelerate and optimise the selection of drugs deserving further testing in phase 3 trials. Although there is still a small role for single-arm and non-comparative phase 2 designs, emphasis is placed on the potential role that comparative randomised phase 2 designs--such as screening designs, selection designs, discontinuation designs, and adaptive designs, including seamless phase 2/3 designs--can have. The rational incorporation of these designs, as determined by the specific clinical setting and the trial's endpoints or goals, has the potential to substantially advance new drug development in neuro-oncology. PMID:22554547

  12. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

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    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  13. The differences in aspects of parent-child interactions in healthy and oncologically ill children

    Czech Academy of Sciences Publication Activity Database

    Slezáčková, Alena; Jamrichová, J.; Blatný, Marek; Jelínek, Martin; Kepák, T.

    2011-01-01

    Roč. 26, č. 2 (2011), s. 59-60. ISSN 0887-0446. [European Health Psychology Conference: Engaging with Other Health Professions: Challenges and Perspectives /25./. 20.09.2011-24.09.2011, Hersonissos, Kréta] R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional research plan: CEZ:AV0Z7025918 Keywords : oncologically ill children * parent-child interactions * family functioning Subject RIV: AN - Psychology

  14. Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre

    Directory of Open Access Journals (Sweden)

    Arathi Srinivasan

    2015-01-01

    Full Text Available Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed treatment and those currently undergoing treatment, is comparable in both the groups. Abandonment of treatment after initiating therapy was not seen in the financially supported group whereas abandonment of treatment after initiation was seen in one child in the non-funded group. Conclusions: Besides intensive treatment with good supportive care, financial support also has an important impact on compliance and abandonment in all socioeconomic strata of society. Financial support from private cancer support groups also has its impact beyond the patient and family, in reducing the burden on government institutions by non-governmental funding in private sector. Improvement in the delivery of pediatric oncology care in developing countries could be done by financial support from the private sector.

  15. A Phase I Study of Cixutumumab (IMC-A12) in Combination with Temsirolimus (CCI-779) in Children with Recurrent Solid Tumors: A Children’s Oncology Group Phase 1 Consortium Report

    Science.gov (United States)

    Fouladi, Maryam; Perentesis, John P.; Wagner, Lars M.; Vinks, Alexander A.; Reid, Joel M.; Ahern, Charlotte; Thomas, George; Mercer, Carol A.; Krueger, Darcy A.; Houghton, Peter J.; Doyle, L. Austin; Chen, Helen; Weigel, Brenda; Blaney, Susan M.

    2015-01-01

    Purpose To determine the maximum tolerated dose (MTD), dose-limiting toxicities (DLT), pharmacokinetics, and biologic effects of cixutumumab administered in combination with temsirolimus to children with refractory solid tumors. Experimental Design Cixutumumab and temsirolimus were administered intravenously once every 7 days in 28 day cycles. Pharmacokinetic and biology studies, including assessment of mTOR downstream targets in peripheral blood mononuclear cells, were performed during the first cycle. Results Thirty-nine patients, median age 11.8 years (range, 1–21.5), with recurrent solid or CNS tumors were enrolled of who 33 were fully assessable for toxicity. There were four dose levels, which included two dose reductions and a subsequent intermediated dose escalation: (1) IMC-A12 6 mg/kg, temsirolimus 15 mg/m2; (2) IMC-A12 6 mg/kg, temsirolimus 10 mg/m2; (3) IMC-A12 4 mg/kg, temsirolimus 8 mg/m2 and (4) IMC-A12 6 mg/kg, temsirolimus 8 mg/m2. Mucositis was the predominant DLT. Other DLTs included: hypercholesterolemia, fatigue, thrombocytopenia, and increased ALT. Target inhibition (decreased S6K1 and PAkt) in PBMNCs was noted at all dose levels. Marked interpatient variability in temsirolimus PK parameters was noted. At 8 mg/m2, the median temsirolimus AUC was 2946 ng•h/mL (range, 937–5536) with a median sirolimus AUC of 767 ng•h/mL (range, 245–3675). Conclusions The recommended pediatric phase II doses for the combination of cixutumumab and temsirolimus are 6 mg/kg and 8 mg/m2, respectively. PMID:25467181

  16. Patterns of Relapse From a Phase 3 Study of Response-Based Therapy for Intermediate-Risk Hodgkin Lymphoma (AHOD0031): A Report From the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Dharmarajan, Kavita V. [Mount Sinai Medical Center, New York, New York (United States); Friedman, Debra L. [Vanderbilt University, Nashville, Tennessee (United States); Schwartz, Cindy L. [MD Anderson Cancer Center, Houston, Texas (United States); Chen, Lu [Children' s Oncology Group, Arcadia, California (United States); FitzGerald, T.J. [Quality Assurance Review Center, Lincoln, Rhode Island (United States); McCarten, Kathleen M. [Rhode Island Hospital/Warren Alpert Medical School at Brown University, Providence, Rhode Island (United States); Kessel, Sandy K.; Iandoli, Matt [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Constine, Louis S. [University of Rochester Medical Center, Rochester, New York (United States); Wolden, Suzanne L., E-mail: woldens@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2015-05-01

    Purpose: The study was designed to determine whether response-based therapy improves outcomes in intermediate-risk Hodgkin lymphoma. We examined patterns of first relapse in the study. Patients and Methods: From September 2002 to July 2010, 1712 patients <22 years old with stage I-IIA with bulk, I-IIAE, I-IIB, and IIIA-IVA with or without doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide were enrolled. Patients were categorized as rapid (RER) or slow early responders (SER) after 2 cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC). The SER patients were randomized to 2 additional ABVE-PC cycles or augmented chemotherapy with 21 Gy involved field radiation therapy (IFRT). RER patients were stipulated to undergo 2 additional ABVE-PC cycles and were then randomized to 21 Gy IFRT or no further treatment if complete response (CR) was achieved. RER without CR patients were non-randomly assigned to 21 Gy IFRT. Relapses were characterized without respect to site (initial, new, or both; and initial bulk or initial nonbulk), and involved field radiation therapy field (in-field, out-of-field, or both). Patients were grouped by treatment assignment (SER; RER/no CR; RER/CR/IFRT; and RER/CR/no IFRT). Summary statistics were reported. Results: At 4-year median follow-up, 244 patients had experienced relapse, 198 of whom were fully evaluable for review. Those who progressed during treatment (n=30) or lacked relapse imaging (n=16) were excluded. The median time to relapse was 12.8 months. Of the 198 evaluable patients, 30% were RER/no CR, 26% were SER, 26% were RER/CR/no IFRT, 16% were RER/CR/IFRT, and 2% remained uncategorized. The 74% and 75% relapses involved initially bulky and nonbulky sites, respectively. First relapses rarely occurred at exclusively new or out-of-field sites. By contrast, relapses usually occurred at nodal sites of initial bulky and nonbulky disease. Conclusion: Although

  17. Patterns of Relapse From a Phase 3 Study of Response-Based Therapy for Intermediate-Risk Hodgkin Lymphoma (AHOD0031): A Report From the Children's Oncology Group

    International Nuclear Information System (INIS)

    Purpose: The study was designed to determine whether response-based therapy improves outcomes in intermediate-risk Hodgkin lymphoma. We examined patterns of first relapse in the study. Patients and Methods: From September 2002 to July 2010, 1712 patients <22 years old with stage I-IIA with bulk, I-IIAE, I-IIB, and IIIA-IVA with or without doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide were enrolled. Patients were categorized as rapid (RER) or slow early responders (SER) after 2 cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC). The SER patients were randomized to 2 additional ABVE-PC cycles or augmented chemotherapy with 21 Gy involved field radiation therapy (IFRT). RER patients were stipulated to undergo 2 additional ABVE-PC cycles and were then randomized to 21 Gy IFRT or no further treatment if complete response (CR) was achieved. RER without CR patients were non-randomly assigned to 21 Gy IFRT. Relapses were characterized without respect to site (initial, new, or both; and initial bulk or initial nonbulk), and involved field radiation therapy field (in-field, out-of-field, or both). Patients were grouped by treatment assignment (SER; RER/no CR; RER/CR/IFRT; and RER/CR/no IFRT). Summary statistics were reported. Results: At 4-year median follow-up, 244 patients had experienced relapse, 198 of whom were fully evaluable for review. Those who progressed during treatment (n=30) or lacked relapse imaging (n=16) were excluded. The median time to relapse was 12.8 months. Of the 198 evaluable patients, 30% were RER/no CR, 26% were SER, 26% were RER/CR/no IFRT, 16% were RER/CR/IFRT, and 2% remained uncategorized. The 74% and 75% relapses involved initially bulky and nonbulky sites, respectively. First relapses rarely occurred at exclusively new or out-of-field sites. By contrast, relapses usually occurred at nodal sites of initial bulky and nonbulky disease. Conclusion: Although

  18. Online focus groups as a tool to collect data in hard-to-include populations : examples from paediatric oncology

    NARCIS (Netherlands)

    Tates, Kiek; Zwaanswijk, Marieke; Otten, Roel; van Dulmen, Sandra; Hoogerbrugge, Peter M.; Kamps, Willem A.; Bensing, Jozien M.

    2009-01-01

    Background: The purpose of this article is to describe and evaluate the methodology of online focus group discussions within the setting of paediatric oncology. Methods: Qualitative study consisting of separate moderated asynchronous online discussion groups with 7 paediatric cancer patients (aged 8

  19. Caring for children with brain tumors in an oncology ward: a phenomenologic-hermeneutic study

    Directory of Open Access Journals (Sweden)

    Chiara Fioretti

    2014-01-01

    Full Text Available Brain tumors are the most common form of solid tumors in childhood and are characterized by an uncertain prognosis, often meaning tumor invasive surgical procedures in the first steps of the patient’s treatment. In a Pediatric Oncology Ward, children with brain tumors are considered a challenge for health professionals, due to the nature of the relationship between the child, the parents, and the health care providers in the initial phase of the patient’s illness. Here we present a phenomenologic-hermeneutic study, developed in the Oncology Ward of a Hospital in Southern Spain. All the caregivers of the Ward underwent interviews concerning their experience in caring for children with brain tumors. Interviews were recorded and transcribed with the consent of the participants and were analyzed by content themes. In the present paper, we focus on the experiences concerning the first meeting of the professionals with the children and their families and the principal critical issues related to the communication of the diagnosis.

  20. RADIATION THERAPY ONCOLOGY GROUP TRANSLATIONAL RESEARCH PROGRAM STEM CELL SYMPOSIUM : INCORPORATING STEM CELL HYPOTHESES INTO CLINICAL TRIALS

    NARCIS (Netherlands)

    Woodward, Wendy A.; Bristow, Robert G.; Clarke, Michael F.; Coppes, Robert P.; Cristofanilli, Massimo; Duda, Dan G.; Fike, John R.; Hambardzumyan, Dolores; Hill, Richard P.; Jordan, Craig T.; Milas, Luka; Pajonk, Frank; Curran, Walter J.; Dicker, Adam P.; Chen, Yuhchyau

    2009-01-01

    At a meeting of the Translation Research Program of the Radiation Therapy Oncology Group held in early 2008, attendees focused on updating the current state of knowledge in cancer stem cell research and discussing ways in which this knowledge can be translated into clinical use across all disease si

  1. Group Music Training and Children's Prosocial Skills

    OpenAIRE

    E Glenn Schellenberg; Corrigall, Kathleen A.; Sebastian P Dys; Tina Malti

    2015-01-01

    We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect w...

  2. Primary nephrectomy and intraoperative tumor spill: Report from the Children’s Oncology Group (COG) renal tumors committee

    Science.gov (United States)

    Gow, Kenneth W.; Barnhart, Douglas C.; Hamilton, Thomas E.; Kandel, Jessica J.; Chen, Mike K.S.; Ferrer, Fernando A.; Price, Mitchell R.; Mullen, Elizabeth A.; Geller, James I.; Gratias, Eric J.; Rosen, Nancy; Khanna, Geetika; Naranjo, Arlene; Ritchey, Michael L.; Grundy, Paul E.; Dome, Jeffrey S.; Ehrlich, Peter F.

    2015-01-01

    Purpose Initial Children’s Oncology Group (COG) management for Wilms’ tumor (WT) consists of primary nephroureterectomy with lymph node sampling. While this provides accurate staging to define further treatment, it may result in intraoperative spill (IOS), which is associated with higher recurrence rates and therefore requires more intensive therapy. The purpose of this study is to determine current rates and identify factors which may predispose a patient to IOS. Methods The study population was drawn from the AREN03B2 renal tumor banking and classification study of the Children’s Oncology Group. All children with a first time occurrence of a renal mass were eligible for the study. At the time of enrollment and prior to risk stratification, the institution is required to submit operative notes, pathology specimens, a chest computed tomography scan (CT), and a contrast-enhanced CT or magnetic resonance imaging (MRI) of the abdomen and pelvis for central imaging review. These data are then used to determine an initial risk classification and therapeutic protocol eligibility. Patients who had a unilateral nephroureterectomy for favorable histology WT underwent further review to assure data accuracy and to clarify details regarding the spill. Analyses were performed using chi square and logistic regression. Odd ratios (OR) are shown with 95% confidence intervals. Results There were 1,131 primary nephrectomies for unilateral WT with an IOS rate of 9.7% with an additional 1.8% having possible tumor spill during renal vein or IVC tumor thrombectomy. IOS correlated with diameter (>12cm, p<0.0001) and laterality (right, p=0.0414). Simple logistic regression indicated that IOS increased 2.7% [p=0.0240, OR 1.027 (1.004, 1.052)] with each 1 cm increase in diameter (3 –21cm) and 4.7% [p=0.0147 OR 1.047 (1.009, 1.086)] with each 100 g increase in weight (80 – 1800 g). Multiple logistic regression indicated that laterality [right p=0.048, OR 1.46 (1.004, 2.110)] and

  3. How Do Children Share Information in Groups?

    Science.gov (United States)

    Gummerum, Michaela; Leman, Patrick J.; Hollins, Tara S.

    2014-01-01

    Group decision making should be particularly beneficial when group members share unique information, because then a group can make a better decision than each group member alone. This study examined how elementary-school children share unique information during group decision making. Seventy-nine groups of 3 same-sex and same-age 7- and 9-year-old…

  4. Accrual to Trans-Tasman Radiation Oncology Group-sponsored trials 2010-2012

    International Nuclear Information System (INIS)

    Few trials groups report analyses of accrual. Although Trans-Tasman Radiation Oncology Group (TROG) has reported accrual within individual trials, no analysis has ever been reported. Type A trials are those trials for which TROG is the principal sponsor and are dependent on accrual from TROG centres. The aim of this study was to review accrual rates to type A trials over the last 3 years. All type A trials that had presented accrual data during the TROG annual scientific meetings and the trials review meetings between April 2010 and April 2012 were reviewed. Expected accrual rate (EAR) and actual accrual rate (AAR) were estimated from accrual curves as well as initial delays in accrual. Ratios of AAR to EAR (RAEAR) were calculated. There were 16 type A trials from which estimates could be made. The median EAR was 40 patients per year and the median AAR was 20 patients per year. Wide variations in each were noted and the median RAEAR was 0.67. The median initial delay was 7.5 months. Although TROG is a highly successful trials organisation, the median AAR is only half of the median EAR and in only three trials (19%) was the AAR the same or more than the EAR. Future reports could address potential factors affecting the AAR but would require prospective data collection. The RAEAR is one of many factors that can be used to help determine which trials should continue. Overall rates of accrual can be used as a record of TROG's productivity.

  5. Group Music Training and Children's Prosocial Skills.

    Science.gov (United States)

    Schellenberg, E Glenn; Corrigall, Kathleen A; Dys, Sebastian P; Malti, Tina

    2015-01-01

    We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect was limited to children who had poor prosocial skills before the lessons began. The effect was evident even when the lessons were compulsory, which minimized the role of self-selection. The results suggest that group music training facilitates the development of prosocial skills. PMID:26506414

  6. Group Music Training and Children's Prosocial Skills.

    Directory of Open Access Journals (Sweden)

    E Glenn Schellenberg

    Full Text Available We investigated if group music training in childhood is associated with prosocial skills. Children in 3rd or 4th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect was limited to children who had poor prosocial skills before the lessons began. The effect was evident even when the lessons were compulsory, which minimized the role of self-selection. The results suggest that group music training facilitates the development of prosocial skills.

  7. General surgeons' views on Oncologic Multidisciplinary Group meetings as part of colorectal cancer care.

    Science.gov (United States)

    Feroci, Francesco; Lenzi, Elisa; Baraghini, Maddalena; Cantafio, Stefano; Scatizzi, Marco

    2012-12-01

    This study aimed to assess the current effectiveness of Oncologic Multidisciplinary Groups (OMGs) meetings across central Tuscany through surgeons' reports and their individual perceived benefits on colorectal cancer management. One hundred and sixty-seven general surgeons received a questionnaire with 21 questions covering organizational characteristics of OMGs and the individual perceived benefits of OMGs. The responses were analyzed by hospital setting (teaching vs. community hospital). The reply rate was 62.8 %, and 82 respondent surgeons (49.1 %) were involved in the treatment of colorectal cancer patients. At community hospitals, there was a more frequent participation of medical oncologists, radiation oncologists and pathologists; a less selection of discussed cases was performed; and almost all decisions were inserted into official patient charts (p OMGs ensure that all treatment options are considered and improve timeliness of care, patient outcomes, patient satisfaction and communication with patients (p OMGs offer a modest degree of protection from malpractice but improve communications between colleagues and are an opportunity for personal professional development. Professionals regularly participating in well-conducted and well-organized OMGs for colorectal cancer felt that the multidisciplinary strategy may be advantageous to both patients and caregivers. PMID:22987014

  8. Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians

    International Nuclear Information System (INIS)

    Purpose: Radiation Therapy Oncology Group (RTOG) physicians were surveyed to determine their approach to and attitudes toward cancer pain management. Methods and Materials: Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting. Results: Eighty-three percent believed the majority of cancer patients with pain were undermedicated. Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% would wait until the patient's prognosis was 6 months or less before starting maximal analgesia. Adjuvants and prophylactic side effect management were underutilized in the treatment plan. Barriers to pain management included poor pain assessment (77%), patient reluctance to report pain (60%), patient reluctance to take analgesics (72%), and staff reluctance to prescribe opioids (41%). Conclusions: Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiation oncologists as an important resource for the treatment of cancer pain

  9. Mantle planning: report of the Australasian radiation oncology lymphoma group film survey and consensus guidelines

    International Nuclear Information System (INIS)

    The purpose of the present paper was to measure the variation in mantle radiotherapy planning in Australia and New Zealand. A chest X-ray (CXR) of a patient in the supine position with a neck node marked by wire was sent to every radiation oncologist in Australia and New Zealand. They were to mark on the CXR the lung blocks that they would use to treat this patient, assuming that the patient had stage IA Hodgkin's disease. These marks were compared with a small sample of radiologists who were asked to define the mediastinum on the same CXR. Radiation oncologists were also asked to complete a short questionnaire about other modifications to their treatment fields and their experience with this technique. One hundred and six films were sent out and 44 radiation oncologists replied. There was a maximum variation in the placement of their lung blocks of 6 cm. Half of the lung blocks were within a 2-cm range. One respondent said they would not use a mantle field to treat this patient. Mediastinal coverage was inadequate in at least 50% of cases. There was a very large variation in mantle field planning practices within Australia and New Zealand. For this reason Australasian Radiation Oncology Lymphoma Group has produced consensus guidelines for mantle block design. These are appended to the present paper. Copyright (1999) Blackwell Science Pty Ltd

  10. Validation and Simplification of the Radiation Therapy Oncology Group Recursive Partitioning Analysis Classification for Glioblastoma

    International Nuclear Information System (INIS)

    Purpose: Previous recursive partitioning analysis (RPA) of patients with malignant glioma (glioblastoma multiforme [GBM] and anaplastic astrocytoma [AA]) produced six prognostic groups (I-VI) classified by six factors. We sought here to determine whether the classification for GBM could be improved by using an updated Radiation Therapy Oncology Group (RTOG) GBM database excluding AA and by considering additional baseline variables. Methods and Materials: The new analysis considered 42 baseline variables and 1,672 GBM patients from the expanded RTOG glioma database. Patients receiving radiation only were excluded such that all patients received radiation+carmustine. 'Radiation dose received' was replaced with 'radiation dose assigned.' The new RPA models were compared with the original model by applying them to a test dataset comprising 488 patients from six other RTOG trials. Fitness of the original and new models was evaluated using explained variation. Results: The original RPA model explained more variations in survival in the test dataset than did the new models (20% vs. 15%) and was therefore chosen for further analysis. It was reduced by combining Classes V and VI to produce three prognostic classes (Classes III, IV, and V+VI), as Classes V and VI had indistinguishable survival in the test dataset. The simplified model did not further improve performance (explained variation 18% vs. 20%) but is easier to apply because it involves only four variables: age, performance status, extent of resection, and neurologic function. Applying this simplified model to the updated GBM database resulted in three distinct classes with median survival times of 17.1, 11.2, and 7.5 months for Classes III, IV, and V+VI, respectively. Conclusions: The final model, the simplified original RPA model combining Classes V and VI, resulted in three distinct prognostic groups defined by age, performance status, extent of resection, and neurologic function. This classification will be used

  11. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gay, Hiram A., E-mail: hgay@radonc.wustl.edu [Washington University School of Medicine, St Louis, MO (United States); Barthold, H. Joseph [Commonwealth Hematology and Oncology, Weymouth, MA (United States); Beth Israel Deaconess Medical Center, Boston, MA (Israel); O' Meara, Elizabeth [Radiation Therapy Oncology Group, Philadelphia, PA (United States); Bosch, Walter R. [Washington University School of Medicine, St Louis, MO (United States); El Naqa, Issam [Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec (Canada); Al-Lozi, Rawan [Washington University School of Medicine, St Louis, MO (United States); Rosenthal, Seth A. [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); Lawton, Colleen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Zietman, Anthony [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Myerson, Robert [Washington University School of Medicine, St Louis, MO (United States); Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Willett, Christopher [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Kachnic, Lisa A. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States); Jhingran, Anuja [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Portelance, Lorraine [University of Miami, Miami, FL (United States); Ryu, Janice [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); and others

    2012-07-01

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

  12. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    International Nuclear Information System (INIS)

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, AdnexaR, AdnexaL, Prostate, SeminalVesc, PenileBulb, FemurR, and FemurL. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

  13. Modern Radiation Therapy for Primary Cutaneous Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    International Nuclear Information System (INIS)

    Primary cutaneous lymphomas are a heterogeneous group of diseases. They often remain localized, and they generally have a more indolent course and a better prognosis than lymphomas in other locations. They are highly radiosensitive, and radiation therapy is an important part of the treatment, either as the sole treatment or as part of a multimodality approach. Radiation therapy of primary cutaneous lymphomas requires the use of special techniques that form the focus of these guidelines. The International Lymphoma Radiation Oncology Group has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the International Lymphoma Radiation Oncology Group steering committee on the use of radiation therapy in primary cutaneous lymphomas in the modern era

  14. Modern Radiation Therapy for Primary Cutaneous Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena, E-mail: lena.specht@regionh.dk [Departments of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Dabaja, Bouthaina [Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Stanford, California (United States)

    2015-05-01

    Primary cutaneous lymphomas are a heterogeneous group of diseases. They often remain localized, and they generally have a more indolent course and a better prognosis than lymphomas in other locations. They are highly radiosensitive, and radiation therapy is an important part of the treatment, either as the sole treatment or as part of a multimodality approach. Radiation therapy of primary cutaneous lymphomas requires the use of special techniques that form the focus of these guidelines. The International Lymphoma Radiation Oncology Group has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the International Lymphoma Radiation Oncology Group steering committee on the use of radiation therapy in primary cutaneous lymphomas in the modern era.

  15. Sociodemographic analysis of patients in radiation therapy oncology group clinical trials

    International Nuclear Information System (INIS)

    Purpose: To assess the degree to which the sociodemographic characteristics of patients enrolled in Radiation Therapy Oncology Group (RTOG) clinical trails are representative of the general population. Methods and Materials: Sociodemographic data were collected on 4016 patients entered in 33 open RTOG studies between July 1991 and June 1994. The data analyzed included educational attainment, age, gender, and race. For comparison, we obtained similar data from the U.S. Department of Census. We also compared our RTOG data with Surveillance Epidemiology and End Results (SEER) data for patients who received radiation therapy, to determine how RTOG patients compared with cancer patients in general, and with patients with cancers at sites typically treated with radiotherapy. Results: Overall, the sociodemographic characteristics of patients entered in RTOG trials were similar to those of the Census data. We found that, in every age group of African-American men and at nearly every level of educational attainment, the proportion of RTOG trial participants mirrored the proportion in the census data. Significant differences were noted only in the youngest category of African-American men, where the RTOG accrues more in the lower educational categories and fewer with college experience. For African-American women, we found a similar pattern in every age group and at each level of educational attainment. As with men, RTOG trials accrued a considerably larger proportion of younger, less educated African-American women than the census reported. Using SEER for comparison, the RTOG enrolled proportionately more African-American men to trials all cancer sites combined, and for prostate and head and neck cancer. In head and neck trials, the RTOG enrolled nearly twice as many African-American men than would be predicted by SEER data. In lung cancer trials, RTOG underrepresented African-American men significantly; however, there was no difference for brain cancer trials. There were

  16. Feasibility of Economic Analysis of Radiation Therapy Oncology Group (RTOG) 91-11 Using Medicare Data

    International Nuclear Information System (INIS)

    Purpose: The specific aim of this analysis was to evaluate the feasibility of performing a cost-effectiveness analysis using Medicare data from patients treated on a randomized Phase III clinical trial. Methods and Materials: Cost data included Medicare Part A and Part B costs from all providers-inpatient, outpatient, skilled nursing facility, home health, hospice, and physicians-and were obtained from the Centers for Medicare and Medicaid Services for patients eligible for Medicare, treated on Radiation Therapy Oncology Group (RTOG) 9111 between 1992 and 1996. The 47-month expected discounted (annual discount rate of 3%) cost for each arm of the trial was calculated in 1996 dollars, with Kaplan-Meier sampling average estimates of survival probabilities for each month and mean monthly costs. Overall and disease-free survival was also discounted 3%/year. The analysis was performed from a payer's perspective. Incremental cost-effectiveness ratios were calculated comparing the chemotherapy arms to the radiation alone arm. Results: Of the 547 patients entered, Medicare cost data and clinical outcomes were available for 66 patients. Reasons for exclusion included no RTOG follow-up, Medicare HMO enrollment, no Medicare claims since trial entry, and trial entry after 1996. Differences existed between groups in tumor characteristics, toxicity, and survival, all which could affect resource utilization. Conclusions: Although we were able to test the methodology of economic analysis alongside a clinical trial using Medicare data, the results may be difficult to translate to the entire trial population because of non-random missing data. Methods to improve Medicare data capture and matching to clinical trial samples are required.

  17. Evidence-based recommendations of postoperative radiotherapy in lung cancer from Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

    Science.gov (United States)

    Gómez, A; González, J A; Couñago, F; Vallejo, C; Casas, F; de Dios, N Rodríguez

    2016-04-01

    Locally advanced non-small cell lung cancer (NSCLC) is a diversified illness in which postoperative radiation therapy (PORT) for complete resection with positive hiliar (pN1) and/or mediastinal (pN2) lymph nodes is controversial. Although several studies have shown that PORT has beneficial effects, randomized trials are needed to demonstrate its impact on overall survival. In this review, the Spanish Radiation Oncology Group for Lung Cancer describes the most relevant literature on PORT in NSCLC patients stage pN1-2. In addition, we have outlined the current recommendations of different national and international clinical guidelines and have also specified practical issues regarding treatment volume definition, doses and fractionation. PMID:26280402

  18. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

    Energy Technology Data Exchange (ETDEWEB)

    Velde, Joris van de [Ghent University, Department of Anatomy, Ghent (Belgium); Ghent University, Department of Radiotherapy, Ghent (Belgium); Vercauteren, Tom; Gersem, Werner de; Vandecasteele, Katrien; Vuye, Philippe; Vanpachtenbeke, Frank; Neve, Wilfried de [Ghent University, Department of Radiotherapy, Ghent (Belgium); Wouters, Johan; Herde, Katharina d' ; Kerckaert, Ingrid; Hoof, Tom van [Ghent University, Department of Anatomy, Ghent (Belgium)

    2014-07-15

    The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.) [German] Ziel der Studie war

  19. The evolution of radiation therapy oncology group (RTOG) protocols for nonsmall cell lung cancer

    International Nuclear Information System (INIS)

    Over the past 2 decades, the Radiation Therapy Oncology Group (RTOG) has played a significant role in clarifying the role of radiation therapy (RT) in the treatment of nonsmall cell lung cancer (NSCLC). RTOG lung cancer research has evolved over this time period through a systematic succession of investigations. For unresectable NSCLC, the dependence of local tumor control and survival on total dose of standard fractionation RT, as well as pretreatment performance characteristics, was demonstrated in initial RTOG trials. Subsequently, further radiation dose intensification was tested using altered fractionation RT to total doses up to 32% higher than standard RT to 60 Gy, given as either hyperfractionation or accelerated fractionation, while attempting to retain acceptable normal tissue toxicity. These higher doses required rethinking of established RT techniques and limitations, as well as careful surveillance of acute and late toxicity. A survival advantage was shown for hyperfractionation to 69.6 Gy, in favorable performance patients, compared to 60 Gy. Further testing of high dose standard RT will use three-dimensional, conformal techniques to minimize toxicity. RTOG further extended the theme of treatment intensification for unresectable NSCLC by evaluating combined chemotherapy (CT) and RT. Improved local control and survival was shown for induction CT followed by standard RT to 60 Gy, compared to standard RT (60 Gy) and altered fractionation RT (69.6 Gy). The intent of current studies is to optimize dose and scheduling of combined CT and standard RT, as well as combined CT and altered fractionation RT. Noncytotoxic RT adjuvants, such as hypoxic cell sensitizers, nonspecific immune stimulants, and biologic response modifiers have also been studied. Resectable NSCLC has also been an RTOG focus, with studies of preoperative and postoperative RT, CT, and CT/RT, including the prognostic value of serum and tissue factors. RTOG studies have yielded incremental

  20. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

    International Nuclear Information System (INIS)

    The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.)

  1. External evaluation of the Radiation Therapy Oncology Group brachial plexus contouring protocol: several issues identified

    International Nuclear Information System (INIS)

    The aims of the study were to evaluate interobserver variability in contouring the brachial plexus (BP) using the Radiation Therapy Oncology Group (RTOG)-approved protocol and to analyse BP dosimetries. Seven outliners independently contoured the BPs of 15 consecutive patients. Interobserver variability was reviewed qualitatively (visually by using planning axial computed-tomography images and anteroposterior digitally reconstructed radiographs) and quantitatively (by volumetric and statistical analyses). Dose–volume histograms of BPs were calculated and compared. We found significant interobserver variability among outliners in both qualitative and quantitative analyses. These were most pronounced for the T1 nerve roots on visual inspection and for the BP volume on statistical analysis. The BP volumes were smaller than those described in the RTOG atlas paper, with a mean volume of 20.8cc (range 11–40.7 cc) compared with 33±4cc (25.1–39.4cc). The average values of mean dose, maximum dose, V60Gy, V66Gy and V70Gy for patients treated with conventional radiotherapy and IMRT were 42.2Gy versus 44.8Gy, 64.5Gy versus 68.5Gy, 6.1% versus 7.6%, 2.9% versus 2.4% and 0.6% versus 0.3%, respectively. This is the first independent external evaluation of the published protocol. We have identified several issues, including significant interobserver variation. Although radiation oncologists should contour BPs to avoid dose dumping, especially when using IMRT, the RTOG atlas should be used with caution. Because BPs are largely radiologically occult on CT, we propose the term brachial-plexus regions (BPRs) to represent regions where BPs are likely to be present. Consequently, BPRs should in principle be contoured generously.

  2. Compliance with therapeutic guidelines in Radiation Therapy Oncology Group prospective gastrointestinal clinical trials

    International Nuclear Information System (INIS)

    Background: This report analyzes the adherence to radiation therapy protocol guidelines in contemporary Radiation Therapy Oncology Group (RTOG) gastrointestinal trials. We aim to provide insight into current standards and compliance of radiation therapy field design and administration. Methods: From 1994 to 2006, the Gastrointestinal Cancer Committee of the RTOG initiated and completed 15 phase I–III clinical trials utilizing radiation therapy in the multimodality treatment of gastrointestinal cancers. In each protocol, details for planning and executing radiation therapy were outlined and each protocol contained scoring criteria for these components of radiation therapy, characterized according to per-protocol, variation acceptable and deviation unacceptable. Review of treatment planning and implementation was performed in all studies following therapy completion. Results: Radiation therapy planning and implementation was reviewed in 2309 of 2312 (99.9%) patients. The mean rate of compliance over all for the 15 protocols was 65% (total of the 2309 analyzed patients). The mean variation acceptable rate was 21% whereas the mean deviation unacceptable rate was 5%. The mean “other” rate (no RT given or incomplete RT due to death, progression or refusal) was 8%. Two of the 15 trials (13%) had deviation unacceptable rates >10%. In four studies incorporating pre-treatment review of radiation therapy planning and treatment, compliance with protocol therapy was enhanced. Conclusions: The fidelity of radiation planning and execution detailed in protocol to actual therapy is heterogeneous, with a mean per-protocol rate of 65%. As clinical trials evolve, available technology should permit efficient pre-treatment review processes, thus facilitating compliance to protocol therapy. These analyses should also permit prospective analysis of outcome measures by compliance to therapy.

  3. A Group Experience with Physically Handicapped Children.

    Science.gov (United States)

    Castle, Norma

    1980-01-01

    Describes a group experience program developed as an alternative to the long-term hospitalization of physically handicapped children. The program emphasizes emotional growth through participation in meetings designed to counteract dependency. (CM)

  4. Coping style and performance status in a group of oncological inpatients

    OpenAIRE

    Cecilia Chau Pérez-Aranibar; Hugo Morales Córdova; Micaela Wetzell Espinoza

    2002-01-01

    The associations between coping styles, measured by COPE Test, dispositional version (Carver,Scheier and Weintraub, 1989), and Health Status inferred through a performance status, measured by Karnofsky's Index of Behavioral Performance are examined. The study focuses upon 28 oncological in patients. Positive moderate Pearson's correlations were found between these two variables in this correlational-descriptive study. These were interpreted in the following sense: the larger use of the style,...

  5. Emergent Leadership in Children's Discussion Groups

    Science.gov (United States)

    Li, Yuan; Anderson, Richard C.; Nguyen-Jahiel, Kim; Dong, Ting; Archodidou, Anthi; Kim, Il-Hee; Kuo, Li-Jen; Clark, Ann-Marie; Wu, Xiaoying; Jadallah, May; Miller, Brian

    2007-01-01

    Emergent leadership was examined in 12 discussion groups in 4 fourth-grade classrooms. Children's leadership moves were coded from transcripts of 10 free-flowing, open-format discussions of each of the 12 groups. The transcripts encompassed 26,000 turns for speaking, including 22,000 child turns of which 1,700 were judged to serve one of five…

  6. The integration of psychology in pediatric oncology research and practice: collaboration to improve care and outcomes for children and families.

    Science.gov (United States)

    Kazak, Anne E; Noll, Robert B

    2015-01-01

    Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families at diagnosis, during treatment, and beyond. Dramatic improvements in survival have occurred as a result of increasingly aggressive multimodal therapies delivered in the context of clinical research trials. Nonetheless, cancers remain a leading cause of death in children, and their treatments have short- and long-term impacts on health and well-being. For over 35 years, pediatric psychologists have partnered with pediatric oncology teams to make many contributions to our understanding of the impact of cancer and its treatment on children and families and have played prominent roles in providing an understanding of treatment-related late effects and in improving quality of life. After discussing the incidence of cancer in children, its causes, and the treatment approaches to it in pediatric oncology, we present seven key contributions of psychologists to collaborative and integrated care in pediatric cancer: managing procedural pain, nausea, and other symptoms; understanding and reducing neuropsychological effects; treating children in the context of their families and other systems (social ecology); applying a developmental perspective; identifying competence and vulnerability; integrating psychological knowledge into decision making and other clinical care issues; and facilitating the transition to palliative care and bereavement. We conclude with a discussion of the current status of integrating knowledge from psychological research into practice in pediatric cancer. PMID:25730721

  7. Radiation Therapy Oncology Group Translational Research Program Stem Cell Symposium: Incorporating Stem Cell Hypotheses into Clinical Trials

    International Nuclear Information System (INIS)

    At a meeting of the Translation Research Program of the Radiation Therapy Oncology Group held in early 2008, attendees focused on updating the current state of knowledge in cancer stem cell research and discussing ways in which this knowledge can be translated into clinical use across all disease sites. This report summarizes the major topics discussed and the future directions that research should take. Major conclusions of the symposium were that the flow cytometry of multiple markers in fresh tissue would remain the standard technique of evaluating cancer-initiating cells and that surrogates need to be developed for both experimental and clinical use.

  8. Impact of cytogenetics on the outcome of adult acute lymphoblastic leukemia: results of Southwest Oncology Group 9400 study

    OpenAIRE

    Pullarkat, Vinod; Slovak, Marilyn L.; Kopecky, Kenneth J.; Forman, Stephen J.; Appelbaum, Frederick R.

    2008-01-01

    We examined the prognostic impact of cytogenetics on the outcome of 200 acute lymphoblastic leukemia (ALL) patients 15 to 65 years of age enrolled in Southwest Oncology Group (SWOG)–9400 study. Evaluable cytogenetics or fluorescence in situ hybridization studies were available in 140 (70%) patients. Four karyotype categories (normal [n = 31, 22%], t(9;22)/BCR/ABL1 [n = 36, 26%], other unfavorable [−7, +8, or 11q23 rearrangement, n = 19, 13%], and miscellaneous [n = 54, 39%]) and the biologica...

  9. Fungal infection risk groups among school children

    Directory of Open Access Journals (Sweden)

    Elżbieta Ejdas

    2014-08-01

    Full Text Available The aim of the study was to evaluate the relationship between ocurrence of fungi in children and living environment (city - countryside, sex, age, diet, undergone diseases therapy with antibiotics and exposure to hospital environment, and to indicate children potentially vulnerable to fungal infections. The material was consisted of swabs collected from the oral cavily, the throat and the nose of healthy children, aged 6-9 and 10-15, from both urban and rural environmens. Candida albicans, the basic aetiological factor in thc majority of mycoses recorded in humans, unquestionably prevailed in the group of the 13 speciec of yeast-like fungi and yeasts isolated. Records of C. glabrata and C. krusei increasing numbers of whose strains show resistance to basic antimycoties, as well as relatively frequent records of Trichosporon beigelii, Saccharomycopsis capsularis and Saccharomyces sp., fungi whose expansiveness and enzymatic activity have been growing, may be considered disconcerting. Vulnerability to fungal infection increases following anti-bacterial antibiotic therapy in the majority of subjects regardless season or age. This is particularly true primarily of the most stable ontocoenosis of the throat. Younger children, on the other hand, are the most vulnerable foUowing infection of the respiratory system. Fungi are likely to colonise the nose in this case. Children living in the countryside who had been ll immediately prior to the collection of the material constitute the highest risk group of the occurrence of fungi in any of the ontocoenoses studied. A greater number of positive inoculations were recorded in these children in comparison to the children from the city. It may be indicative of a more extensive spectrum of natural reservoirs of fungi and the vectors of their transmission in rural areas than those in the city, lower health hygiene and lower immunity or of a more common carriage of fungi among rural children.

  10. Safe Anesthesia for Radiotherapy in Pediatric Oncology: St. Jude Children's Research Hospital Experience, 2004-2006

    International Nuclear Information System (INIS)

    Purpose: To determine the incidence of anesthesia-related complications in children undergoing radiotherapy and the associated risk factors. Methods and Materials: We retrospectively investigated the incidence and types of anesthesia-related complications and examined their association with age, weight, oncology diagnosis, type of anesthetic (propofol vs. propofol and adjuncts), total propofol dose, anesthetic duration, type of radiotherapy procedure (simulation vs. radiotherapy) and patient position (prone vs. supine). Results: Between July 2004 and June 2006, propofol was used in 3,833 procedures (3,611 radiotherapy sessions and 222 simulations) in 177 patients. Complications occurred during 49 anesthetic sessions (1.3%). On univariate analysis, four factors were significantly associated with the risk of complications: procedure duration (p <0.001), total propofol dose (p <0.001), use of adjunct agents (vs. propofol alone; p = 0.029), and simulation (vs. radiotherapy; p = 0.014). Patient position (prone vs. supine) was not significantly associated with the frequency of complications (odds ratio, 0.71; 95% confidence interval, 0.33-1.53; p = 0.38). On multivariate analysis, the procedure duration (p <0.0001) and total propofol dose (p ≤0.03) were the most significant risk factors after adjustment for age, weight, anesthetic type, and procedure type. We found no evidence of the development of tolerance to propofol. Conclusion: The rate of anesthesia-related complications was low (1.3%) in our study. The significant risk factors were procedure duration, total propofol dose, the use of adjunct agents with propofol, and simulation (vs. radiotherapy)

  11. Empathy, Group Norms and Children's Ethnic Attitudes

    Science.gov (United States)

    Nesdale, Drew; Griffith, Judith; Durkin, Kevin; Maass, Anne

    2005-01-01

    Two minimal group studies (Ns=150, 123) examined the impact of emotional empathy on the ethnic attitudes of 5 to 12-year old white Anglo-Australian children. Study 1 evaluated the relationship between empathy and attitudes towards a same (Anglo-Australian) versus different ethnicity (Pacific Islander) outgroup. A significant empathy x outgroup…

  12. Cerebral sinus venous thromboses in children with acute lymphoblastic leukaemia - a multicentre study from the Nordic Society of Paediatric Haematology and Oncology

    DEFF Research Database (Denmark)

    Ranta, Susanna; Tuckuviene, Ruta; Mäkipernaa, Anne;

    2014-01-01

    We present a prospective multicentre cohort of 20 children with acute lymphoblastic leukaemia (ALL) and cerebral sinus venous thrombosis (CSVT). The study covers a period of 5 years and comprises 1038 children treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO...

  13. Coping style and performance status in a group of oncological inpatients

    Directory of Open Access Journals (Sweden)

    Cecilia Chau Pérez-Aranibar

    2002-06-01

    Full Text Available The associations between coping styles, measured by COPE Test, dispositional version (Carver,Scheier and Weintraub, 1989, and Health Status inferred through a performance status, measured by Karnofsky's Index of Behavioral Performance are examined. The study focuses upon 28 oncological in patients. Positive moderate Pearson's correlations were found between these two variables in this correlational-descriptive study. These were interpreted in the following sense: the larger use of the style, the less health status among the scales suppression of competent activities, procrastination of coping, instrumental social support, focusing and releasing of emotions and behavioral disengagement. The active coping scale presented a negative correlationwith regard to Performance Status as a health measure.

  14. Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    International Nuclear Information System (INIS)

    Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL, involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU), as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype, anatomy, the treatment intent, and other treatment modalities that may be have been used before RT

  15. Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Yahalom, Joachim, E-mail: yahalomj@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Specht, Lena [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Li, Ye-Xiong [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Wirth, Andrew [Division of Radiation Oncology, Peter MacCallum Cancer Institute, St. Andrews Place, East Melbourne (Australia)

    2015-05-01

    Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL, involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU), as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype, anatomy, the treatment intent, and other treatment modalities that may be have been used before RT.

  16. Patterns of radiotherapy practice for biliary tract cancer in Japan: results of the Japanese radiation oncology study group (JROSG) survey

    International Nuclear Information System (INIS)

    The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established. A questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions. The median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy. This study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan

  17. The role of stereotactic ablative radiotherapy in oncological and non-oncological clinical settings: highlights from the 7th Meeting of AIRO--Young Members Working Group (AIRO Giovani).

    Science.gov (United States)

    Franco, Pierfrancesco; De Bari, Berardino; Ciammella, Patrizia; Fiorentino, Alba; Chiesa, Silvia; Amelio, Dante; Pinzi, Valentina; Bonomo, Pierluigi; Vagge, Stefano; Fiore, Michele; Comito, Tiziana; Cecconi, Agnese; Mortellaro, Gianluca; Bruni, Alessio; Trovò, Marco; Filippi, Andrea Riccardo; Greto, Daniela; Alongi, Filippo

    2014-01-01

    Stereotactic ablative radiotherapy is a modern cancer treatment strategy able to deliver highly focused radiation in one or a few fractions with a radical intent in several clinical settings. Young radiation oncologists need a constant and tailored update in this context to improve patient care in daily clinical practice. A recent meeting of AIRO Giovani (AIRO--Young Members Working Group) was specifically addressed to this topic, presenting state-of-the-art knowledge, based on the latest evidence in this field. Highlights of the congress are summarized and presented in this report, including thorough contributions of the speakers dealing with the role of stereotactic ablative radiotherapy in both oncological and non-oncological diseases, divided according to anatomical and clinical scenarios: intra-cranial settings (brain malignant primary tumors, metastases, benign tumors and functional disorders) and extra-cranial indications (lung primary tumors and metastases, thoracic re-irradiation, liver, lymph node and bone metastases, prostate cancer). With literature data discussed during the congress as a background, stereotactic ablative radiotherapy has proved to be a consolidated treatment approach in specific oncological and non-oncological scenarios, as well as a promising option in other clinical settings, requiring a further prospective validation in the near future. We herein present an updated overview of stereotactic ablative radiotherapy use in the clinic. PMID:25688503

  18. Local Control With Reduced-Dose Radiotherapy for Low-Risk Rhabdomyosarcoma: A Report From the Children’s Oncology Group D9602 Study

    International Nuclear Information System (INIS)

    Purpose: To analyze the effect of reduced-dose radiotherapy on local control in children with low-risk rhabdomyosarcoma (RMS) treated in the Children’s Oncology Group D9602 study. Methods and Materials: Patients with low-risk RMS were nonrandomly assigned to receive radiotherapy doses dependent on the completeness of surgical resection of the primary tumor (clinical group) and the presence of involved regional lymph nodes. After resection, most patients with microscopic residual and uninvolved nodes received 36 Gy, those with involved nodes received 41.4 to 50.4 Gy, and those with orbital primary tumors received 45 Gy. All patients received vincristine and dactinomycin, with cyclophosphamide added for patient subsets with a higher risk of relapse in Intergroup Rhabdomyosarcoma Study Group III and IV studies. Results: Three hundred forty-two patients were eligible for analysis; 172 received radiotherapy as part of their treatment. The cumulative incidence of local/regional failure was 15% in patients with microscopic involved margins when cyclophosphamide was not part of the treatment regimen and 0% when cyclophosphamide was included. The cumulative incidence of local/regional failure was 14% in patients with orbital tumors. Protocol-specified omission of radiotherapy in girls with Group IIA vaginal tumors (n = 5) resulted in three failures for this group. Conclusions: In comparison with Intergroup Rhabdomyosarcoma Study Group III and IV results, reduced-dose radiotherapy does not compromise local control for patients with microscopic tumor after surgical resection or with orbital primary tumors when cyclophosphamide is added to the treatment program. Girls with unresected nonbladder genitourinary tumors require radiotherapy for postsurgical residual tumor for optimal local control to be achieved.

  19. Effects of Group Norms on Children's Intentions to Bully

    Science.gov (United States)

    Nesdale, Drew; Durkin, Kevin; Maass, Anne; Kiesner, Jeff; Griffiths, Judith A.

    2008-01-01

    A minimal group study examined the effect of peer group norms on children's direct and indirect bullying intentions. Prior to an inter-group drawing competition, children (N = 85) aged seven and nine years were assigned to a group that had a norm of out-group dislike or out-group liking. Results indicated that, regardless of group norms, the…

  20. Association of systolic blood pressure drop with intravenous administration of itraconazole in children with hemato-oncologic disease

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2015-12-01

    Full Text Available Hyeong Jin Lee,1,* Bongjin Lee,2,* June Dong Park,2 Hyung Joo Jeong,2 Yu Hyeon Choi,2 Hee Young Ju,1 Che Ry Hong,1 Ji Won Lee,1 Hyery Kim,1 Dong In Suh,3 Kyung Duk Park,1 Hyoung Jin Kang,1 Hee Young Shin,1 Hyo Seop Ahn1 1Department of Pediatrics, Cancer Research Institute, 2Division of Pediatric Intensive Care, Department of Pediatrics, 3Division of Pulmonology, Department of Pediatrics, Seoul National University College of Medicine, Seoul National University, Seoul, South Korea *These authors contributed equally to this work Purpose: Although few adverse effects have been reported for itraconazole, a widely used antifungal therapy for febrile neutropenia, we found intravenous (IV itraconazole to be associated with serious cases of blood pressure (BP drop. We therefore evaluated the incidence and risk factors for BP drop during IV administration of the drug.Materials and methods: We reviewed the medical records of children with hemato-oncologic disease who were treated with IV itraconazole from January 2012 to December 2013. By analyzing systolic BP (SBP measurements made from 4 hours before through to 4 hours after itraconazole administration, we evaluated the changes in SBP and the risk factors for an SBP drop, especially clinically meaningful (≥20% drops.Results: Itraconazole was administered 2,627 times to 180 patients. The SBP during the 4 hours following itraconazole administration was lower than during the 4 hours before administration (104 [53.0–160.33 mmHg] versus 105 [59.8–148.3 mmHg]; P<0.001. The decrease in SBP was associated with the application of continuous renal replacement therapy (CRRT (P=0.012 and the use of inotropic (P=0.005 and hypotensive drugs (P=0.021. A clinically meaningful SBP drop was seen in 5.37% (141 out of 2,627 of the administrations, and the use of inotropics (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.22–13.92; P<0.001, reducing the dose of inotropics (OR 8.08; 95% CI 1.39–46.94; P=0

  1. Sporadic Retinoblastoma and Parental Smoking and Alcohol Consumption before and after Conception: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Azary, Saeedeh; Ganguly, Arupa; Bunin, Greta R.; Lombardi, Christina; Park, Andrew S.; Ritz, Beate; Heck, Julia E.

    2016-01-01

    Background Retinoblastoma is the most frequent tumor of the eye in children and very little is known about the etiology of non-familial (sporadic) retinoblastoma. In this study we examined whether parental tobacco smoking or alcohol consumption (pre- or post-conception) contribute to the two phenotypes (bilateral or unilateral) of sporadic retinoblastoma. Methods Two large multicenter case-control studies identified 488 cases through eye referral centers in the United States and Canada or through the Children’s Oncology Group. Controls (n = 424) were selected from among friends and relatives of cases and matched by age. Risk factor information was obtained via telephone interview. We employed multivariable logistic regression to estimate the effects of parental tobacco smoking and alcohol consumption on retinoblastoma. Findings Maternal smoking before and during pregnancy contributed to unilateral retinoblastoma risk in the child: year before pregnancy conditional Odds Ratio (OR), 8.9; 95% confidence interval (CI) 1.5–51, and unconditional OR, 2.4; 95% CI, 1.3–4.7; month before or during pregnancy, conditional OR, 3.3; 95% CI, 0.5–20.8, and unconditional OR, 2.8; 95% CI, 1.1–7.0. No association was found for maternal or paternal alcohol consumption. Conclusion The results of this study indicate that maternal active smoking during pregnancy may be a risk factor for sporadic retinoblastoma. Our study supports a role for tobacco exposures in embryonal tumors. PMID:26991078

  2. Decree 302/013. It amend Art. 5 of Decree 202/005 on the integration of the National Oncology Committee and it create a Standing Advisory Group

    International Nuclear Information System (INIS)

    The decree is about an adaptation of the integration of the national committee on oncologic o including representatives of the Faculty of Medicine of the University of the Republic and representatives of the National Board of Health and Honorary Commission to Fight Cancer that is proposed.Creating a Standing Advisory Group is also suggested

  3. Minimal Groups Increase Young Children's Motivation and Learning on Group-Relevant Tasks

    Science.gov (United States)

    Master, Allison; Walton, Gregory M.

    2013-01-01

    Three experiments ("N" = 130) used a minimal group manipulation to show that just perceived membership in a social group boosts young children's motivation for and learning from group-relevant tasks. In Experiment 1, 4-year-old children assigned to a minimal "puzzles group" persisted longer on a challenging puzzle than children identified as the…

  4. Pretreatment factors significantly influence quality of life in cancer patients: A Radiation Therapy Oncology Group (RTOG) analysis

    International Nuclear Information System (INIS)

    Purpose The purpose of this analysis was to assess the impact of pretreatment factors on quality of life (QOL) in cancer patients. Methods and Materials Pretreatment QOL (via Functional Assessment of Cancer Therapy [FACT], version 2) was obtained in 1,428 patients in several prospective Radiation Therapy Oncology Group (RTOG) trials including nonmetastatic head-and-neck (n = 1139), esophageal (n = 174), lung (n = 51), rectal (n = 47), and prostate (n = 17) cancer patients. Clinically meaningful differences between groups were defined as a difference of 1 standard error of measurement (SEM). Results The mean FACT score for all patients was 86 (20.7-112) with SEM of 5.3. Statistically significant differences in QOL were observed based on age, race, Karnofsky Performance Status, marital status, education level, income level, and employment status, but not by gender or primary site. Using the SEM, there were clinically meaningful differences between patients ≤50 years vs. ≥65 years. Hispanics had worse QOL than whites. FACT increased linearly with higher Karnofsky Performance Status and income levels. Married patients (or live-in relationships) had a better QOL than single, divorced, or widowed patients. College graduates had better QOL than those with less education. Conclusion Most pretreatment factors meaningfully influenced baseline QOL. The potentially devastating impact of a cancer diagnosis, particularly in young and minority patients, must be addressed

  5. Influence of bromodeoxyuridine radiosensitization on malignant glioma patient survival: a retrospective comparison of survival data from the Northern California oncology group (NCOG) and radiation therapy oncology group trials (RTOG) for glioblastoma multiforme and anaplastic astrocytoma

    International Nuclear Information System (INIS)

    Purpose: To examine the effect of treatment using Bromodeoxyuridine (BrdU) during radiation therapy on malignant glioma patient survival by comparing historical survival data from several large clinical trials. Methods: A retrospective analysis of patient data from Radiation Therapy Oncology Group (RTOG) trials 74-01, 79-18, and 83-02 and the Northern California Oncology Group (NCOG) study 6G-82-1 was conducted. Patient data was supplied by both groups, and analyzed by the RTOG. Pretreatment characteristics including age, extent of surgery, Karnofsky Performance Status (KPS), and histopathology were collected; the only treatment variable evaluated was the use of BrdU during radiation therapy. Radiation dose, dose-fractionation schedule, use of chemotherapy, and/or type of chemotherapy was not controlled for in the analyses. Univariate and multivariate analyses were conducted to examine the potential treatment effect of BrdU on patient survival. Results: Data from 334 patients treated with BrdU on NCOG 6G-82-1 and 1743 patients treated without BrdU on 3 RTOG studies was received. Patients were excluded from the review if confirmation of eligibility could not be obtained, if the patient was ineligible for the study they entered, if central pathology review was not done, or if radiotherapy data was not available. Patients treated according to the RTOG studies had to start radiotherapy within 4 weeks of surgery; no such restriction existed for the NCOG studies. To ensure comparability between the studies, patients from the NCOG studies who began treatment longer than 40 days from surgery were also excluded. The final data set included 296 cases from the NCOG studies (89%) and 1478 cases from the RTOG studies (85%). For patients with glioblastoma multiforme (GBM) the median survival was 9.8 months in the RTOG studies and 13.0 months in the NCOG trial (p < 0.0001). For patients with AA the median survival was 35.1 months for the RTOG studies and 42.8 months in the NCOG

  6. Group Play Therapy with Sexually Abused Preschool Children: Group Behaviors and Interventions

    Science.gov (United States)

    Jones, Karyn Dayle

    2002-01-01

    Group play therapy is a common treatment modality for children who have been sexually abused. Sexually abused preschoolers exhibit different group play therapy behaviors than do nonabused children. Group workers need to be aware of these differences and know the appropriate group interventions. This article describes group play therapy with…

  7. Implementation and Evaluation of the Modified Feeling Great Program for Oncology Children

    Science.gov (United States)

    McCaffrey, C. Nadeane

    2006-01-01

    Purpose: Designed to reduce anxiety and boost self-concept, The Modified Feeling Great Program (MFGP) consisted of a series of mental training exercises used to improve the quality of life for 6-17 year old children (N=20) with cancer. More specifically, the children were taught how to relax, look for highlights (good things that happen to them),…

  8. The Effects of Music and Group Stage on Group Leader and Member Behavior in Psychoeducational Groups for Children of Divorce

    Science.gov (United States)

    Cercone, Kristin; DeLucia-Waack, Janice

    2012-01-01

    This study examined the effects of music and group stage on group process and group leader and member behavior within 8-week psychoeducational groups for children of divorce. Audiotapes of group sessions were rated using the Interactional Process Analysis and the Group Sessions Ratings Scale. Both treatment groups were very similar in terms of…

  9. The prognostic value of nestin expression in newly diagnosed glioblastoma: Report from the Radiation Therapy Oncology Group

    International Nuclear Information System (INIS)

    Nestin is an intermediate filament protein that has been implicated in early stages of neuronal lineage commitment. Based on the heterogeneous expression of nestin in GBM and its potential to serve as a marker for a dedifferentiated, and perhaps more aggressive phenotype, the Radiation Therapy Oncology Group (RTOG) sought to determine the prognostic value of nestin expression in newly diagnosed GBM patients treated on prior prospective RTOG clinical trials. Tissue microarrays were prepared from 156 patients enrolled in these trials. These specimens were stained using a mouse monoclonal antibody specific for nestin and expression was measured by computerized quantitative image analysis using the Ariol SL-50 system. The parameters measured included both staining intensity and the relative area of expression within a specimen. This resulted into 3 categories: low, intermediate, and high nestin expression, which was then correlated with clinical outcome. A total of 153 of the 156 samples were evaluable for this study. There were no statistically significant differences between pretreatment patient characteristics and nestin expression. There was no statistically significant difference in either overall survival or progression-free survival (PFS) demonstrated, although a trend in decreased PFS was observed with high nestin expression (p = 0.06). Although the correlation of nestin expression and histologic grade in glioma is of considerable interest, the presented data does not support its prognostic value in newly diagnosed GBM. Further studies evaluating nestin expression may be more informative when studied in lower grade glioma, in the context of markers more specific to tumor stem cells, and using more recent specimens from patients treated with temozolomide in conjunction with radiation

  10. Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Dabaja, Bouthaina S. [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Filippi, Andrea R. [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Illidge, Tim [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Petersen, Peter M.; Schut, Deborah A. [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Garcia, John [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Headley, Jayne [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Parent, Amy; Guibord, Benoit [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ragona, Riccardo [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Specht, Lena [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark)

    2015-05-01

    Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs.

  11. Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

    International Nuclear Information System (INIS)

    Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs

  12. Quality assurance experience with the randomized neuropathic bone pain trial (Trans-Tasman Radiation Oncology Group, 96.05)

    International Nuclear Information System (INIS)

    Background and purpose: Trans-Tasman Radiation Oncology Group 96.05 is a prospective randomized controlled trial comparing a single 8 Gy with 20 Gy in five fractions of radiotherapy (RT) for neuropathic pain due to bone metastases. This paper summarizes the quality assurance (QA) activities for the first 234 patients (accrual target 270). Materials and methods: Independent audits to assess compliance with eligibility/exclusion criteria and appropriateness of treatment of the index site were conducted after each cohort of approximately 45 consecutive patients. Reported serious adverse events (SAEs) in the form of cord/cauda equina compression or pathological fracture developing at the index site were investigated and presented in batches to the Independent Data Monitoring Committee. Finally, source data verification of the RT prescription page and treatment records was undertaken for each of the first 234 patients to assess compliance with the protocol. Results: Only one patient was found conclusively not to have genuine neuropathic pain, and there were no detected 'geographical misses' with RT fields. The overall rate of detected infringements for other eligibility criteria over five audits (225 patients) was 8% with a dramatic improvement after the first audit. There has at no stage been a statistically significant difference in SAEs by randomization arm. There was a 22% rate of RT protocol variations involving ten of the 14 contributing centres, although the rate of major dose violations (more than ±10% from protocol dose) was only 6% with no statistically significant difference by randomization arm (P=0.44). Conclusions: QA auditing is an essential but time-consuming component of RT trials, including those assessing palliative endpoints. Our experience confirms that all aspects should commence soon after study activation

  13. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group.

    Science.gov (United States)

    Wen, Patrick Y; Macdonald, David R; Reardon, David A; Cloughesy, Timothy F; Sorensen, A Gregory; Galanis, Evanthia; Degroot, John; Wick, Wolfgang; Gilbert, Mark R; Lassman, Andrew B; Tsien, Christina; Mikkelsen, Tom; Wong, Eric T; Chamberlain, Marc C; Stupp, Roger; Lamborn, Kathleen R; Vogelbaum, Michael A; van den Bent, Martin J; Chang, Susan M

    2010-04-10

    Currently, the most widely used criteria for assessing response to therapy in high-grade gliomas are based on two-dimensional tumor measurements on computed tomography (CT) or magnetic resonance imaging (MRI), in conjunction with clinical assessment and corticosteroid dose (the Macdonald Criteria). It is increasingly apparent that there are significant limitations to these criteria, which only address the contrast-enhancing component of the tumor. For example, chemoradiotherapy for newly diagnosed glioblastomas results in transient increase in tumor enhancement (pseudoprogression) in 20% to 30% of patients, which is difficult to differentiate from true tumor progression. Antiangiogenic agents produce high radiographic response rates, as defined by a rapid decrease in contrast enhancement on CT/MRI that occurs within days of initiation of treatment and that is partly a result of reduced vascular permeability to contrast agents rather than a true antitumor effect. In addition, a subset of patients treated with antiangiogenic agents develop tumor recurrence characterized by an increase in the nonenhancing component depicted on T2-weighted/fluid-attenuated inversion recovery sequences. The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies. The Response Assessment in Neuro-Oncology Working Group is an international effort to develop new standardized response criteria for clinical trials in brain tumors. In this proposal, we present the recommendations for updated response criteria for high-grade gliomas. PMID:20231676

  14. Implementation of Remote 3-Dimensional Image Guided Radiation Therapy Quality Assurance for Radiation Therapy Oncology Group Clinical Trials

    International Nuclear Information System (INIS)

    Purpose: To report the process and initial experience of remote credentialing of three-dimensional (3D) image guided radiation therapy (IGRT) as part of the quality assurance (QA) of submitted data for Radiation Therapy Oncology Group (RTOG) clinical trials; and to identify major issues resulting from this process and analyze the review results on patient positioning shifts. Methods and Materials: Image guided radiation therapy datasets including in-room positioning CT scans and daily shifts applied were submitted through the Image Guided Therapy QA Center from institutions for the IGRT credentialing process, as required by various RTOG trials. A centralized virtual environment is established at the RTOG Core Laboratory, containing analysis tools and database infrastructure for remote review by the Physics Principal Investigators of each protocol. The appropriateness of IGRT technique and volumetric image registration accuracy were evaluated. Registration accuracy was verified by repeat registration with a third-party registration software system. With the accumulated review results, registration differences between those obtained by the Physics Principal Investigators and from the institutions were analyzed for different imaging sites, shift directions, and imaging modalities. Results: The remote review process was successfully carried out for 87 3D cases (out of 137 total cases, including 2-dimensional and 3D) during 2010. Frequent errors in submitted IGRT data and challenges in the review of image registration for some special cases were identified. Workarounds for these issues were developed. The average differences of registration results between reviewers and institutions ranged between 2 mm and 3 mm. Large discrepancies in the superior-inferior direction were found for megavoltage CT cases, owing to low spatial resolution in this direction for most megavoltage CT cases. Conclusion: This first experience indicated that remote review for 3D IGRT as part of QA

  15. Increasing the Athletic Group Play of Children with Autism

    Science.gov (United States)

    Miltenberger, Catherine A.; Charlop, Marjorie H.

    2014-01-01

    A multiple baseline design across three children with autism and within child across activity was used to assess the effects of interventions designed to teach children with autism to play two common athletic group games, handball and 4-square. Treatment consisted of two phases. In Phase I, athletic skills training, the children participated in…

  16. Group acceptance and emotional competence of preadolescent children

    Directory of Open Access Journals (Sweden)

    Petrović Jelica

    2007-01-01

    Full Text Available This study examines contribution of emotional competence on socially competent behavior of preadolescents. The following emotional competencies were registered in 397 children: emotion recognition, emotional regulation, empathy and style of coping with aversive emotions. Discriminant analysis was conducted in order to identify emotional competencies that differentiate among the groups of participants with different levels of social preference. The data showed that groups of popular children, rejected children, and children of average sociometric status significantly differ with respect to their emotional competence. Children rejected by their peers displayed the lowest level of emotional competence. .

  17. Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program

    OpenAIRE

    Via, Paola Dalla; Opocher, Enrico; Pinello, Maria Luisa; Calderone, Milena; Viscardi, Elisabetta; Clementi, Maurizio; Battistella, Pier Antonio; Laverda, Anna Maria; Dalt, Liviana Da; Perilongo, Giorgio

    2007-01-01

    We evaluated the visual outcome of a cohort of children with neurofibromatosis type 1 (NF1) and optic pathway glioma (OPG) treated according to standardized therapeutic guidelines. The study population consisted of all consecutive patients with NF1 and OPG referred to a specialized pediatric neuro-oncology program between 1994 and 2004. Treatment was instituted only in cases of progressive disease or clinical deterioration. Treatment modalities were chemotherapy (based on vincristine/carbopla...

  18. Impact of Cancer Support Groups on Childhood Cancer Treatment and Abandonment in a Private Pediatric Oncology Centre

    OpenAIRE

    Arathi Srinivasan; Khushboo Tiwari; Julius Xavier Scott; Priya Ramachandran; Mathangi Ramakrishnan

    2015-01-01

    Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed...

  19. Phase II study of topotecan plus cranial radiation for glioblastoma multiforme: results of Radiation Therapy Oncology Group 9513

    International Nuclear Information System (INIS)

    Purpose: A Phase II trial was conducted by the Radiation Therapy Oncology Group (RTOG) to compare the survival of patients with glioblastoma multiforme treated with topotecan combined with standard cranial radiotherapy (RT) for matched patients treated in prior RTOG studies. A secondary objective was to document the acute and late toxicities of this combination of chemotherapy and RT. Methods and Materials: Eighty-seven patients with histologically confirmed glioblastoma multiforme received standard cranial RT (60 Gy/30 fractions in 6 weeks) plus topotecan 1.5 mg/m2 per day i.v. for 5 d/wk every 3 weeks for 3 cycles. Eighty-four patients were evaluated, of whom 60 (71%) were ≥50 years, 44 (52%) were men, and 61 (73%) had a Karnofsky performance status of ≥80. Twenty-nine percent of patients had undergone biopsies, 48% partial resections, and 21% gross total resections. Two resections were unspecified as to the extent of tumor removal. Fourteen percent of patients were recursive partitioning analysis Class III, 46% were Class IV, 35% were Class V, and 5% were Class VI. Results: The median survival was 9.3 months. Sixty-seven patients (80%) had progression. The 1-year survival rate was 32%. One patient remained alive without recurrence. RTOG 9513 patients were matched with patients in an RTOG clinical trial database from previous clinical trials. The matching variables were age, Karnofsky performance status, mental status, and prior surgery. No statistically significant difference was found between the survival of the study patients and that of the matched patients from the RTOG database. Fifty-four percent of patients had Grade IV acute toxicity. The toxicity was primarily hematologic. Four patients had Grade III late central nervous system toxicities. Conclusion: Topotecan administered at a dose of 1.5 mg/m2 per day i.v. for 5 d/wk every 3 weeks for 3 cycles given concurrently with standard cranial RT for glioblastoma does not produce a statistically

  20. Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

    International Nuclear Information System (INIS)

    use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines

  1. Phase II Radiation therapy oncology group trial of weekly paclitaxel and conventional external beam radiation therapy for supratentorial glioblastoma multiforme

    International Nuclear Information System (INIS)

    Purpose: Fractionated external beam radiotherapy (EBRT) ± carmustine (BCNU) is the standard of care for patients with glioblastoma multiforme (GBM), but survival results remain poor. Preclinical studies indicate synergy between RT and paclitaxel (TAX) in astrocytoma cell lines. Phase I studies in GBM have demonstrated a maximum tolerated dose for TAX of 225 mg/m2/3 h/week x 6, during EBRT, with no exacerbation of typical RT-induced toxicities. The Radiation Therapy Oncology Group (RTOG) therefore mounted a Phase II study to determine the feasibility and efficacy of conventional EBRT and concurrent weekly TAX at its MTD. Patients and Methods: Sixty-two patients with histologic diagnosis of GBM were enrolled from 8/16/96 through 3/21/97 in a multi-institutional Phase II trial of EBRT and TAX 225 mg/m2/3 h (1-3 h before EBRT), administered the first treatment day of each RT week. Total EBRT dose was 60 Gy (200 cGy/fraction), 5 days per week. A smaller treatment field, to include gross disease plus a margin only, was used after 46 Gy. Results: Sixty-one patients (98%) were evaluable. Median age was 55 years (range, 28-78). Seventy-four percent were ≥50 years. Recursive partitioning analysis (RPA) Classes III, IV, V, VI included 10 (17%), 21 (34%), 25 (41%), and 5 (8%) patients, respectively. Gross total resection was performed in only 16%. There was no Grade 3 or 4 neutropenia or thrombocytopenia. Hypersensitivity reactions precluding further use of TAX occurred in 4 patients. There were 2 instances of late neurotoxicity (4% Grade 3 or 4). Ninety-one percent of patients received treatment per protocol. Seventy-seven percent completed prescribed treatment (6 weeks). Of 35 patients with measurable disease, CR/PR was observed in 23%, MR in 17%, and SD in 43%. Seventeen percent demonstrated progression at first follow-up. Median potential follow-up time is 20 months. Median survival is 9.7 months, with median survivals for RPA classes III, IV, V, and VI of 16.3, 10.2, 9

  2. Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena, E-mail: lena.specht@regionh.dk [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Christie Hospital NHS Trust, Manchester (United Kingdom); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen (Denmark); Constine, Louis S. [Department of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Eich, Hans Theodor [Department of Radiation Oncology, University of Münster (Germany); Girinsky, Theodore [Department of Radiation Oncology, Institut Gustave-Roussy, Villejuif (France); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Mauch, Peter [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Mikhaeel, N. George [Department of Clinical Oncology and Radiotherapy, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States)

    2014-07-15

    use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines.

  3. Do Spirituality and Faith Make a Difference? Report from the Southern European Psycho-Oncology Study Group

    OpenAIRE

    Travado, L; Grassi, L; Gil, F.; C. Martins; C. Ventura; Bairradas, J

    2010-01-01

    OBJECTIVE: In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study--SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in So...

  4. Early group bias in the Faroe Islands: Cultural variation in children's group-based reasoning.

    Science.gov (United States)

    Schug, Mariah G; Shusterman, Anna; Barth, Hilary; Patalano, Andrea L

    2016-09-01

    Recent developmental research demonstrates that group bias emerges early in childhood. However, little is known about the extent to which bias in minimal (i.e., arbitrarily assigned) groups varies with children's environment and experience, and whether such bias is universal across cultures. In this study, the development of group bias was investigated using a minimal groups paradigm with 46 four- to six-year-olds from the Faroe Islands. Children observed in-group and out-group members exhibiting varying degrees of prosocial behaviour (egalitarian or stingy sharing). Children did not prefer their in-group in the pretest, but a pro-in-group and anti-out-group sentiment emerged in both conditions in the posttest. Faroese children's response patterns differ from those of American children [Schug, M. G., Shusterman, A., Barth, H., & Patalano, A. L. (2013). Minimal-group membership influences children's responses to novel experience with group members. Developmental Science, 16(1), 47-55], suggesting that intergroup bias shows cultural variation even in a minimal groups context. PMID:26444259

  5. Quality Indicators in Radiation Oncology

    International Nuclear Information System (INIS)

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts

  6. User involvement: children's participation in a parent-baby group.

    Science.gov (United States)

    Maconochie, Heloise; McNeill, Fiona

    2010-08-01

    According to the National Service Framework, children have a right to participate in the development of healthcare services and yet research suggests that young children are at risk of exclusion from user involvement initiatives. This paper outlines the findings of a participatory action research project conducted with families attending a health visitors' parent-baby group. A combination of participatory research methods were used to ascertain the infants' perspectives of the service and this led to a number of changes in terms of professional attitudes, service provision and working practices. Changes in professional attitudes included acknowledging the importance of social interaction to the children, recognising young children's views as embodied and produced within social interactions, and respecting children as active contributors and not simply as passive recipients of healthcare services. Changes in service provision resulted in redistributing resources, structures and spaces to take account of children's perspectives. Finally, reciprocity and responsiveness were seen as key components in enhancing young children's participation. PMID:20722326

  7. Specifics of psychomotor development in group of congenital blind children

    OpenAIRE

    Zbyněk Janečka; Kateřina Chrobáková; Michal Mayer

    2011-01-01

    Ontogenesis of the psychomotor development in group of congenital blind children has its own specifics. Visual defect is influenced by many things. In the period from birth to two years of age occur in children, significant changes in cognitive, psychomotor and social development. Compared with the normal sighted population go the development of congenital blind children in all these areas slower. Visual deprivation also influenced on development of body posture. More important is whether the...

  8. Danish Focus group protocol for children & adults

    DEFF Research Database (Denmark)

    Werther, Michelle Nadia; Pedersen, Dorthe; Sansolios, Sanne

    2010-01-01

    child (Heary & Hennessy, 2002). As in this particularly research it is decided to use the FG method to collect the dietary empiric, it must also be recognised that this method is not common to use with children at the age of 5, and therefore finding literature with best suitable ways to conduct the......As one aim of the research was to gain knowledge about children’s perception on food and meals as well as physical activity, it was decided that a qualitative method would be most appropriate. In addition the use of FG as research method was chosen, as this method gives the researcher the...... opportunity to explore the children’s knowledge and perception of a given subject. Thus recognizes the participants as experts of their world. FG’s have the additional advantages of minimize the possibility of the children responding to please the interviewer, and also remove the pressure from the individual...

  9. Group Play Interventions for Children: Strategies for Teaching Prosocial Skills

    Science.gov (United States)

    Reddy, Linda A.

    2011-01-01

    Group play interventions are used to meet a broad range of developmental needs in children from various backgrounds. This book is for mental health practitioners working with children aged 5 through 12 to help them learn important social skills and self-control strategies such as making friends, asking for and offering help, controlling hands and…

  10. Young children's motor interference is influenced by novel group membership

    OpenAIRE

    Schaik, J.E. van; Endedijk, H.M.; Stapel, J.C.; Hunnius, S.

    2016-01-01

    From early childhood onward, individuals use behavior copying to communicate liking and belonging. This non-verbal signal of affiliation is especially relevant in the context of social groups and indeed both children and adults copy in-group more than out-group members. Given the societal importance of inter-group interactions, it is imperative to understand the mechanistic level at which group modulations of copying occur early in development. The current study was designed to investigate th...

  11. Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group: 2011 consensus guidelines for curative radiotherapy for urothelial carcinoma of the bladder

    International Nuclear Information System (INIS)

    Curative radiotherapy, with or without concurrent chemotherapy, is recognized as a standard treatment option for muscle-invasive bladder cancer. It is commonly used for two distinct groups of patients: either for those medically unfit for surgery, or as part of a 'bladder preserving' management plan incorporating the possibility of salvage cystectomy. However, in both situations, the approach to radiotherapy varies widely around the world. The Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recognised a need to develop consistent, evidence-based guidelines for patient selection and radiotherapy technique in the delivery of curative radiotherapy. Following a workshop convened in May 2009, a working party collated opinions and conducted a wide literature appraisal linking each recommendation with the best available evidence. This process was subject to ongoing re-presentation to the Faculty of Radiation Oncology Genito-Urinary Group members prior to final endorsement. These Guidelines include patient selection, radiation target delineation, dose and fractionation schedules, normal tissue constraints and investigational techniques. Particular emphasis is given to the rationale for the target volumes described. These Guidelines provide a consensus-based framework for the delivery of curative radiotherapy for muscle-invasive bladder cancer. Widespread input from radiation oncologists treating bladder cancer ensures that these techniques are feasible in practice. We recommend these Guidelines be adopted widely in order to encourage a uniformly high standard of radiotherapy in this setting, and to allow for better comparison of outcomes.

  12. Human group A rotavirus infections in children in Denmark

    DEFF Research Database (Denmark)

    Midgley, S; Böttiger, B; Jensen, T G;

    2014-01-01

    One of the leading causes of severe childhood gastroenteritis are group A rotaviruses, and they have been found to be associated with similar to 40% of the annual gastroenteritis-associated hospitalizations in young Danish children...

  13. Group acceptance and emotional competence of preadolescent children

    OpenAIRE

    Petrović Jelica; Zotović Marija

    2007-01-01

    This study examines contribution of emotional competence on socially competent behavior of preadolescents. The following emotional competencies were registered in 397 children: emotion recognition, emotional regulation, empathy and style of coping with aversive emotions. Discriminant analysis was conducted in order to identify emotional competencies that differentiate among the groups of participants with different levels of social preference. The data showed that groups of popular children, ...

  14. Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

    International Nuclear Information System (INIS)

    Performing intensity-modulated radiotherapy (IMRT) on head and neck cancer patients (HNCPs) requires robust training and experience. Thus, in 2011, the Head and Neck Cancer Working Group (HNCWG) of the Italian Association of Radiation Oncology (AIRO) organized a study group with the aim to run a literature review to outline clinical practice recommendations, to suggest technical solutions and to advise target volumes and doses selection for head and neck cancer IMRT. The main purpose was therefore to standardize the technical approach of radiation oncologists in this context. The following paper describes the results of this working group. Volumes, techniques/strategies and dosage were summarized for each head-and-neck site and subsite according to international guidelines or after reaching a consensus in case of weak literature evidence

  15. Acquired aplastic anemia in Korean children: treatment guidelines from the Bone Marrow Failure Committee of the Korean Society of Pediatric Hematology Oncology.

    Science.gov (United States)

    Kook, Hoon; Chung, Nack-Gyun; Kang, Hyoung Jin; Im, Ho Joon

    2016-04-01

    The treatment of choice for aplastic anemia (AA) in children has been HLA-matched family donor (MFD) hematopoietic stem cell transplantation (HSCT). For those lacking MFD, immunosuppressive therapy (IST) consisting of horse antithymocyte globulin (ATG) and cyclosporine has been successful. The choices of second and third line treatments are more complex and debatable, especially in the situation of unavailability of horse ATG. IST with rabbit ATG seems to be less effective. Recently, improved survival of non-MFD HSCTs has been documented. The outcome of matched or mismatched unrelated donor, umbilical cord blood, or haploidentical family donor transplantations will be discussed in AA children after IST failure. Experimental approaches of upfront HSCT using non-MFDs will be briefly touched. In this review, a treatment guideline for children with AA from the Korean Society of Pediatric Hematology Oncology will be presented along with a brief review of literature on current clinical practices in Korea. PMID:26894608

  16. Radiotherapy Quality Assurance Report From Children's Oncology Group AHOD0031

    International Nuclear Information System (INIS)

    Purpose: A phase 3 trial assessing response-based therapy in intermediate-risk Hodgkin lymphoma mandated real-time central review of involved field radiation therapy (IFRT) and imaging records by a centralized review center to maximize protocol compliance. We report the impact of centralized radiation therapy review on protocol compliance. Methods and Materials: Review of simulation films, port films, and dosimetry records was required before and after treatment. Records were reviewed by study-affiliated or review center–affiliated radiation oncologists. A deviation of 6% to 10% from protocol-specified dose was scored as “minor”; a deviation of >10% was “major.” A volume deviation was scored as “minor” if margins were less than specified or “major” if fields transected disease-bearing areas. Interventional review and final compliance review scores were assigned to each radiation therapy case and compared. Results: Of 1712 patients enrolled, 1173 underwent IFRT at 256 institutions in 7 countries. An interventional review was performed in 88% of patients and a final review in 98%. Overall, minor and major deviations were found in 12% and 6% of patients, respectively. Among the cases for which ≥1 pre-IFRT modification was requested by the Quality Assurance Review Center and subsequently made by the treating institution, 100% were made compliant on final review. By contrast, among the cases for which ≥1 modification was requested but not made by the treating institution, 10% were deemed compliant on final review. Conclusions: In a large trial with complex treatment pathways and heterogeneous radiation therapy fields, central review was performed in a large percentage of cases before IFRT and identified frequent potential deviations in a timely manner. When suggested modifications were performed by the institutions, deviations were almost eliminated

  17. Radiotherapy Quality Assurance Report From Children's Oncology Group AHOD0031

    Energy Technology Data Exchange (ETDEWEB)

    Dharmarajan, Kavita V. [Mount Sinai Medical Center, New York, New York (United States); Friedman, Debra L. [Vanderbilt University, Nashville, Tennessee (United States); FitzGerald, T.J. [Quality Assurance Review Center, Lincoln, Rhode Island (United States); McCarten, Kathleen M. [Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States); Constine, Louis S. [University of Rochester Medical Center, Rochester, New York (United States); Chen, Lu [Children' s Oncology Group, Arcadia, California (United States); Kessel, Sandy K.; Iandoli, Matt; Laurie, Fran [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Schwartz, Cindy L. [MD Anderson Cancer Center, Houston, Texas (United States); Wolden, Suzanne L., E-mail: woldens@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2015-04-01

    Purpose: A phase 3 trial assessing response-based therapy in intermediate-risk Hodgkin lymphoma mandated real-time central review of involved field radiation therapy (IFRT) and imaging records by a centralized review center to maximize protocol compliance. We report the impact of centralized radiation therapy review on protocol compliance. Methods and Materials: Review of simulation films, port films, and dosimetry records was required before and after treatment. Records were reviewed by study-affiliated or review center–affiliated radiation oncologists. A deviation of 6% to 10% from protocol-specified dose was scored as “minor”; a deviation of >10% was “major.” A volume deviation was scored as “minor” if margins were less than specified or “major” if fields transected disease-bearing areas. Interventional review and final compliance review scores were assigned to each radiation therapy case and compared. Results: Of 1712 patients enrolled, 1173 underwent IFRT at 256 institutions in 7 countries. An interventional review was performed in 88% of patients and a final review in 98%. Overall, minor and major deviations were found in 12% and 6% of patients, respectively. Among the cases for which ≥1 pre-IFRT modification was requested by the Quality Assurance Review Center and subsequently made by the treating institution, 100% were made compliant on final review. By contrast, among the cases for which ≥1 modification was requested but not made by the treating institution, 10% were deemed compliant on final review. Conclusions: In a large trial with complex treatment pathways and heterogeneous radiation therapy fields, central review was performed in a large percentage of cases before IFRT and identified frequent potential deviations in a timely manner. When suggested modifications were performed by the institutions, deviations were almost eliminated.

  18. Group crisis intervention for children during ongoing war conflict.

    Science.gov (United States)

    Thabet, Abdel Aziz; Vostanis, Panos; Karim, Khalid

    2005-08-01

    The aim of this study was to evaluate the short-term impact of a group crisis intervention for children aged 9-15 years from five refugee camps in the Gaza Strip during ongoing war conflict. Children were selected if they reported moderate to severe posttraumatic stress reactions, and were allocated to group intervention (N=47) encouraging expression of experiences and emotions through storytelling, drawing, free play and role-play; education about symptoms (N=22); or no intervention (N=42). Children completed the CPTSD-RI and the CDI pre- and post-intervention. No significant impact of the group intervention was established on children's posttraumatic or depressive symptoms. Possible explanations of the findings are discussed, including the continuing exposure to trauma and the non-active nature of the intervention. PMID:15981138

  19. Children's Implicit and Explicit Ethnic Group Attitudes, Ethnic Group Identification, and Self-Esteem

    Science.gov (United States)

    Davis, Stephanie C.; Leman, Patrick J.; Barrett, Martyn

    2007-01-01

    An increasing amount of research explores how children distinguish different aspects of ethnic group attitudes. However, little work has focused on how these aspects tie in with other social and psychological processes. In the present study, 112 black and white children aged 5-, 7- and 9-years completed tests of implicit and explicit ethnic group…

  20. Group Rhythmic Synchrony and Attention in Children

    Directory of Open Access Journals (Sweden)

    Alexander K Khalil

    2013-09-01

    Full Text Available Synchrony, or the coordinated processing of time, is an often-overlooked yet critical context for human interaction. This study tests the relationship between the ability to synchronize rhythmically in a group setting with the ability to attend in 102 elementary schoolchildren. Impairments in temporal processing have frequently been shown to exist in clinical populations with learning disorders, particularly those with Attention Deficit Hyperactivity Disorder (ADHD. Based on this evidence, we hypothesized that the ability to synchronize rhythmically in a group setting—an instance of the type of temporal processing necessary for successful interaction and learning—would be correlated with the ability to attend across the continuum of the population. A music class is an ideal setting for the study of interpersonal timing. In order to measure synchrony in this context, we constructed instruments that allowed the recording and measurement of individual rhythmic performance. The SWAN teacher questionnaire was used as a measurement of attentional behavior. We find that the ability to synchronize with others in a group music class can predict a child’s attentional behavior.

  1. Obesity status trajectory groups among elementary school children

    Science.gov (United States)

    Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. T...

  2. The Group Project for Holocaust Survivors and Their Children.

    Science.gov (United States)

    Danieli, Yael

    1981-01-01

    Describes a program, both rehabilitative and preventive, which provides individual, family, group, and community work for Holocaust survivors and their children. Six group experiences are offered: awareness, self-help, long-term therapy, mixed, multiple-family, and intergenerational. (Author/DB)

  3. Racial Differences in CYP3A4 Genotype and Survival Among Men Treated on Radiation Therapy Oncology Group (RTOG) 9202: A Phase III Randomized Trial

    International Nuclear Information System (INIS)

    Purpose: Inherited genotypes may explain the inferior outcomes of African American (AA) men with prostate cancer. To understand how variation in CYP3A4 correlated with outcomes, a retrospective examination of the CYP3A4*1B genotype was performed on men treated with Radiation Therapy Oncology Group (RTOG) 92-02. Methods and Materials: From 1,514 cases, we evaluated 56 (28.4%) of 197 AA and 54 (4.3%) of 1,274 European American (EA) patients. All patients received goserelin and flutamide for 2 months before and during RT (STAD-RT) ± 24 months of goserelin (long-term androgen deprivation plus radiation [LTAD-RT]). Events studied included overall survival and biochemical progression using American Society for Therapeutic Radiology and Oncology consensus guidelines. Results: There were no differences in outcome in patients in with or without CYP3A4 data. There was an association between race and CYP3A4 polymorphisms with 75% of EAs having the Wild Type compared to only 25% of AA men (p <0.0001). There was no association between CYP3A4 classification or race and survival or progression. Conclusions: The samples analyzed support previously reported observations about the distribution of CYP3A4*1B genotype by race, but race was not associated with poorer outcome. However, patient numbers were limited, and selection bias cannot be completely ruled out

  4. Radiation oncology

    International Nuclear Information System (INIS)

    The Radiation Oncology Division has had as its main objectives both to operate an academic training program and to carry out research on radiation therapy of cancer. Since fiscal year 1975, following a directive from ERDA, increased effort has been given to research. The research activities have been complemented by the training program, which has been oriented toward producing radiation oncologists, giving physicians short-term experience in radiation oncology, and teaching medical students about clinical cancer and its radiation therapy. The purpose of the research effort is to improve present modalities of radiation therapy of cancer. As in previous years, the Division has operated as the Radiation Oncology Program of the Department of Radiological Sciences of the University of Puerto Rico School of Medicine. It has provided radiation oncology support to patients at the University Hospital and to academic programs of the University of Puerto Rico Medical Sciences Campus. The patients, in turn, have provided the clinical basis for the educational and research projects of the Division. Funding has been primarily from PRNC (approx. 40%) and from National Cancer Institute grants channeled through the School of Medicine (approx. 60%). Special inter-institutional relationships with the San Juan Veterans Administration Hospital and the Metropolitan Hospital in San Juan have permitted inclusion of patients from these institutions in the Division's research projects. Medical physics and radiotherapy consultations have been provided to the Radiotherapy Department of the VA Hospital

  5. Anthropometric assessment of a Middle Eastern group of autistic children

    Institute of Scientific and Technical Information of China (English)

    Nagwa A Meguid; Wafaa A Kandeel; Khaled E Wakeel; Aly A El-Nofely

    2014-01-01

    Background: Growth abnormalities are uniquely associated with autism spectrum disorders (ASD); however, the extent to which growth abnormalities are present has hardly been investigated. The current study aims to compare the differences in anthropometric parameters in a group of autistic Egyptian children and the healthy normal population. Methods: We recruited 100 children with ASD from the Outpatient Clinic for "Autistic Children" at the Medical Research Hospital of Excellence, National Research Centre in Cairo, Egypt. They were diagnosed by DSM-IV criteria of the American Psychiatric Association, Autism Diagnostic Interview-Revised, and Childhood Autism Rating Scale. Of these children at age of 3-10 years, 71 were males and 29 females. Eight anthropometric parameters were assessed in view of data of the healthy Egyptians of pertinent sex and age. Results: Weight and body mass index increased because of a signifi cant increase in subcutaneous fat thickness. This tendency with a probable decrease in muscle mass was more evident in male or in older children, likely resulting from sedentary life style and food selectivity. Conclusions: The Z head circumference score and its variance signifi cantly increased especially in males or older children, suggesting the relative overgrowth of the brain in a substantial percentage of Egyptian children with autism. We concluded that increased fat composition in Egyptian autistic children with decreased muscle mass necessitates tailoring a specially designed food supplementation program to ameliorate the severity of autism symptoms.

  6. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    DEFF Research Database (Denmark)

    Illidge, Tim; Specht, Lena; Yahalom, Joachim;

    2014-01-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning...... tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of...... reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT...

  7. Costing the components of pain management. Analysis of Trans-Tasman Radiation Oncology Group trial (TROG 96.05): One versus five fractions for neuropathic bone pain

    International Nuclear Information System (INIS)

    Background and purpose: Bone metastases causing neuropathic pain (NBP) have traditionally been treated with fractionated radiotherapy (RT). A recently reported randomised Trans-Tasman Radiation Oncology Group trial (TROG 96.05) supports this approach in many cases [Roos DE, Turner SL, O'Brien PC et al. Randomised trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05). Radiother Oncol 2005;75:54-63]. This study sought to compare costs to the Australian health-care system for patients receiving 1 versus 5 fractions for NBP. Patients and methods: The RT and medication costs for 245 patients treated on TROG 96.05 were determined from trial data out to 3 months from RT. Admission costs and causes were derived from hospital records. Results: RT costs (including re-treatments) were calculated to be 222 and 724 Australian dollars (A$) per patient for the 8 Gy/1 and 20 Gy/5 arms, respectively. This difference increased when analgesics (A$192 versus A$229) and related hospital admissions (A$1411 versus A$1893) were considered. Sensitivity analysis demonstrated an incremental cost saving of between A$795 and A$1468 for single fraction RT. Admission rates had the strongest potential to distort cost differences. Conclusions: Clinical outcomes are paramount in choice of fractionation scheme but are optimally considered in the light of economic implications. Overall cost differences between fractionation schedules may vary greatly from those incurred by the RT treatment centre alone. Ideally, such economic evaluations should be planned at the outset of a trial

  8. Specifics of psychomotor development in group of congenital blind children

    Directory of Open Access Journals (Sweden)

    Zbyněk Janečka

    2011-03-01

    Full Text Available Ontogenesis of the psychomotor development in group of congenital blind children has its own specifics. Visual defect is influenced by many things. In the period from birth to two years of age occur in children, significant changes in cognitive, psychomotor and social development. Compared with the normal sighted population go the development of congenital blind children in all these areas slower. Visual deprivation also influenced on development of body posture. More important is whether the development proceeds in stages that correspond to the development of normal vision child. If development proceeds in the right direction is the temporal aspect criterion rather orientation. For blind children is also important to strengthen the ability to correctly identify their own body through somatognosy. Stereognosy in turn determines the degree of contact with the outer world and focus it in relation to the physical schema.

  9. Insufficiency Fractures After Pelvic Radiation Therapy for Uterine Cervical Cancer: An Analysis of Subjects in a Prospective Multi-institutional Trial, and Cooperative Study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)

    Energy Technology Data Exchange (ETDEWEB)

    Tokumaru, Sunao, E-mail: tokumaru@cc.saga-u.ac.jp [Department of Heavy Particle Therapy and Radiation Oncology, Saga University, Saga (Japan); Toita, Takafumi [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa (Japan); Oguchi, Masahiko [Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kato, Shingo [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Matsuyama (Japan); Shikama, Naoto [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tuskuba (Japan); Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita (Japan); Kagami, Yoshikazu [Department of Radiology, Showa University School of Medicine, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); and others

    2012-10-01

    Purpose: To investigate pelvic insufficiency fractures (IF) after definitive pelvic radiation therapy for early-stage uterine cervical cancer, by analyzing subjects of a prospective, multi-institutional study. Materials and Methods: Between September 2004 and July 2007, 59 eligible patients were analyzed. The median age was 73 years (range, 37-84 years). The International Federation of Gynecologic Oncology and Obstetrics stages were Ib1 in 35, IIa in 12, and IIb in 12 patients. Patients were treated with the constant method, which consisted of whole-pelvic external-beam radiation therapy of 50 Gy/25 fractions and high-dose-rate intracavitary brachytherapy of 24 Gy/4 fractions without chemotherapy. After radiation therapy the patients were evaluated by both pelvic CT and pelvic MRI at 3, 6, 12, 18, and 24 months. Diagnosis of IF was made when the patients had both CT and MRI findings, neither recurrent tumor lesions nor traumatic histories. The CT findings of IF were defined as fracture lines or sclerotic linear changes in the bones, and MRI findings of IF were defined as signal intensity changes in the bones, both on T1- and T2-weighted images. Results: The median follow-up was 24 months. The 2-year pelvic IF cumulative occurrence rate was 36.9% (21 patients). Using Common Terminology Criteria for Adverse Events version 3.0, grade 1, 2, and 3 IF were seen in 12 (21%), 6 (10%), and 3 patients (5%), respectively. Sixteen patients had multiple fractures, so IF were identified at 44 sites. The pelvic IF were frequently seen at the sacroileal joints (32 sites, 72%). Nine patients complained of pain. All patients' pains were palliated by rest or non-narcotic analgesic drugs. Higher age (>70 years) and low body weight (<50 kg) were thought to be risk factors for pelvic IF (P=.007 and P=.013, Cox hazard test). Conclusions: Cervical cancer patients with higher age and low body weight may be at some risk for the development of pelvic IF after pelvic radiation therapy.

  10. Insufficiency Fractures After Pelvic Radiation Therapy for Uterine Cervical Cancer: An Analysis of Subjects in a Prospective Multi-institutional Trial, and Cooperative Study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)

    International Nuclear Information System (INIS)

    Purpose: To investigate pelvic insufficiency fractures (IF) after definitive pelvic radiation therapy for early-stage uterine cervical cancer, by analyzing subjects of a prospective, multi-institutional study. Materials and Methods: Between September 2004 and July 2007, 59 eligible patients were analyzed. The median age was 73 years (range, 37-84 years). The International Federation of Gynecologic Oncology and Obstetrics stages were Ib1 in 35, IIa in 12, and IIb in 12 patients. Patients were treated with the constant method, which consisted of whole-pelvic external-beam radiation therapy of 50 Gy/25 fractions and high-dose-rate intracavitary brachytherapy of 24 Gy/4 fractions without chemotherapy. After radiation therapy the patients were evaluated by both pelvic CT and pelvic MRI at 3, 6, 12, 18, and 24 months. Diagnosis of IF was made when the patients had both CT and MRI findings, neither recurrent tumor lesions nor traumatic histories. The CT findings of IF were defined as fracture lines or sclerotic linear changes in the bones, and MRI findings of IF were defined as signal intensity changes in the bones, both on T1- and T2-weighted images. Results: The median follow-up was 24 months. The 2-year pelvic IF cumulative occurrence rate was 36.9% (21 patients). Using Common Terminology Criteria for Adverse Events version 3.0, grade 1, 2, and 3 IF were seen in 12 (21%), 6 (10%), and 3 patients (5%), respectively. Sixteen patients had multiple fractures, so IF were identified at 44 sites. The pelvic IF were frequently seen at the sacroileal joints (32 sites, 72%). Nine patients complained of pain. All patients' pains were palliated by rest or non-narcotic analgesic drugs. Higher age (>70 years) and low body weight (<50 kg) were thought to be risk factors for pelvic IF (P=.007 and P=.013, Cox hazard test). Conclusions: Cervical cancer patients with higher age and low body weight may be at some risk for the development of pelvic IF after pelvic radiation therapy.

  11. Guidelines on Vaccinations in Paediatric Haematology and Oncology Patients

    OpenAIRE

    Simone Cesaro; Mareva Giacchino; Francesca Fioredda; Angelica Barone; Laura Battisti; Stefania Bezzio; Stefano Frenos; Raffaella De Santis; Susanna Livadiotti; Serena Marinello; Andrea Giulio Zanazzo; Désirée Caselli

    2014-01-01

    Objective. Vaccinations are the most important tool to prevent infectious diseases. Chemotherapy-induced immune depression may impact the efficacy of vaccinations in children. Patients and Methods. A panel of experts of the supportive care working group of the Italian Association Paediatric Haematology Oncology (AIEOP) addressed this issue by guidelines on vaccinations in paediatric cancer patients. The literature published between 1980 and 2013 was reviewed. Results and Conclusion. During in...

  12. AN INTEGRATIVE GROUP PSYCHOTHERAPY PROGRAM FOR CHILDREN. THE WIZARDING SCHOOL

    OpenAIRE

    Oana Maria Popescu; Silvia Georgiana Gane

    2012-01-01

    One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy). The program takes place within a fa...

  13. Children Displaced by Hurricane Katrina: A Focus Group Study

    Science.gov (United States)

    Pfefferbaum, Betty; Houston, J. Brian; Wyche, Karen Fraser; Van Horn, Richard L.; Reyes, Gilbert; Jeon-Slaughter, Haekyung; North, Carol S.

    2008-01-01

    Focus groups were conducted with 23 children and adolescents, aged 9 to 17 years, who relocated from Louisiana to Texas following Hurricane Katrina to explore their disaster, evacuation, and resettlement experiences. The resilience described by some was remarkable and, despite evidence of cultural disparity and stigma, many identified positive…

  14. Small Group Intervention for Children with Attention Disorders.

    Science.gov (United States)

    Houck, Gail; King, Mary Catherine; Tomlinson, Bill; Vrabel, Ann; Wecks, Kathleen

    2002-01-01

    Two practice improvement projects that provided small group experiences for children with attention deficit/hyperactivity disorder (ADHD) and disruptive behavior addressed: communication, friendship, self-control, and social problem solving. One provided activities for elementary students with ADHD (treated with medication only). Another provided…

  15. Report on the International Colloquium on Cardio-Oncology (Rome, 12–14 March 2014)

    Science.gov (United States)

    Ewer, Michael; Gianni, Luca; Pane, Fabrizio; Sandri, Maria Teresa; Steiner, Rudolf K; Wojnowski, Leszek; Yeh, Edward T; Carver, Joseph R; Lipshultz, Steven E; Minotti, Giorgio; Armstrong, Gregory T; Cardinale, Daniela; Colan, Steven D; Darby, Sarah C; Force, Thomas L; Kremer, Leontien CM; Lenihan, Daniel J; Sallan, Stephen E; Sawyer, Douglas B; Suter, Thomas M; Swain, Sandra M; van Leeuwen, Flora E

    2014-01-01

    Cardio-oncology is a relatively new discipline that focuses on the cardiovascular sequelae of anti-tumour drugs. As any other young adolescent discipline, cardio-oncology struggles to define its scientific boundaries and to identify best standards of care for cancer patients or survivors at risk of cardiovascular events. The International Colloquium on Cardio-Oncology was held in Rome, Italy, 12–14 March 2014, with the aim of illuminating controversial issues and unmet needs in modern cardio-oncology. This colloquium embraced contributions from different kind of disciplines (oncology and cardiology but also paediatrics, geriatrics, genetics, and translational research); in fact, cardio-oncology goes way beyond the merging of cardiology with oncology. Moreover, the colloquium programme did not review cardiovascular toxicity from one drug or the other, rather it looked at patients as we see them in their fight against cancer and eventually returning to everyday life. This represents the melting pot in which anti-cancer therapies, genetic backgrounds, and risk factors conspire in producing cardiovascular sequelae, and this calls for screening programmes and well-designed platforms of collaboration between one key professional figure and another. The International Colloquium on Cardio-Oncology was promoted by the Menarini International Foundation and co-chaired by Giorgio Minotti (Rome), Joseph R Carver (Philadelphia, Pennsylvania, United States), and Steven E Lipshultz (Detroit, Michigan, United States). The programme was split into five sessions of broad investigational and clinical relevance (what is cardiotoxicity?, cardiotoxicity in children, adolescents, and young adults, cardiotoxicity in adults, cardiotoxicity in special populations, and the future of cardio-oncology). Here, the colloquium chairs and all the session chairs briefly summarised what was said at the colloquium. Topics and controversies were reported on behalf of all members of the working group

  16. Percutaneous nephrolithotomy in children in different age groups

    DEFF Research Database (Denmark)

    Guven, Selcuk; Frattini, Antonio; Onal, Bulent;

    2013-01-01

    participating centres in the PCNL Global Study, as categorised in different age groups. PATIENTS AND METHODS: •  The Clinical Research Office of the Endourological Society (CROES) Study was conducted from November 2007 to December 2009, and included 96 centres and >5800 patients. •  All children aged ≤14 years...... in the PCNL Global Study database were the focus of the study. RESULTS: •  In all, 107 children aged ≤14 years were included in the analysis. •  The PCNL procedure was conducted in 13 patients (12.1%) in the supine position; tubeless PCNL was performed in 15 patients (14%); and balloon dilatation was......Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Without age being a limiting risk factor, recent reports have shown that almost any version of percutaneous nephrolithotomy (PCNL) can be safely applied in children. As there has been no...

  17. SELF-HELP GROUPS FOR PARENTS WITH MENTALLY RETARDED CHILDREN

    Directory of Open Access Journals (Sweden)

    Vaska STANCHEVA-POPKOSTADINOVA

    1997-09-01

    Full Text Available This presentation concerns a group for parents of mentally retarded children.A group of these parents receives professional help and environmental support. The parents are encouraged to assume responsibility in the everyday life educational process of their children.As Baker / 1980 / states: “ If parents cope better on daily basis with the child who has mental retardation, not only the child but also the parents would benefit”.Taking part in the group gave the parents:· the opportunity to meet other parents with the same children;· to talk to other parents and feel less isolated;· to share information and experiences, skills and ideas;· the opportunity to listen to the needs and problems of other parents;· to change the ways of working to meet the child’s needs;· share information about the possibilities of education and services;· parents are encouraged to meet together to support one another;· parents need a special approach to many problems existing in their families.· the education in the group puts the beginning of the work with the parents.The idea is to gather the efforts of specialists from different fields and to establish multi-disciplinary group aiming to work with the parents and create a good collaboration and partnership between them in order to improve the living conditions and services to the retarded persons.This paper reports on the development, evaluation and dissemination of the program for education of parents with mentally retarded children. At the Symposium we will be able to present the results of the effectiveness of the education.

  18. Half-body and local chest irradiation as consolidation following response to standard induction chemotherapy for disseminated small cell lung cancer: an Eastern cooperative oncology group pilot report

    International Nuclear Information System (INIS)

    A two-institution Phase II Pilot Study for the Eastern Cooperative Oncology Group (ECOG) used standard induction chemotherapy (cyclophosphamide and CCNU) followed by consolidation radiation therapy (RT) (600 rad of upper half-body irradiation plus 2000 rad in one week of localized chest irradiation) followed by maintenance chemotherapy in patients with extensive small cell bronchogenic carcinoma (SCBC). Nineteen patients were entered and 9 (47%) had partial responses (PR) after induction chemotherapy. No complete responses (CR) were seen. The 10 patients whose disease progressed were ineligible for consolidation RT and died with a short median survival time (MST) of 15 weeks. Of the 9 patients who were consolidated, 7 (78%) had complete responses in the chest; five (63%) became overall complete responders. The MST of all consolidated responders was 44 weeks. At this writing, two of the 5 patients who achieved CR after RT consolidation were alive without disease for more than one year; another patient was alive with disease for almost one year. A control group consisting of patients with extensive SCBC was used for comparison; these patients were treated by the two participating institutions in an earlier ECOG protocol with the same chemotherapy regimen but without RT consolidation

  19. Strategic Plans to Promote Head and Neck Cancer Translational Research Within the Radiation Therapy Oncology Group: A Report From the Translational Research Program

    International Nuclear Information System (INIS)

    Head and neck cancer is the fifth most common cancer in the United States, with an overall survival rate of approximately 40-50%. In an effort to improve patient outcomes, research efforts designed to maximize benefit and reduce toxicities of therapy are in progress. Basic research in cancer biology has accelerated this endeavor and provided preclinical data and technology to support clinically relevant advances in early detection, prognostic and predictive biomarkers. Recent completion of the Human Genome Project has promoted the rapid development of novel 'omics' technologies that allow more broad based study from a systems biology perspective. However, clinically relevant application of resultant gene signatures to clinical trials within cooperative groups has advanced slowly. In light of the large numbers of variables intrinsic to biomarker studies, validation of preliminary data for clinical implementation presents a significant challenge and may only be realized with large trials that involve significant patient numbers. The Radiation Therapy Oncology Group (RTOG) Head and Neck Cancer Translational Research Program recognizes this problem and brings together three unique features to facilitate this research: (1) availability of large numbers of clinical specimens from homogeneously treated patients through multi-institutional clinical trials; (2) a team of physicians, scientists, and staff focused on patient-oriented head-and-neck cancer research with the common goal of improving cancer care; and (3) a funding mechanism through the RTOG Seed Grant Program. In this position paper we outline strategic plans to further promote translational research within the framework of the RTOG

  20. Imaging Opportunities in Radiation Oncology

    International Nuclear Information System (INIS)

    Interdisciplinary efforts may significantly affect the way that clinical knowledge and scientific research related to imaging impact the field of Radiation Oncology. This report summarizes the findings of an intersociety workshop held in October 2008, with the express purpose of exploring 'Imaging Opportunities in Radiation Oncology.' Participants from the American Society for Radiation Oncology (ASTRO), National Institutes of Health (NIH), Radiological Society of North America (RSNA), American Association of physicists in Medicine (AAPM), American Board of Radiology (ABR), Radiation Therapy Oncology Group (RTOG), European Society for Therapeutic Radiology and Oncology (ESTRO), and Society of Nuclear Medicine (SNM) discussed areas of education, clinical practice, and research that bridge disciplines and potentially would lead to improved clinical practice. Findings from this workshop include recommendations for cross-training opportunities within the allowed structured of Radiology and Radiation Oncology residency programs, expanded representation of ASTRO in imaging related multidisciplinary groups (and reciprocal representation within ASTRO committees), increased attention to imaging validation and credentialing for clinical trials (e.g., through the American College of Radiology Imaging Network (ACRIN)), and building ties through collaborative research as well as smaller joint workshops and symposia.

  1. Dental fluorosis severity in a group of school children

    Directory of Open Access Journals (Sweden)

    Susy Yukie Fujibayashi

    2011-04-01

    Full Text Available Introduction and objective: This study aimed to assess the prevalence and severity of dental fluorosis in a group of school children in the city of Campo do Tenente (Parana, Brazil in order to compare the mean fluoride concentration in public water supply and discuss the effective values for fluoridation of water supply, as well as, the need of control of fluoride concentration within the water consumed by population. Material and methods: Firstly, 362 children enrolled in regular public schools, at elementary level, were examined by a single researcher, previously calibrated for Dean’s index application. From these, 90 children were affected by some degree of fluorosis, but only 40 returned the signed free and clarified consent form for participating in the research. Results: It was found that 42.5% of the children presented mild fluorosis and 32.5% moderate fluorosis. Moreover, it was observed that the average fluoride concentration in public water supply, in 2004, was 1.7 ppm of fluoride. Conclusion: These results demonstrate the need of a closer supervision of the city situation, by the inclusion of fluoridation external control and constant monitoring of the oral health status of the population.

  2. Peanut sensitization in a group of allergic Egyptian children

    Directory of Open Access Journals (Sweden)

    Hossny Elham

    2011-05-01

    Full Text Available Abstract Background There are no published data on peanut sensitization in Egypt and the problem of peanut allergy seems underestimated. We sought to screen for peanut sensitization in a group of atopic Egyptian children in relation to their phenotypic manifestations. Methods We consecutively enrolled 100 allergic children; 2-10 years old (mean 6.5 yr. The study measurements included clinical evaluation for site of allergy, possible precipitating factors, consumption of peanuts (starting age and last consumption, duration of breast feeding, current treatment, and family history of allergy as well as skin prick testing with a commercial peanut extract, and serum peanut specific and total IgE estimation. Children who were found sensitized to peanuts were subjected to an open oral peanut challenge test taking all necessary precautions. Results Seven subjects (7% were sensitized and three out of six of them had positive oral challenge denoting allergy to peanuts. The sensitization rates did not vary significantly with gender, age, family history of allergy, breast feeding duration, clinical form of allergy, serum total IgE, or absolute eosinophil count. All peanut sensitive subjects had skin with or without respiratory allergy. Conclusions Peanut allergy does not seem to be rare in atopic children in Egypt. Skin prick and specific IgE testing are effective screening tools to determine candidates for peanut oral challenging. Wider scale multicenter population-based studies are needed to assess the prevalence of peanut allergy and its clinical correlates in our country.

  3. Evaluation of support group interventions for children in troubled families: study protocol for a quasi-experimental control group study

    OpenAIRE

    Skerfving, Annemi; Johansson, Fredrik; Elgán, Tobias H

    2014-01-01

    Background Support groups for children in troubled families are available in a majority of Swedish municipalities. They are used as a preventive effort for children in families with different parental problems such as addiction to alcohol/other drugs, mental illness, domestic violence, divorce situations, or even imprisonment. Children from families with these problems are a well-known at-risk group for various mental health and social problems. Support groups aim at strengthening children’s ...

  4. Multimerin-1 (MMRN1) as Novel Adverse Marker in Pediatric Acute Myeloid Leukemia: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Laszlo, George S.; Alonzo, Todd A.; Gudgeon, Chelsea J.; Harrington, Kimberly H.; Gerbing, Robert B.; Wang, Yi-Cheng; Ries, Rhonda E.; Raimondi, Susana C.; Hirsch, Betsy A.; Gamis, Alan S.; Meshinchi, Soheil; Walter, Roland B.

    2015-01-01

    PURPOSE Exploratory gene expression array analyses suggested multimerin-1 (MMRN1) to be a predictive biomarker in acute myeloid leukemia (AML). Following-up on these studies, we evaluated the role of MMRN1 expression as outcome predictor in 2 recent Children’s Oncology Group trials. EXPERIMENTAL DESIGN We retrospectively quantified MMRN1 expression in 183 participants of AAML03P1 and 750 participants of AAML0531 by reverse-transcriptase polymerase chain reaction and correlated expression levels with disease characteristics and clinical outcome. RESULTS In AAML03P1, the highest quartile of MMRN1 expression (expression ≥0.5 relative to β-glucuronidase; n=45) was associated with inferior event-free survival (EFS; Phazard ratio [HR]=1.57 [95% confidence interval: 1.17–2.12] p=0.003) and EFS (HR=1.34 [1.04–1.73] p=0.025), and higher relapse risk (HR=1.40 [1.01–1.94] p=0.044). CONCLUSIONS Together, our studies identify MMRN1 expression as a novel biomarker that may refine AML risk-stratification. PMID:25825478

  5. Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the Postoperative Treatment of Pancreatic Head Cancer

    International Nuclear Information System (INIS)

    Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

  6. Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01): lessons learned

    International Nuclear Information System (INIS)

    Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment). Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated 'help-desk' team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%), technical problems (46%) while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support. (author)

  7. Nab-paclitaxel plus gemcitabine as first-line palliative chemotherapy in a patient with metastatic pancreatic cancer with Eastern Cooperative Oncology Group performance status of 2

    Science.gov (United States)

    MARTÍN, ANDRÉS J. MUÑOZ; ALFONSO, PILAR GARCÍA; RUPÉREZ, ANA B.; JIMÉNEZ, MIGUEL MARTÍN

    2016-01-01

    Metastatic pancreatic cancer (PC) has been associated with a considerably poor prognosis. Due to its toxicity, first-line combination chemotherapy is limited to patients with a good performance status (PS). Previously nab-paclitaxel plus gemcitabine has been demonstrated to improve the overall survival rate in patients with advanced pancreatic cancer with a good PS. The present study reports a case of a patient with metastatic PC with a poor PS (Eastern Cooperative Oncology Group 2) and a complex set of comorbidities treated with nab-paclitaxel plus gemcitabine as a first-line palliative therapy. Adjusted doses of nab-paclitaxel plus gemcitabine reached a favourable clinical, radiological and biochemical response in the present patient, which increased the quality of life for the patient. Eventually, the patient succumbed to acute cholangitis. Based on the results of the present study, nab-paclitaxel plus gemcitabine appears to be a favourable treatment as first-line palliative chemotherapy for patients with metastatic PC, comorbidities and poor PS. PMID:27347207

  8. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    International Nuclear Information System (INIS)

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control

  9. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Illidge, Tim, E-mail: Tim.Illidge@ics.manchester.ac.uk [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Specht, Lena [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Aleman, Berthe [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Constine, Louis [Departments of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Dabaja, Bouthaina [Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dharmarajan, Kavita [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Ricardi, Umberto [Radiation Oncology Unit, Department of Oncology, University of Torino, Torino (Italy); Wirth, Andrew [Division of Radiation Oncology, Peter MacCallum Cancer Institute, St. Andrews Place, East Melbourne (Australia)

    2014-05-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.

  10. Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01: Lessons learned

    Directory of Open Access Journals (Sweden)

    Daniel Pham

    2013-01-01

    Full Text Available Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment. Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated "help-desk" team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%, technical problems (46% while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support.

  11. Advanced Stage Mucinous Adenocarcinoma of the Ovary is both Rare and Highly Lethal: A Gynecologic Oncology Group Study

    Science.gov (United States)

    Zaino, Richard J.; Brady, Mark F.; Lele, Subodh M.; Michael, Helen; Greer, Benjamin; Bookman, Michael A.

    2010-01-01

    Background Primary mucinous adenocarcinomas of the ovary are uncommon and their biologic behavior uncertain. Retrospective studies suggest that many mucinous carcinomas diagnosed as primary to the ovary were actually metastatic from another site. A prospective randomized trial provided an opportunity to estimate the frequency of mucinous tumors, diagnostic reproducibility, and clinical outcomes. Methods A phase III trial enrolled 4000 women with stage III or IV ovarian carcinoma, treated by surgical staging and debulking, with randomization to one of five chemotherapeutic arms. Slides and pathology reports classified as primary mucinous carcinoma were reviewed independently by three pathologists. Cases were re-classified as primary or metastatic to the ovary according to two methods. Overall survival (OS) of reclassified groups was compared with each other and with that of patients with serous carcinomas. Results Forty-four cases were classified as mucinous adenocarcinoma at review. Using either method, only about one third were interpreted by the three reviewers as primary mucinous carcinomas. Reproducibility of interpretations among the reviewers was high with unanimity of opinion in 30 of the 44 (68%) cases. The median survival (MS) did not differ significantly between the groups interpreted as primary or metastatic, but the OS was significantly less than that for women with serous carcinoma (14 vs 42 months, p<0.001). Conclusion Advanced stage mucinous carcinoma of the ovary is very rare and is associated with poor OS. Many mucinous adenocarcinomas that are diagnosed as primary ovarian neoplasms appear to be metastatic to the ovary. PMID:20862744

  12. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Rusch, V.W.; Griffin, B.R.; Livingston, R.B. (Univ. of Washington, Seattle (USA))

    1989-10-01

    Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

  13. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

    International Nuclear Information System (INIS)

    Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted

  14. Multimodality treatment of primary nonresectable intrahepatic cholangiocarcinoma with I-131 anti-CEA: A radiation therapy oncology group study

    International Nuclear Information System (INIS)

    Thirty-seven patients (57% with metastasis and/or who has previously undergone chemotherapy) with primary unresectable intrahepatic cholangiocarcinoma were prospectively treated with external beam radiation therapy, chemotherapy, and I-131 anti-carcinoembryonic antigen (CEA) antibody. The regimen led to partial remission in 26.6% of patients, according to CT scan digitized tumor volume analysis, and in 33.3% (25.9% with partial remission, 7.4% with complete emission) according to physical examination findings. Therapy began with whole liver irradiation (2.1 Gy, 0.3 Gy per fraction, delivered 4 days a week, with 10-MV photons) and, on alternate days, chemotherapy (Adriamycin, 15 mg, + 5-fluorouracil [5-FU], 500 mg). One month later, Adriamycin, 15 mg, + 5-FU, 500 mg, was administered on day 0; 20 mCi of I-131 anti-CEA on day 1; and 10 mCi of I-131 anti-CEA on day 6. Tumor effective half-life was 3-5 days. Median tumor dose (20 mCi + 10 mCi) was 6.2 Gy. Antibody therapy was administered in 2-month cycles. Grade IV thrombocytopenia and leukopenia each occurred in 3.2% of patient administrations. Median survival for the entire group was 6.5 months; for responders, it was 15.2 months. The longest partial remission is presently more than 4 years

  15. Metabolic Tumor Volume as a Prognostic Imaging-Based Biomarker for Head-and-Neck Cancer: Pilot Results From Radiation Therapy Oncology Group Protocol 0522

    International Nuclear Information System (INIS)

    Purpose: To evaluate candidate fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging biomarkers for head-and-neck chemoradiotherapy outcomes in the cooperative group trial setting. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0522 patients consenting to a secondary FDG-PET/CT substudy were serially imaged at baseline and 8 weeks after radiation. Maximum standardized uptake value (SUVmax), SUV peak (mean SUV within a 1-cm sphere centered on SUVmax), and metabolic tumor volume (MTV) using 40% of SUVmax as threshold were obtained from primary tumor and involved nodes. Results: Of 940 patients entered onto RTOG 0522, 74 were analyzable for this substudy. Neither high baseline SUVmax nor SUVpeak from primary or nodal disease were associated with poor treatment outcomes. However, primary tumor MTV above the cohort median was associated with worse local-regional control (hazard ratio 4.01, 95% confidence interval 1.28-12.52, P=.02) and progression-free survival (hazard ratio 2.34, 95% confidence interval 1.02-5.37, P=.05). Although MTV and T stage seemed to correlate (mean MTV 6.4, 13.2, and 26.8 for T2, T3, and T4 tumors, respectively), MTV remained a strong independent prognostic factor for progression-free survival in bivariate analysis that included T stage. Primary MTV remained prognostic in p16-associated oropharyngeal cancer cases, although sample size was limited. Conclusion: High baseline primary tumor MTV was associated with worse treatment outcomes in this limited patient subset of RTOG 0522. Additional confirmatory work will be required to validate primary tumor MTV as a prognostic imaging biomarker for patient stratification in future trials

  16. Quality assurance standards drive improvements in the profile of radiation therapy departments participating in trials of the EORTC Radiation Oncology Group

    International Nuclear Information System (INIS)

    Background and purpose: The Facility Questionnaire (FQ) of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group (EORTC-ROG) evaluates the human, technical and organizational resources at each EORTC member institution. The purpose of this study is to use the FQ database to assess the improvement of radiation therapy (RT) structures and resources within the EORTC compared to the previous surveys performed by our group. Material and methods: We report the content of the current FQ database, completed online by 156 EORTC candidate member institutions from 22 countries between February 2011 and February 2013. Results are compared to FQ-published data from 1992 and 2007. Results: The average number of patients per year per EORTC institution is 2381 (range 350–12,000) an 18.2% increase compared to the 2007 figures. From 2007 to 2013 the average number of radiation oncologists, physicists and radiation technologists per EORTC institution has increased by 27% (from 8.5 to 10.8), 41% (from 5.2 to 7.4) and 38% (from 26.1 to 36.1) respectively. Consequently the number of patients per year per radiation oncologist has decreased from 258 to 243, for physicists from 426 to 354 and for radiation technologists from 107 to 86. One hundred and forty-six (94%) and 101 (65%) institutions can now deliver IMRT and SBRT, compared to 77 (79%) and 53 (54%) in 2007. Conclusions: The standards set by the EORTC-ROG are met by a continually improving number of institutions, helping to safeguard use of advanced technologies in EORTC-ROG clinical trials

  17. Metabolic Tumor Volume as a Prognostic Imaging-Based Biomarker for Head-and-Neck Cancer: Pilot Results From Radiation Therapy Oncology Group Protocol 0522

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, David L., E-mail: david.schwartz@utsw.edu [Department of Radiation Oncology, University of Texas Southwestern School of Medicine, Dallas, Texas (United States); Harris, Jonathan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Yao, Min [Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Opanowski, Adam; Levering, Anthony [American College of Radiology Imaging Network, Philadelphia, Pennsylvania (United States); Ang, K. Kian [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Trotti, Andy M. [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida (United States); Garden, Adam S. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Christopher U. [Sutter Medical Group, Sacramento, California (United States); Harari, Paul [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Foote, Robert [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Holland, John [Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon (United States); Zhang, Qiang [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California (United States)

    2015-03-15

    Purpose: To evaluate candidate fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging biomarkers for head-and-neck chemoradiotherapy outcomes in the cooperative group trial setting. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0522 patients consenting to a secondary FDG-PET/CT substudy were serially imaged at baseline and 8 weeks after radiation. Maximum standardized uptake value (SUVmax), SUV peak (mean SUV within a 1-cm sphere centered on SUVmax), and metabolic tumor volume (MTV) using 40% of SUVmax as threshold were obtained from primary tumor and involved nodes. Results: Of 940 patients entered onto RTOG 0522, 74 were analyzable for this substudy. Neither high baseline SUVmax nor SUVpeak from primary or nodal disease were associated with poor treatment outcomes. However, primary tumor MTV above the cohort median was associated with worse local-regional control (hazard ratio 4.01, 95% confidence interval 1.28-12.52, P=.02) and progression-free survival (hazard ratio 2.34, 95% confidence interval 1.02-5.37, P=.05). Although MTV and T stage seemed to correlate (mean MTV 6.4, 13.2, and 26.8 for T2, T3, and T4 tumors, respectively), MTV remained a strong independent prognostic factor for progression-free survival in bivariate analysis that included T stage. Primary MTV remained prognostic in p16-associated oropharyngeal cancer cases, although sample size was limited. Conclusion: High baseline primary tumor MTV was associated with worse treatment outcomes in this limited patient subset of RTOG 0522. Additional confirmatory work will be required to validate primary tumor MTV as a prognostic imaging biomarker for patient stratification in future trials.

  18. Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies—Assessment of Nodal Distribution in Gynecological Malignancies

    International Nuclear Information System (INIS)

    Purpose: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. Methods and Materials: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. Results: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. Conclusions: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to

  19. Protein Kinase A RI-α Predicts for Prostate Cancer Outcome: Analysis of Radiation Therapy Oncology Group Trial 86-10

    International Nuclear Information System (INIS)

    Purpose: The RI-α regulatory subunit of protein kinase A type 1 (PKA) is constitutively overexpressed in human cancer cell lines and is associated with active cell growth and neoplastic transformation. This report examined the association between PKA expression and the endpoints of biochemical failure (BF), local failure (LF), distant metastasis (DM), cause-specific mortality (CSM), and overall mortality in men treated with radiotherapy, with or without short-term androgen deprivation in Radiation Therapy Oncology Group trial 86-10. Methods and Materials: Pretreatment archival diagnostic tissue samples from 80 patients were stained for PKA by immunohistochemical methods from a parent cohort of 456 cases. PKA intensity was scored manually and by image analysis. The Cox proportional hazards model for overall mortality and Fine and Gray's regression models for CSM, DM, LF and BF were then applied to determine the relationship of PKA expression to the endpoints. Results: The pretreatment characteristics of the missing and determined PKA groups were not significantly different. On univariate analyses, a high PKA staining intensity was associated with BF (image analysis, continuous variable, p = 0.022), LF (image analysis, dichotomized variable, p = 0.011), CSM (manual analysis, p = 0.037; image analysis, continuous, p = 0.014), and DM (manual analysis, p = 0.029). On multivariate analyses, the relationships to BF (image analysis, continuous, p = 0.03), LF (image analysis, dichotomized, p = 0.002), and DM remained significant (manual analysis, p = 0.018). In terms of CSM, a trend toward an association was seen (manual analysis, p = 0.08; image analysis, continuous, p = 0.09). Conclusion: PKA overexpression was significantly related to patient outcome and is a potentially useful biomarker for identifying high-risk prostate cancer patients who might benefit from a PKA knockdown strategy

  20. Vascular endothelial growth factor (VEGF) expression in locally advanced prostate cancer: secondary analysis of radiation therapy oncology group (RTOG) 8610

    International Nuclear Information System (INIS)

    Angiogenesis is a key element in solid-tumor growth, invasion, and metastasis. VEGF is among the most potent angiogenic factor thus far detected. The aim of the present study is to explore the potential of VEGF (also known as VEGF-A) as a prognostic and predictive biomarker among men with locally advanced prostate cancer. The analysis was performed using patients enrolled on RTOG 8610, a phase III randomized control trial of radiation therapy alone (Arm 1) versus short-term neoadjuvant and concurrent androgen deprivation and radiation therapy (Arm 2) in men with locally advanced prostate carcinoma. Tissue samples were obtained from the RTOG tissue repository. Hematoxylin and eosin slides were reviewed, and paraffin blocks were immunohistochemically stained for VEGF expression and graded by Intensity score (0–3). Cox or Fine and Gray’s proportional hazards models were used. Sufficient pathologic material was available from 103 (23%) of the 456 analyzable patients enrolled in the RTOG 8610 study. There were no statistically significant differences in the pre-treatment characteristics between the patient groups with and without VEGF intensity data. Median follow-up for all surviving patients with VEGF intensity data is 12.2 years. Univariate and multivariate analyses demonstrated no statistically significant correlation between the intensity of VEGF expression and overall survival, distant metastasis, local progression, disease-free survival, or biochemical failure. VEGF expression was also not statistically significantly associated with any of the endpoints when analyzed by treatment arm. This study revealed no statistically significant prognostic or predictive value of VEGF expression for locally advanced prostate cancer. This analysis is among one of the largest sample bases with long-term follow-up in a well-characterized patient population. There is an urgent need to establish multidisciplinary initiatives for coordinating further research in the area of

  1. Children in Residential Group Care with No Family Ties: Facing Existential Aloneness

    Science.gov (United States)

    Dvir, Orly; Weiner, Anita; Kupermintz, Hagai

    2012-01-01

    The issue of children living in residential group care in Israel completely without family ties is studied in order to explore the feelings of staff and uncover possible characteristics of these children. Data were collected through focus groups, questionnaires, and life stories of children who left group care at 18 years of age. Results reveal…

  2. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    International Nuclear Information System (INIS)

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment

  3. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Theodore S., E-mail: tshong1@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Bosch, Walter R. [Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri (United States); Krishnan, Sunil [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kim, Tae K. [Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women' s College Hospital, University of Toronto, Toronto, Ontario (Canada); Mamon, Harvey J. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Shyn, Paul [Department of Radiology, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (United States); Seong, Jinsil [Department of Radiation Oncology, Yonsei University Medical College, Seoul (Korea, Republic of); Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Cheng, Jason C. [Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Feng, Mary U. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States); Stephans, Kevin L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Roberge, David [Department of Radiation Oncology, Montreal General Hospital/McGill University Health Centre, Montreal, Quebec (Canada); Crane, Christopher [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); and others

    2014-07-15

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment

  4. PET/MR in children. Initial clinical experience in paediatric oncology using an integrated PET/MR scanner

    OpenAIRE

    Hirsch, Franz Wolfgang; Sattler, Bernhard; Sorge, Ina; Kurch, Lars; Viehweger, Adrian; Ritter, Lutz; Werner, Peter; Jochimsen, Thies; Barthel, Henryk; Bierbach, Uta; Till, Holger; Sabri, Osama; Kluge, Regine

    2013-01-01

    Use of PET/MR in children has not previously been reported, to the best of our knowledge. Children with systemic malignancies may benefit from the reduced radiation exposure offered by PET/MR. We report our initial experience with PET/MR hybrid imaging and our current established sequence protocol after 21 PET/MR studies in 15 children with multifocal malignant diseases. The effective dose of a PET/MR scan was only about 20% that of the equivalent PET/CT examination. Simultaneous acquisition ...

  5. Older Age Predicts Decreased Metastasis and Prostate Cancer-Specific Death for Men Treated With Radiation Therapy: Meta-Analysis of Radiation Therapy Oncology Group Trials

    International Nuclear Information System (INIS)

    Purpose: The impact of age on prostate cancer (PCa) outcome has been controversial; therefore, we analyzed the effect of age on overall survival (OS), distant metastasis, prostate cancer-specific death (PCSD), and nonprostate cancer death (NPCD) on patients with locally advanced PCa. Methods and Materials: Patients who participated in four Radiation Therapy Oncology Group (RTOG) phase III trials, 8531, 8610, 9202, and 9413, were studied. Cox proportional hazards regression was used for OS analysis, and cumulative events analysis with Fine and Gray’s regression was used for analyses of metastasis, PCSD, and NPCD. Results: Median follow-up of 4,128 patients with median age of 70 (range, 43-88 years) was 7.3 years. Most patients had high-risk disease: cT3 to cT4 (54%) and Gleason scores (GS) of 7 (45%) and 8 to 10 (27%). Older age (≤70 vs. >70 years) predicted for decreased OS (10-year rate, 55% vs. 41%, respectively; p 70 years remained associated with decreased OS (hazard ratio [HR], 1.56 [95% confidence interval [CI], 1.43-1.70] p < 0.0001) but with decreased metastasis (HR, 0.72 [95% CI, 0.63-0.83] p < 0.0001) and PCSD (HR, 0.78 [95% CI, 0.66-0.92] p < 0.0001). Finally, the impact of the duration of androgen deprivation therapy as a function of age was evaluated. Conclusions: These data support less aggressive PCa in older men, independent of other clinical features. While the biological underpinning of this finding remains unknown, stratification by age in future trials appears to be warranted.

  6. Ki-67 Is an Independent Predictor of Metastasis and Cause-Specific Mortality for Prostate Cancer Patients Treated on Radiation Therapy Oncology Group (RTOG) 94-08

    Energy Technology Data Exchange (ETDEWEB)

    Verhoven, Bret [University of Wisconsin Carbone Cancer Center, Madison, Wisconsin (United States); Yan, Yan [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Ritter, Mark, E-mail: ritter@humonc.wisc.edu [University of Wisconsin Carbone Cancer Center, Madison, Wisconsin (United States); Khor, Li-Yan [Case Medical Center, Cleveland, Ohio (United States); Hammond, Elizabeth [LDS Hospital, Salt Lake City, Utah (United States); Jones, Christopher [Radiological Associates of Sacramento, Sacramento, California (United States); Amin, Mahul [Cedars-Sinai Medical Center, Los Angeles, California (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Ontario (Canada); Zeitzer, Kenneth [Albert Einstein Medical Center, Philadelphia, Pennsylvania (United States); Pollack, Alan [University of Miami Miller School of Medicine, Miami, Florida (United States)

    2013-06-01

    Purpose: The association of Ki-67 staining index (Ki67-SI) with overall survival (OS), disease-specific mortality (DSM), distant metastasis (DM), and biochemical failure (BF) was examined in men with favorable- to intermediate-risk prostate cancer receiving radiation therapy (RT) alone or with short-term androgen deprivation (ADT) in Radiation Therapy Oncology Group (RTOG) 94-08. Methods and Materials: 468 patients (23.6%) on RTOG 94-08 had sufficient tissue for Ki67-SI analysis. The median follow-up time was 7.9 years. Ki67-SI was determined by immunohistochemistry and quantified manually and by image analysis. Correlative analysis versus clinical outcome was performed using the third quartile (≥Q3) cutpoint. A proportional hazards multivariable analysis (MVA) dichotomized covariates in accordance with trial stratification and randomization criteria. Results: In MVAs adjusted for all treatment covariates, high Ki67-SI (≥Q3) was correlated with increased DSM (hazard ratio [HR] 2.48, P=.03), DM (HR 3.5, P=.002), and BF (HR 3.55, P<.0001). MVA revealed similar Ki67-associated hazard ratios in each separate treatment arm for DSM, DM, and BF; these reached significance only for DM in the RT-alone arm and for BF in both arms. Ki67-SI was not a significant predictor of intraprostatic recurrence assessed by repeated biopsy 2 years after treatment. Patients with a high or low Ki67-SI seemed to experience a similar relative benefit from the addition of ADT to radiation. Conclusions: High Ki67-SI independently predicts for increased DSM, DM, and protocol BF in primarily intermediate-risk prostate cancer patients treated with RT with or without ADT on RTOG 94-08 but does not predict for local recurrence or for increased relative benefit from ADT. This and prior studies lend support for the use of Ki67-SI as a stratification factor in future trials.

  7. Phase 2 Study of Temozolomide-Based Chemoradiation Therapy for High-Risk Low-Grade Gliomas: Preliminary Results of Radiation Therapy Oncology Group 0424

    International Nuclear Information System (INIS)

    Purpose: Radiation Therapy Oncology Group (RTOG) 0424 was a phase 2 study of a high-risk low-grade glioma (LGG) population who were treated with temozolomide (TMZ) and radiation therapy (RT), and outcomes were compared to those of historical controls. This study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months and a 20% improvement in 3-year overall survival (OS) rate from 54% to 65% at a 10% significance level (1-sided) and 96% power. Methods and Materials: Patients with LGGs with 3 or more risk factors for recurrence (age ≥40 years, astrocytoma histology, bihemispherical tumor, preoperative tumor diameter of ≥6 cm, or a preoperative neurological function status of >1) were treated with RT (54 Gy in 30 fractions) and concurrent and adjuvant TMZ. Results: From 2005 to 2009, 129 evaluable patients (75 males and 54 females) were accrued. Median age was 49 years; 91% had a Zubrod score of 0 or 1; and 69%, 25%, and 6% of patients had 3, 4, and 5 risk factors, respectively. Patients had median and minimum follow-up examinations of 4.1 years and 3 years, respectively. The 3-year OS rate was 73.1% (95% confidence interval: 65.3%-80.8%), which was significantly improved compared to that of prespecified historical control values (P<.001). Median survival time has not yet been reached. Three-year progression-free survival was 59.2%. Grades 3 and 4 adverse events occurred in 43% and 10% of patients, respectively. One patient died of herpes encephalitis. Conclusions: The 3-year OS rate of 73.1% for RTOG 0424 high-risk LGG patients is higher than that reported for historical controls (P<.001) and the study-hypothesized rate of 65%

  8. Treatment of Advanced Non Small Cell Lung Cancer in Routine Care: A Retrospective Analysis of 212 Consecutive Patients Treated in a Community Based Oncology Group Practice

    Directory of Open Access Journals (Sweden)

    Hubert Koeppler

    2009-01-01

    Full Text Available Treatment outcome data generated in prospective trials are intrinsically biased due to necessary selection criteria. Therefore the results obtained may not reflect the actual impact of current treatment options for an unselected general population. We analysed the treatment modalities and the outcome in 212 consecutive patients with non small cell lung cancer stages IIIB and IV who were seen in a community based oncology group practice between 6/1995 and 6/2006. 93 presented with stage IIIB and 119 with stage IV. Chemotherapy was given to 194/212 patients (92%, 114 patients (54% received palliative radiation at one point during treatment. Treatment consisted of chemotherapy only in 86 patients (40% and radiation only in 6 patients. 12 patients received best supportive care only. Patients with stage IIIB have survival rates at 12, 24 and 36 months of 64%, 27% and 21% respectively and for patients with stage IV the survival rates at 12, 24 and 36 months are 40%, 19% and 11% respectively. The median survival for stages IIIB and IV is 16 and 11 months respectively. In a multivariate analysis incorporating the factors stage (IIIB vs. IV, age (70 vs. 70 years and performance status (WHO 0/1 vs. 2/3 only stage and performance status were independent factors for survival. These retrospective data concerning analysis of survival , response rates and toxicity in a community setting confirm published results of phase II-III studies and indicate that results generated in prospective trials can be transferred into routine care.

  9. Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas: Radiation Therapy Oncology Group Trial 9402

    International Nuclear Information System (INIS)

    Purpose: Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Methods and Materials: Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. Results: For survivors, MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95% CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95% CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. Conclusion: MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival.

  10. Impact of Gender, Partner Status, and Race on Locoregional Failure and Overall Survival in Head and Neck Cancer Patients in Three Radiation Therapy Oncology Group Trials

    International Nuclear Information System (INIS)

    Purpose: We investigated the impact of race, in conjunction with gender and partner status, on locoregional control (LRC) and overall survival (OS) in three head and neck trials conducted by the Radiation Therapy Oncology Group (RTOG). Methods and Materials: Patients from RTOG studies 9003, 9111, and 9703 were included. Patients were stratified by treatment arms. Covariates of interest were partner status (partnered vs. non-partnered), race (white vs. non-white), and sex (female vs. male). Chi-square testing demonstrated homogeneity across treatment arms. Hazards ratio (HR) was used to estimate time to event outcome. Unadjusted and adjusted HRs were calculated for all covariates with associated 95% confidence intervals (CIs) and p values. Results: A total of 1,736 patients were analyzed. Unpartnered males had inferior OS rates compared to partnered females (adjusted HR = 1.22, 95% CI, 1.09-1.36), partnered males (adjusted HR = 1.20, 95% CI, 1.09-1.28), and unpartnered females (adjusted HR = 1.20, 95% CI, 1.09-1.32). White females had superior OS compared with white males, non-white females, and non-white males. Non-white males had inferior OS compared to white males. Partnered whites had improved OS relative to partnered non-white, unpartnered white, and unpartnered non-white patients. Unpartnered males had inferior LRC compared to partnered males (adjusted HR = 1.26, 95% CI, 1.09-1.46) and unpartnered females (adjusted HR = 1.30, 95% CI, 1.05-1.62). White females had LRC superior to non-white males and females. White males had improved LRC compared to non-white males. Partnered whites had improved LRC compared to partnered and unpartnered non-white patients. Unpartnered whites had improved LRC compared to unpartnered non-whites. Conclusions: Race, gender, and partner status had impacts on both OS and locoregional failure, both singly and in combination.

  11. Radiotherapy quality assurance review in a multi-center randomized trial of limited-disease small cell lung cancer: the Japan Clinical Oncology Group (JCOG) trial 0202

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial that required on-going RT QA review in the JCOG. JCOG 0202 was a multi-center phase III trial comparing two types of consolidation chemotherapy after concurrent chemoradiotherapy for limited-disease small cell lung cancer. RT requirements included a total dose of 45 Gy/30 fx (bis in die, BID/twice a day) without heterogeneity correction; elective nodal irradiation (ENI) of 30 Gy; at least 1 cm margin around the clinical target volume (CTV); and interfraction interval of 6 hours or longer. Dose constraints were defined in regards to the spinal cord and the lung. The QA assessment was classed as per protocol (PP), deviation acceptable (DA), violation unacceptable (VU), and incomplete/not evaluable (I/NE). A total of 283 cases were accrued, of which 204 were fully evaluable, excluding 79 I/NE cases. There were 18 VU in gross tumor volume (GTV) coverage (8% of 238 evaluated); 4 VU and 23 DA in elective nodal irradiation (ENI) (2% and 9% of 243 evaluated, respectively). Some VU were observed in organs at risk (1 VU in the lung and 5 VU in the spinal cord). Overall RT compliance (PP + DA) was 92% (187 of 204 fully evaluable). Comparison between the former and latter halves of the accrued cases revealed that the number of VU and DA had decreased. The results of the RT QA assessment in JCOG 0202 seemed to be acceptable, providing reliable results

  12. Perspectives and practical applications of medical oncologists on defensive medicine (SYSIPHUS study): a study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG).

    Science.gov (United States)

    Tanriverdi, Ozgur; Cay-Senler, Filiz; Yavuzsen, Tugba; Turhal, Serdar; Akman, Tulay; Komurcu, Seref; Cehreli, Ruksan; Ozyilkan, Ozgur

    2015-04-01

    Defensive medicine occasionally indulges unnecessary treatment requests to defend against lawsuits for medical errors and the use of unapproved medical applications. This study determines the attitudes and orientations of medical oncologists on defensive medicine. A cross-sectional survey was sent by e-mail to medical oncologists. The survey was designed to determine the participants' demographic characteristics and defensive medicine practices. The survey measured the attitudes about defensive medicine practices of the oncologists based on a five-point Likert scale (never, rarely, sometimes, often, and always). One hundred and forty-six of a total of 402 physicians serving in oncology were fully filled, and the rate of return invitation was 36 %. The majority of participants were male, with a duration of between 7 and 9 years of work as university hospital officials, and the mean age was 46 ± 9 (years). International guidelines were followed in the most common is NCCN, and the majority of respondents felt that the application of these guidelines improves their defensive medicine. All participants of defensive medicine who stand on the basis of the definition were found to be more afraid of complaints by patients' relatives. Physicians of 45 % was noted that applying defensive medicine. Among the participants were the most frequent checkups of positive defensive approach is defined as increasing or shortening the follow-up period, while avoiding high-risk patients were detected as described in the definition of negative defensive medicine. Both professional groups in both the positive and negative defensive medicine approach defensive medicine approach, academic tasks, work experience and job time, there was a significant correlation between the location. Made in single- and multi-variable analyses, positions were identified both positive and negative defensive medicine is an independent risk factor for direction. Improving the working conditions of young

  13. Bcl-2 and bax expression and prostate cancer outcome in men treated with radiotherapy in Radiation Therapy Oncology Group protocol 86-10

    International Nuclear Information System (INIS)

    Purpose: Bcl-2 and bax are proteins with opposing roles in apoptosis regulation; yet abnormal expression of either has been associated with failure after radiotherapy (RT). In this study we examined bcl-2 and bax expression as predictive markers in men treated with radiotherapy ± androgen deprivation on Radiation Therapy Oncology Group (RTOG) protocol 86-10. Experimental Design: Suitable archival diagnostic tissue was obtained from 119 (26%) patients for bcl-2 analysis and 104 (23%) patients for bax analysis. Cox proportional hazards multivariate analysis was used to determine the relationship of abnormal bcl-2 and bax expression to the end points of local failure, distant metastasis, cause-specific mortality, and overall mortality. Bcl-2 overexpression was classified as any tumor cell cytoplasmic staining and altered bax expression was classified as greater or lesser cytoplasmic staining intensity of tumor cells as compared with adjacent normal prostate epithelium. Results: The study cohort exhibited bcl-2 overexpression in 26% (n = 30) of cases and abnormal bax expression in 47% (n = 49) of cases. A borderline significant relationship was observed between abnormal bax expression and higher Gleason score (p = 0.08). In univariate and multivariate analyses, there was no statistically significant relationship seen between abnormal bcl-2 or bax expression and outcome. Conclusions: Abnormal bcl-2 and bax expression were not related to any of the end points tested. The cohort examined was comprised of patients with locally advanced disease and it is possible that these markers may be of greater value in men with earlier-stage prostate cancer

  14. Phase 2 Study of Temozolomide-Based Chemoradiation Therapy for High-Risk Low-Grade Gliomas: Preliminary Results of Radiation Therapy Oncology Group 0424

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Barbara J., E-mail: barbara.fisher@lhsc.on.ca [London Regional Cancer Program, London, Ontario (Canada); Hu, Chen [Radiation Therapy Oncology Group-Statistical Center, Philadelphia, Pennsylvania (United States); Macdonald, David R. [London Regional Cancer Program, London, Ontario (Canada); Lesser, Glenn J. [Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina (United States); Coons, Stephen W. [Barrow Neurological Institute, Phoenix, Arizona (United States); Brachman, David G. [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Ryu, Samuel [Henry Ford Hospital, Detroit, Michigan (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Liu, Junfeng [GCE Solutions, Inc., Bloomington, Illinois (United States); Chakravarti, Arnab [The Ohio State University, The James, Columbus, Ohio (United States); Mehta, Minesh [University of Maryland Medical Systems, Baltimore, Maryland (United States)

    2015-03-01

    Purpose: Radiation Therapy Oncology Group (RTOG) 0424 was a phase 2 study of a high-risk low-grade glioma (LGG) population who were treated with temozolomide (TMZ) and radiation therapy (RT), and outcomes were compared to those of historical controls. This study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months and a 20% improvement in 3-year overall survival (OS) rate from 54% to 65% at a 10% significance level (1-sided) and 96% power. Methods and Materials: Patients with LGGs with 3 or more risk factors for recurrence (age ≥40 years, astrocytoma histology, bihemispherical tumor, preoperative tumor diameter of ≥6 cm, or a preoperative neurological function status of >1) were treated with RT (54 Gy in 30 fractions) and concurrent and adjuvant TMZ. Results: From 2005 to 2009, 129 evaluable patients (75 males and 54 females) were accrued. Median age was 49 years; 91% had a Zubrod score of 0 or 1; and 69%, 25%, and 6% of patients had 3, 4, and 5 risk factors, respectively. Patients had median and minimum follow-up examinations of 4.1 years and 3 years, respectively. The 3-year OS rate was 73.1% (95% confidence interval: 65.3%-80.8%), which was significantly improved compared to that of prespecified historical control values (P<.001). Median survival time has not yet been reached. Three-year progression-free survival was 59.2%. Grades 3 and 4 adverse events occurred in 43% and 10% of patients, respectively. One patient died of herpes encephalitis. Conclusions: The 3-year OS rate of 73.1% for RTOG 0424 high-risk LGG patients is higher than that reported for historical controls (P<.001) and the study-hypothesized rate of 65%.

  15. Gender, Race, and Survival: A Study in Non-Small-Cell Lung Cancer Brain Metastases Patients Utilizing the Radiation Therapy Oncology Group Recursive Partitioning Analysis Classification

    International Nuclear Information System (INIS)

    Purpose: To explore whether gender and race influence survival in non-small-cell lung cancer (NSCLC) in patients with brain metastases, using our large single-institution brain tumor database and the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) brain metastases classification. Methods and materials: A retrospective review of a single-institution brain metastasis database for the interval January 1982 to September 2004 yielded 835 NSCLC patients with brain metastases for analysis. Patient subsets based on combinations of gender, race, and RPA class were then analyzed for survival differences. Results: Median follow-up was 5.4 months (range, 0-122.9 months). There were 485 male patients (M) (58.4%) and 346 female patients (F) (41.6%). Of the 828 evaluable patients (99%), 143 (17%) were black/African American (B) and 685 (83%) were white/Caucasian (W). Median survival time (MST) from time of brain metastasis diagnosis for all patients was 5.8 months. Median survival time by gender (F vs. M) and race (W vs. B) was 6.3 months vs. 5.5 months (p = 0.013) and 6.0 months vs. 5.2 months (p = 0.08), respectively. For patients stratified by RPA class, gender, and race, MST significantly favored BFs over BMs in Class II: 11.2 months vs. 4.6 months (p = 0.021). On multivariable analysis, significant variables were gender (p = 0.041, relative risk [RR] 0.83) and RPA class (p < 0.0001, RR 0.28 for I vs. III; p < 0.0001, RR 0.51 for II vs. III) but not race. Conclusions: Gender significantly influences NSCLC brain metastasis survival. Race trended to significance in overall survival but was not significant on multivariable analysis. Multivariable analysis identified gender and RPA classification as significant variables with respect to survival.

  16. Ki-67 Is an Independent Predictor of Metastasis and Cause-Specific Mortality for Prostate Cancer Patients Treated on Radiation Therapy Oncology Group (RTOG) 94-08

    International Nuclear Information System (INIS)

    Purpose: The association of Ki-67 staining index (Ki67-SI) with overall survival (OS), disease-specific mortality (DSM), distant metastasis (DM), and biochemical failure (BF) was examined in men with favorable- to intermediate-risk prostate cancer receiving radiation therapy (RT) alone or with short-term androgen deprivation (ADT) in Radiation Therapy Oncology Group (RTOG) 94-08. Methods and Materials: 468 patients (23.6%) on RTOG 94-08 had sufficient tissue for Ki67-SI analysis. The median follow-up time was 7.9 years. Ki67-SI was determined by immunohistochemistry and quantified manually and by image analysis. Correlative analysis versus clinical outcome was performed using the third quartile (≥Q3) cutpoint. A proportional hazards multivariable analysis (MVA) dichotomized covariates in accordance with trial stratification and randomization criteria. Results: In MVAs adjusted for all treatment covariates, high Ki67-SI (≥Q3) was correlated with increased DSM (hazard ratio [HR] 2.48, P=.03), DM (HR 3.5, P=.002), and BF (HR 3.55, P<.0001). MVA revealed similar Ki67-associated hazard ratios in each separate treatment arm for DSM, DM, and BF; these reached significance only for DM in the RT-alone arm and for BF in both arms. Ki67-SI was not a significant predictor of intraprostatic recurrence assessed by repeated biopsy 2 years after treatment. Patients with a high or low Ki67-SI seemed to experience a similar relative benefit from the addition of ADT to radiation. Conclusions: High Ki67-SI independently predicts for increased DSM, DM, and protocol BF in primarily intermediate-risk prostate cancer patients treated with RT with or without ADT on RTOG 94-08 but does not predict for local recurrence or for increased relative benefit from ADT. This and prior studies lend support for the use of Ki67-SI as a stratification factor in future trials

  17. Children's Experiences and Meaning Construction on Parental Divorce: A Focus Group Study

    Science.gov (United States)

    Maes, Sofie D. J.; De Mol, Jan; Buysse, Ann

    2012-01-01

    The global aim of this study was to explore children's narratives of parental divorce. A convenience sample, composed of 11- and 14-year-old children, was recruited. A total of 22 children (12 male, 10 female) participated in this focus group study. The findings show that two components seem to be really important for children during the divorce…

  18. Limited Chemotherapy and Shrinking Field Radiotherapy for Osteolymphoma (Primary Bone Lymphoma): Results From the Trans-Tasman Radiation Oncology Group 99.04 and Australasian Leukaemia and Lymphoma Group LY02 Prospective Trial

    International Nuclear Information System (INIS)

    Purpose: To establish benchmark outcomes for combined modality treatment to be used in future prospective studies of osteolymphoma (primary bone lymphoma). Methods and Materials: In 1999, the Trans-Tasman Radiation Oncology Group (TROG) invited the Australasian Leukemia and Lymphoma Group (ALLG) to collaborate on a prospective study of limited chemotherapy and radiotherapy for osteolymphoma. The treatment was designed to maintain efficacy but limit the risk of subsequent pathological fractures. Patient assessment included both functional imaging and isotope bone scanning. Treatment included three cycles of CHOP chemotherapy and radiation to a dose of 45 Gy in 25 fractions using a shrinking field technique. Results: The trial closed because of slow accrual after 33 patients had been entered. Accrual was noted to slow down after Rituximab became readily available in Australia. After a median follow-up of 4.3 years, the five-year overall survival and local control rates are estimated at 90% and 72% respectively. Three patients had fractures at presentation that persisted after treatment, one with recurrent lymphoma. Conclusions: Relatively high rates of survival were achieved but the number of local failures suggests that the dose of radiotherapy should remain higher than it is for other types of lymphoma. Disability after treatment due to pathological fracture was not seen.

  19. Oncology Nursing Society

    Science.gov (United States)

    ... Hill Days Monday, August 22, 2016 Oncology Nursing Society Announces Support for DAISY Foundation Monday, August 8, 2016 Oncology Nursing Society and Haymarket Media Inc. Announce Navigation Summit Collaboration ...

  20. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239

    International Nuclear Information System (INIS)

    Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m2 IV) was given on day 1 and etoposide (120 mg/m2 IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CI 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538/Cancer and

  1. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239

    Energy Technology Data Exchange (ETDEWEB)

    Komaki, Ritsuko, E-mail: rkomaki@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Ettinger, David S. [Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States); Videtic, Gregory M.M. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Bradley, Jeffrey D. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Langer, Corey J. [Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sause, William T. [Radiation Center, LDS Hospital, Salt Lake City, Utah (United States); Curran, Walter J. [Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pennsylvania (United States); Choy, Hak [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)

    2012-07-15

    Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m{sup 2} IV) was given on day 1 and etoposide (120 mg/m{sup 2} IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CI 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538

  2. Outcome Evaluation of a Group Treatment of Sexually Abused and Reactive Children

    Science.gov (United States)

    Duffany, Adrienne; Panos, Patrick T.

    2009-01-01

    Objective: To determine the effectiveness of group therapy in treating sexually abused children to prevent recidivism (subsequently re-abused or becoming abusers themselves). Methods: Recidivism rates of 617 children were compared between sexually abused children who received group treatment with those whose parents refused treatment.…

  3. A Programmatic Description of a Social Skills Group for Young Children with Autism

    Science.gov (United States)

    Leaf, Justin B.; Dotson, Wesley H.; Oppenheim-Leaf, Misty L.; Sherman, James A.; Sheldon, Jan B.

    2012-01-01

    Deficits in social skills are a common problem for children with autism. One method of developing appropriate social skills in children with autism has been group instruction. To date, however, group instruction has produced mixed results. The purpose of this article is to describe a promising method of teaching social skills to children in small…

  4. PET/MR in children. Initial clinical experience in paediatric oncology using an integrated PET/MR scanner

    International Nuclear Information System (INIS)

    Use of PET/MR in children has not previously been reported, to the best of our knowledge. Children with systemic malignancies may benefit from the reduced radiation exposure offered by PET/MR. We report our initial experience with PET/MR hybrid imaging and our current established sequence protocol after 21 PET/MR studies in 15 children with multifocal malignant diseases. The effective dose of a PET/MR scan was only about 20% that of the equivalent PET/CT examination. Simultaneous acquisition of PET and MR data combines the advantages of the two previously separate modalities. Furthermore, the technique also enables whole-body diffusion-weighted imaging (DWI) and statements to be made about the biological cellularity and nuclear/cytoplasmic ratio of tumours. Combined PET/MR saves time and resources. One disadvantage of PET/MR is that in order to have an effect, a significantly longer examination time is needed than with PET/CT. In our initial experience, PET/MR has turned out to be an unexpectedly stable and reliable hybrid imaging modality, which generates a complementary diagnostic study of great additional value. (orig.)

  5. PET/MR in children. Initial clinical experience in paediatric oncology using an integrated PET/MR scanner

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, Franz Wolfgang; Sorge, Ina; Viehweger, Adrian; Ritter, Lutz [University of Leipzig, Department of Paediatric Radiology, Leipzig (Germany); Sattler, Bernhard; Kurch, Lars; Werner, Peter; Jochimsen, Thies; Barthel, Henryk; Sabri, Osama; Kluge, Regine [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Bierbach, Uta [University of Leipzig, Department of Paediatric Oncology, Leipzig (Germany); Till, Holger [University of Leipzig, Department of Paediatric Surgery, Leipzig (Germany)

    2013-07-15

    Use of PET/MR in children has not previously been reported, to the best of our knowledge. Children with systemic malignancies may benefit from the reduced radiation exposure offered by PET/MR. We report our initial experience with PET/MR hybrid imaging and our current established sequence protocol after 21 PET/MR studies in 15 children with multifocal malignant diseases. The effective dose of a PET/MR scan was only about 20% that of the equivalent PET/CT examination. Simultaneous acquisition of PET and MR data combines the advantages of the two previously separate modalities. Furthermore, the technique also enables whole-body diffusion-weighted imaging (DWI) and statements to be made about the biological cellularity and nuclear/cytoplasmic ratio of tumours. Combined PET/MR saves time and resources. One disadvantage of PET/MR is that in order to have an effect, a significantly longer examination time is needed than with PET/CT. In our initial experience, PET/MR has turned out to be an unexpectedly stable and reliable hybrid imaging modality, which generates a complementary diagnostic study of great additional value. (orig.)

  6. [Treatment outcome for myelodysplastic syndromes (MDS) obtained by the Polish Children's Leukemia/Lymphoma Study Group].

    Science.gov (United States)

    Chybicka, A; Kołecki, P; Pietras, W; Bogusławska-Jaworska, J; Wójcik, D; Armata, J; Eliasińska, A; Kowalczyk, J; Jackowska, T; Klus, K; Matysiak, M; Krauze, A; Stefańska, K; Rokicka-Milewska, R; Wiśniewska-Slusarz, H

    1998-02-01

    Fourty children with MDS treated in seven centres of The Polish Children's Leukemia Lymphoma Study Group in period 1975-1998y were included to the study. In 16 children RAEB-T, in 2 CMML in 10 RA and in 12 RAEB were diagnosed. Our and literature data showed that BMT is the best therapy for children with MDS. For children, who don't have a donor for BMT. Roacutan therapy seems to be the most effective. PMID:9686518

  7. Genetic variation in DNA-repair pathways and response to radiochemotherapy in esophageal adenocarcinoma: a retrospective cohort study of the Eastern Cooperative Oncology Group

    Directory of Open Access Journals (Sweden)

    Wu Xifeng

    2011-05-01

    Full Text Available Abstract Background Recent data in esophageal cancer suggests the variant allele of a single-nucleotide polymorphism (SNP in XRCC1 may be associated with resistance to radiochemotherapy. However, this SNP has not been assessed in a histologically homogeneous clinical trial cohort that has been treated with a uniform approach. In addition, whether germline DNA may serve as a surrogate for tumor genotype at this locus is unknown in this disease. Our objective was to assess this SNP in relation to the pathologic complete response (pCR rate in subjects with esophageal adenocarcinoma who received cisplatin-based preoperative radiochemotherapy in a multicenter clinical trial (Eastern Cooperative Oncology Group 1201. As a secondary aim, we investigated the rate of allelic imbalance between germline and tumor DNA. Methods Eighty-one eligible treatment-naïve subjects with newly diagnosed resectable esophageal adenocarcinoma received radiotherapy (45 Gy concurrent with cisplatin-based chemotherapy, with planned subsequent surgical resection. The primary endpoint was pCR, defined as complete absence of tumor in the surgical specimen after radiochemotherapy. Using germline DNA from 60 subjects, we examined the base-excision repair SNP, XRCC1 Arg399Gln, and 4 other SNPs in nucleotide excision (XPD Lys751Gln and Asp312Asn, ERCC1 3' flank and double-stranded break (XRCC2 5' flank repair pathways, and correlated genotype with pCR rate. Paired tumor tissue was used to estimate the frequency of allelic imbalance at the XRCC1 SNP. Results The variant allele of the XRCC1 SNP (399Gln was detected in 52% of subjects. Only 6% of subjects with the variant allele experienced a pCR, compared to 28% of subjects without the variant allele (odds ratio 5.37 for failing to achieve pCR, p = 0.062. Allelic imbalance at this locus was found in only 10% of informative subjects, suggesting that germline genotype may reflect tumor genotype at this locus. No significant association

  8. Neurocognitive outcome in brain metastases patients treated with accelerated-fractionation vs. accelerated-hyperfractionated radiotherapy: an analysis from Radiation Therapy Oncology Group Study 91-04

    International Nuclear Information System (INIS)

    Purpose: To evaluate neurocognitive outcome as measured by the Mini-Mental Status Examination (MMSE) among patients with unresectable brain metastases randomly assigned to accelerated fractionation (AF) vs. accelerated hyperfractionated (AH) whole-brain radiation therapy (WBRT). Methods and Materials: The Radiation Therapy Oncology Group (RTOG) accrued 445 patients with unresectable brain metastases to a Phase III comparison of AH (1.6 Gy b.i.d. to 54.4 Gy) vs. AF (3 Gy q.d. to 30 Gy). All had a KPS of ≥ 70 and a neurologic function status of 0-2. Three hundred fifty-nine patients had MMSEs performed and were eligible for this analysis. Changes in the MMSE were analyzed according to criteria previously defined in the literature. Results: The median survival was 4.5 months for both arms. The average change in MMSE at 2 and 3 months was a drop of 1.4 and 1.1, respectively, in the AF arm as compared to a drop of 0.7 and 1.3, respectively, in the AH arm (p=NS). Overall, 91 patients at 2 months and 23 patients at 3 months had both follow-up MMSE and computed tomography/magnetic resonance imaging documentation of the status of their brain metastases. When an analysis was performed taking into account control of brain metastases, a significant effect on MMSE was observed with time and associated proportional increase in uncontrolled brain metastases. At 2 months, the average change in MMSE score was a drop of 0.6 for those whose brain metastases were radiologically controlled as compared to a drop of 1.9 for those with uncontrolled brain metastases (p=0.47). At 3 months, the average change in MMSE score was a drop of 0.5 for those whose brain metastases were radiologically controlled as compared to a drop of 6.3 for those with uncontrolled brain metastases (p=0.02). Conclusion: Use of AH as compared to AF-WBRT was not associated with a significant difference in neurocognitive function as measured by MMSE in this patient population with unresectable brain metastases and

  9. Genetic variation in DNA-repair pathways and response to radiochemotherapy in esophageal adenocarcinoma: a retrospective cohort study of the Eastern Cooperative Oncology Group

    International Nuclear Information System (INIS)

    Recent data in esophageal cancer suggests the variant allele of a single-nucleotide polymorphism (SNP) in XRCC1 may be associated with resistance to radiochemotherapy. However, this SNP has not been assessed in a histologically homogeneous clinical trial cohort that has been treated with a uniform approach. In addition, whether germline DNA may serve as a surrogate for tumor genotype at this locus is unknown in this disease. Our objective was to assess this SNP in relation to the pathologic complete response (pCR) rate in subjects with esophageal adenocarcinoma who received cisplatin-based preoperative radiochemotherapy in a multicenter clinical trial (Eastern Cooperative Oncology Group 1201). As a secondary aim, we investigated the rate of allelic imbalance between germline and tumor DNA. Eighty-one eligible treatment-naïve subjects with newly diagnosed resectable esophageal adenocarcinoma received radiotherapy (45 Gy) concurrent with cisplatin-based chemotherapy, with planned subsequent surgical resection. The primary endpoint was pCR, defined as complete absence of tumor in the surgical specimen after radiochemotherapy. Using germline DNA from 60 subjects, we examined the base-excision repair SNP, XRCC1 Arg399Gln, and 4 other SNPs in nucleotide excision (XPD Lys751Gln and Asp312Asn, ERCC1 3' flank) and double-stranded break (XRCC2 5' flank) repair pathways, and correlated genotype with pCR rate. Paired tumor tissue was used to estimate the frequency of allelic imbalance at the XRCC1 SNP. The variant allele of the XRCC1 SNP (399Gln) was detected in 52% of subjects. Only 6% of subjects with the variant allele experienced a pCR, compared to 28% of subjects without the variant allele (odds ratio 5.37 for failing to achieve pCR, p = 0.062). Allelic imbalance at this locus was found in only 10% of informative subjects, suggesting that germline genotype may reflect tumor genotype at this locus. No significant association with pCR was noted for other SNPs

  10. Hodgkin Lymphoma at the Paediatric Oncology Unit of Gabriel Touré Teaching Hospital, Bamako, Mali: 5-Year Experience

    OpenAIRE

    T. Sidibé; B. Traoré; F. Traoré-Dicko; Sylla, M.; A. A. Diakité; Diawara, M.; K. Dumke; C. B. Traoré; Togo, A. P.; F. Traoré; B Togo

    2011-01-01

    Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco—Africain d'Oncologie Pédiatrique) Hodgkin lymphoma treatment protocol. Res...

  11. Guidelines for the recognition, prevention, and remediation of burnout in health care professionals participating in the care of children with cancer: report of the SIOP Working Committee on Psychosocial Issues in Pediatric Oncology.

    Science.gov (United States)

    Spinetta, J J; Jankovic, M; Ben Arush, M W; Eden, T; Epelman, C; Greenberg, M L; Gentils Martins, A; Mulhern, R K; Oppenheim, D; Masera, G

    2000-08-01

    This is the eighth official document of the SIOP Working Committee on Psychosocial Issues in Pediatric Oncology, instituted in 1991. It deals with a topic discussed and approved by the SIOP Committee; namely, "Recognition, prevention, and remediation of burnout in health care professionals participating in the care of children with cancer." It is addressed to the Pediatric Oncology community and outlines: 1) the general definition of burnout as mental and physical exhaustion, indifference, sense of failure as a professional, and sense of failure as a person; 2) the causes of burnout from the nature of the work itself, the work environment, and the characteristics of the individual; 3) the prevention of burnout, changing the detrimental aspects of one's work environment and modifying one's own behavior; and accepting methods to remediate burnout when it occurs. PMID:10918235

  12. Toward the Cure of All Children With Cancer Through Collaborative Efforts: Pediatric Oncology As a Global Challenge.

    Science.gov (United States)

    Rodriguez-Galindo, Carlos; Friedrich, Paola; Alcasabas, Patricia; Antillon, Federico; Banavali, Shripad; Castillo, Luis; Israels, Trijn; Jeha, Sima; Harif, Mhammed; Sullivan, Michael J; Quah, Thuan Chong; Patte, Catherine; Pui, Ching-Hon; Barr, Ronald; Gross, Thomas

    2015-09-20

    Advances in the treatment of childhood cancers have resulted in part from the development of national and international collaborative initiatives that have defined biologic determinants and generated risk-adapted therapies that maximize cure while minimizing acute and long-term effects. Currently, more than 80% of children with cancer who are treated with modern multidisciplinary treatments in developed countries are cured; however, of the approximately 160,000 children and adolescents who are diagnosed with cancer every year worldwide, 80% live in low- and middle-income countries (LMICs), where access to quality care is limited and chances of cure are low. In addition, the disease burden is not fully known because of the lack of population-based cancer registries in low-resource countries. Regional and ethnic variations in the incidence of the different childhood cancers suggest unique interactions between genetic and environmental factors that could provide opportunities for etiologic research. Regional collaborative initiatives have been developed in Central and South America and the Caribbean, Africa, the Middle East, Asia, and Oceania. These initiatives integrate regional capacity building, education of health care providers, implementation of intensity-graduated treatments, and establishment of research programs that are adjusted to local capacity and local needs. Together, the existing consortia and regional networks operating in LMICs have the potential to reach out to almost 60% of all children with cancer worldwide. In summary, childhood cancer burden has been shifted toward LMICs and, for that reason, global initiatives directed at pediatric cancer care and control are needed. Regional networks aiming to build capacity while incorporating research on epidemiology, health services, and outcomes should be supported. PMID:26304881

  13. "The children's feedback game": an approach for modifying disruptive group behavior.

    Science.gov (United States)

    Epstein, Y M; Borduin, C M

    1984-01-01

    Adult leaders of groups for children are almost invariably confronted with the problem of disruptive child behavior. Although these adults are usually able to effect at least some level of child compliance, the achievement of such compliance often demands a considerable expenditure of time and forces the leader and children into an adversary relationship. An alternative approach toward disruptive group behavior avoids some of these difficulties by engaging the children themselves as agents of change. The "Children's Feedback Game" provides a mechanism for implementing peer-group modification of undesirable behavior. The game uses an incentive system to teach the children to give and to receive both positive and negative feedback. As these interpersonal skills are developed, group supportiveness and cooperation are enhanced and other group goals are more easily met. The game can be readily adapted to a variety of clinical and teaching situations that involve a group of children. PMID:6711711

  14. Once failed, twice shy: How group-based competition influences risk preference in young children.

    Science.gov (United States)

    Zhu, Yi; Wang, Jiajie; Lv, Xiaofeng; Li, Yansong

    2016-04-01

    Recent developmental research demonstrates that young children tend to be risk-seeking. However, very little is known about the extent to which such a capacity varies with children's group-based experience. Given that between-group competition is a central feature of human social life, this study aimed at examining the influence of group-based competition over risk preference in young children. In total, 234 children from 3 age groups (2-4-year-olds, 5-6-year-olds, and 8-9-year-olds) engaged in an intergroup competition manipulation, which was followed by a prosocial game assessing children's ingroup egalitarianism and a gambling task measuring children's risk preference. We found that children in the intergroup competition condition tended to be risk-averse compared with those who were in the nonintergroup competition condition. Furthermore, we found that an aversion to risk in the intergroup competition condition was driven by such an aversion observed in children from the losing group. In addition, we found a positive relationship between ingroup egalitarianism and risk preference in children from the winning group rather than those from the losing group. Together, our results contribute to the understanding of the effects of group-based experience on children's risk preference and may have important implications for understanding individuals' risky decisions. (PsycINFO Database Record PMID:26974207

  15. Peer Group Status of Gender Dysphoric Children: A Sociometric Study

    OpenAIRE

    Wallien, Madeleine S. C.; Veenstra, Rene; Kreukels, Baudewijntje P. C.; Cohen-Kettenis, Peggy T.

    2010-01-01

    In this sociometric study, we aimed to investigate the social position of gender-referred children in a naturalistic environment. We used a peer nomination technique to examine their social position in the class and we specifically examined bullying and victimization of gender dysphoric children. A total of 28 children (14 boys and 14 girls), referred to a gender identity clinic, and their classmates (n = 495) were included (M age, 10.5 years). Results showed that the gender-referred children...

  16. SOCIAL RESPONSES IN HYPOTHETICAL SITUATIONS OF INTERPERSONAL TENSION, OF A GROUP OF CHILDREN INSTITUTIONALIZED FOR PHYSICAL ABUSE, AND A GROUP OF NON-ABUSED CHILDREN

    OpenAIRE

    CÉSAR REY

    2004-01-01

    This investigation had two objectives: a) to compare the number of punitive and not punitive socialresponses reported toward three hypothetical situations of interpersonal tension, by a group of 39institutionalized for physical abuse children and girls, with that informed by a group of 34 not abusedchildren and girls inscribed to an educational institution, and b) to compare the number of punitive andnot punitive responses that the physically abused children and girls referred in this situati...

  17. Young children's experiences of participating in group treatment for children exposed to intimate partner violence: A qualitative study.

    Science.gov (United States)

    Pernebo, Karin; Almqvist, Kjerstin

    2016-01-01

    The risk of exposure to intimate partner violence (IPV) between caregivers is increased during early childhood. The adverse effects on the health and development of the youngest children may be severe. Effective and promising interventions for children who have experienced IPV have been developed and evaluated. However, there is a lack in knowledge about how the children themselves experience the interventions. The aim of this study was to contribute to the evaluation of group treatment designed to improve the psychological health of young children in the aftermath of family violence by elucidating the children's experiences of participating. Nine children, aged 4 to 6 years, were interviewed after participating in group programmes specifically designed for children who have been exposed to intimate partner violence. A semi-structured interview guide with open-ended questions was used. The interviews were transcribed and analysed using interpretative phenomenological analysis, to ensure a focus on the children's own views and experiences. Five master themes embracing the children's experiences were identified: joy - positive emotional experience of participation; security - feeling safe; relatedness - relationships within the group; to talk - externalised focus on the violence; and competence - new knowledge and skills. Theoretical and clinical implications and the benefit of including very young children's views and experiences in research are discussed. PMID:25410886

  18. Positive Peer Relationships and Risk of Victimization in Chinese and South Korean Children's Peer Groups

    Science.gov (United States)

    Abou-ezzeddine, Tania; Schwartz, David; Chang, Lei; Lee-Shin, Yoolim; Farver, JoAnn; Xu, Yiyuan

    2007-01-01

    This study examined the moderating role of positive peer relationships in the relation between behavioral or academic risk factors and victimization in Asian children's peer groups. We recruited 296 children (161 boys, 135 girls) from Tianjin, China (mean age of 11.5 years) and 122 children (66 boys, 56 girls) from Seoul, South Korea (approximate…

  19. Pointing to "That": Deixis and Shared Intentionality in Young Children's Collaborative Group Work

    Science.gov (United States)

    Murphy, Carol

    2014-01-01

    In this article I present examples of young children's interaction in collaborative group work in mathematics and consider how the children shared intentions, that is, how they influenced the thinking of another. By analysing the children's use of deixis as an aspect of indexicality, I examined how the students pointed out mathematical…

  20. Children's Learning of Number Words in an Indigenous Farming-Foraging Group

    Science.gov (United States)

    Piantadosi, Steven T.; Jara-Ettinger, Julian; Gibson, Edward

    2014-01-01

    We show that children in the Tsimane', a farming-foraging group in the Bolivian rain-forest, learn number words along a similar developmental trajectory to children from industrialized countries. Tsimane' children successively acquire the first three or four number words before fully learning how counting works. However, their learning…

  1. Peer Group Status of Gender Dysphoric Children : A Sociometric Study

    NARCIS (Netherlands)

    Wallien, Madeleine S. C.; Veenstra, Rene; Kreukels, Baudewijntje P. C.; Cohen-Kettenis, Peggy T.

    2010-01-01

    In this sociometric study, we aimed to investigate the social position of gender-referred children in a naturalistic environment. We used a peer nomination technique to examine their social position in the class and we specifically examined bullying and victimization of gender dysphoric children. A

  2. Factors which influence quality of life in patients with non-small cell lung cancer (NSCLC): A radiation therapy oncology group study (RTOG 89-01)

    International Nuclear Information System (INIS)

    Purpose: Prospectively evaluate the quality of life (QOL) of patients with NSCLC participating in a randomized phase III study conducted by the RTOG and Eastern Cooperative Oncology Group. Determine the factors which influence QOL during and post therapy. Materials and Methods: From (4(90)) to (4(94)) to 75 patients (pts) were randomized on RTOG 89-01 between a regimen containing radiation therapy (RT) versus a regimen containing surgery (S). All pts received induction vinblastine and cisplatin, followed by either S or RT and consolidation chemotherapy (CT). Pts were given the self-assessment QOL forms prior to the start of therapy, post induction CT, post RT or S, and periodically during follow-up. Two questionnaires were used: Functional Assessment of Cancer Therapy for lung cancer patients (FACT-L) and Functional Living Index-Cancer (FLIC). The FACT-L consists of 44 questions covering 6 domains (physical, social, and emotional well-being, relationship with physician, fulfilment, and lung cancer specific concerns), FLIC contains 22 questions summing to one total score. Results: 51 pts participated in the QOL endpoint, 24 were excluded: 3 pts refused, institution did not administer QOL questionnaires in 9 pts, 3 completed QOL after start of therapy, 1 institution refused to participate, 5 questionnaires were incomplete/unusable, 1 pt could not read English, and 2 were ineligible for treatment. Participation in QOL was not predicted by any pretreatment characteristic. Women had worse pretreatment QOL (p<0.005, by FLIC) and more problems with disease-related symptoms (p<0.005, by FACT) than men. Pts with KPS 90-100 had better pretreatment QOL than pts with KPS 60-80 (p<0.025, FLIC). Neither race, marital status, education level, age, prior weight loss, nor disease symptoms statistically significantly influenced pretreatment QOL. Initial QOL did not predict overall survival. FACT-L was reported on 25 pts post induction CT. Follow-up FACT-L was available on 12 pts

  3. Children's learning of number words in an indigenous farming-foraging group

    OpenAIRE

    Piantadosi, Steven Thomas; Jara-Ettinger, Julian; Gibson, Edward A.

    2014-01-01

    We show that children in the Tsimane', a farming-foraging group in the Bolivian rain-forest, learn number words along a similar developmental trajectory to children from industrialized countries. Tsimane' children successively acquire the first three or four number words before fully learning how counting works. However, their learning is substantially delayed relative to children from the United States, Russia, and Japan. The presence of a similar developmental trajectory likely indicates th...

  4. Child Abuse in Group of Children with Attention Deficit-Hyperactivity Disorder in Comparison with Normal Children

    OpenAIRE

    Hadianfard, Habib

    2014-01-01

    Background: Children suffer from attention deficit hyperactivity disorder (ADHD) are very difficult to handle. It can be very frustrating and needs an outstanding tolerance. Behavioral difficulties in ADHD children may increase the risk of child abuse for them. The aim of this research was to compare child abuse, and neglect between ADHD group and normal children. Methods: In this cross-sectional study, 30 ADHD students (10 girls and 20 boys) were selected from regional mental behavior disord...

  5. A model parent group for enhancing aggressive children's social competence in Taiwan.

    Science.gov (United States)

    Li, Ming-Hui

    2009-07-01

    This paper presents a semi-structured psychoeducational model of group work for parents of aggressive children based on concepts of co-parenting and bidirectionality. The group was developed for enhancing five Taiwanese aggressive children's social competence by promoting positive interactions within family. Topics covered in the group included identifying parenting styles, forming parental alliances, fostering parent-child mutual initiations/mutual compliances, establishing parent-child co-regulation, and responding to aggressive children's negative emotions. Pre- and post-group comparisons suggested the effectiveness of the group model. PMID:19548787

  6. Population Pharmacokinetics of Cyclophosphamide and Metabolites in Children with Neuroblastoma: a Report from the Children’s Oncology Group

    OpenAIRE

    McCune, Jeannine S.; Salinger, David H.; Vicini, Paolo; Oglesby, Celeste; Blough, David K.; Park, Julie R.

    2008-01-01

    Cyclophosphamide-based regimens are front-line treatment for numerous pediatric malignancies, however current dosing methods result in considerable interpatient variability in tumor response and toxicity. In this pediatric population, our objectives were to 1. quantify and explain the pharmacokinetic variability of cyclophosphamide, and two of its metabolites, hydroxycyclophosphamide (HCY) and carboxyethylphosphoramide mustard (CEPM); 2. apply a population pharmacokinetic model to describe th...

  7. Evaluation and Management of Hearing Loss in Survivors of Childhood and Adolescent Cancers: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Bass, Johnnie K; Knight, Kristin R; Yock, Torunn I; Chang, Kay W; Cipkala, Douglas; Grewal, Satkiran S

    2016-07-01

    Hearing loss (HL) is common in childhood cancer survivors exposed to platinum chemotherapy and/or cranial radiation and can severely impact quality of life. Early detection and appropriate management can mitigate academic, speech, language, social, and psychological morbidity resulting from hearing deficits. This review is targeted as a resource for providers involved in aftercare of childhood cancers. The goal is to promote early identification of survivors at-risk for HL, appropriate evaluation and interpretation of diagnostic tests, timely referral to an audiologist when indicated, and to increase knowledge of current therapeutic options. PMID:26928933

  8. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  9. Obesity risk factors in a representative group of Polish prepubertal children

    OpenAIRE

    Januszek-Trzciąkowska, Aleksandra; Małecka-Tendera, Ewa; Klimek, Katarzyna; Matusik, Paweł

    2013-01-01

    Introduction The study aim was to evaluate risk factors of obesity in Polish children aged 7 to 9 years. Material and methods A representative group of 2571 children (1268 girls and 1303 boys) was randomly selected according to the European Childhood Obesity Group protocol. Weight and height were measured and body mass index (BMI) was calculated. A questionnaire was completed by the children's parents with respect to behavioural and family-related risk factors of obesity. International Obesit...

  10. DETERMINATION OF THE EMPATY LEVELS OF THE RESPONSIBLE PERSONS IN GROUPS AT NURSERIES AND CHILDREN'S HOME

    OpenAIRE

    BİBER, Kazım; Sezer, Türker

    2011-01-01

    ABSTRACT The purpose of this research is to determinate the empathy levels of the responsible persons in groups at nurseries and children's homes which are subject to social services and children society for the protection of children (SHÇEK) and to investigate them according to the some variables. The research was performed as a descriptive study and "Empathy Scale" was used to collect data about the empathy levels of the responsible persons in groups at nurseries and chil...

  11. Preference for High Status Predicts Implicit Outgroup Bias among Children from Low-Status Groups

    Science.gov (United States)

    Newheiser, Anna-Kaisa; Dunham, Yarrow; Merrill, Anna; Hoosain, Leah; Olson, Kristina R.

    2014-01-01

    Whereas members of high-status racial groups show ingroup preference when attitudes are measured implicitly, members of low-status racial groups--both adults and children--typically show no bias, potentially reflecting awareness of the ingroup's low status. We hypothesized that when status differences are especially pronounced, children from…

  12. Young Children Enforce Social Norms Selectively Depending on the Violator's Group Affiliation

    Science.gov (United States)

    Schmidt, Marco F. H.; Rakoczy, Hannes; Tomasello, Michael

    2012-01-01

    To become cooperative members of their cultural groups, developing children must follow their group's social norms. But young children are not just blind norm followers, they are also active norm enforcers, for example, protesting and correcting when someone plays a conventional game the "wrong" way. In two studies, we asked whether young children…

  13. "Make Sure You Keep Our House Safe!" Thematic Analysis of a Children's Psychotherapy Group

    Science.gov (United States)

    Devi, Akasha; Fenn, Edwin

    2012-01-01

    This paper describes a systematic thematic analysis of one particular latency-aged children's group and includes a discussion about potentially helpful outcomes measures. The impetus for our small, practice-based qualitative research project came from the two papers by Reid (1999) and Canham (2002) about children's psychotherapy groups,…

  14. American Society for Radiation Oncology

    Science.gov (United States)

    ... PAC Become an Advocate Log In SNIPEND American Society for Radiation Oncology Plan your time at the ... oncology practices. RO-ILS The only medical specialty society-sponsored incident learning system for radiation oncology. RO ...

  15. Housing standards, social group, and respiratory infections in children of Upernavik, Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, P

    1983-01-01

    rate than other children, but this did not prove to be so. The disease pattern of these children was characterized by a low level of contacts due to certain acute respiratory infections and a high level of contacts due to chronic purulent otitis media, compared with children from higher socio......During one year, contacts with the health service due to respiratory infections--including diseases of ear, nose, and throat--were studied in the 310 children of Upernavik town. 166 contacts were recorded. Children from low socio-economic groups had been expected to have a higher overall contact...

  16. Comparing risk factors in a group of obese children and group of athlets

    Directory of Open Access Journals (Sweden)

    Dalibor Pastucha

    2010-01-01

    Full Text Available Obesity is an increasing problem that more and more often affects children, thus not only the adult population. The aim of this thesis is to compare various elements and life habits of obese children with elements and habits of children practising athletics. These processes are physical activity, healthstate, eating habits, physical condition, breast-feeding period duration and the BMI of the children's parents. We have come upon an agreement with other authors that while comparing the BMI results of the parents, the two sets differed significantly. It was clearly indicated that obese children also have overweight or obese parents. Therefore it can be said that obesity is usually a problem of the whole actual family and its life-style. Regarding birth-weight, breast-feeding period duration, participation in P.E. class or a time spent watching TV or playing a computer, no major differences were noted. However, slight differences in favour to the athletes were seen in their good eating habits, their body-posture and their interest in sports in general. Here, the intensity with which active children practise sports and the time they devote to it are much higher and bigger than the energy and time spent on sports by obese children.

  17. Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach.

    Science.gov (United States)

    Sharif Ishak, Sharifah Intan Zainun; Shohaimi, Shamarina; Kandiah, Mirnalini

    2013-04-01

    The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity. PMID:23610606

  18. Food for thought: the use of food in group therapy with children and adolescents.

    Science.gov (United States)

    Mishna, Faye; Muskat, Barbara; Schamess, Gerald

    2002-01-01

    This article highlights the significance food may have in group therapy with children and adolescents and its meanings for particular group members. It focuses on the interactions between the group members and leaders in response to food. Along with providing actual nutrition, food represents emotional and symbolic nurturing, and may trigger salient conflicts and issues with which group members are struggling. An essential role of the group leader is to manage conflicts that may be evoked by the provision of food. Examples are provided to illustrate themes and meanings related to food in group therapy with children and adolescents. PMID:11797244

  19. Group Administration of the Children's Attributional Style Interview

    Science.gov (United States)

    Rueger, Sandra Yu; Malecki, Christine Kerres

    2007-01-01

    Research testing the reformulated theory of learned helplessness has been limited by the psychometric properties of instruments used to measure children's attributional style. Thus, the goal of this investigation was to modify a relatively new measure of attributional style that has demonstrated strong psychometric properties with young children…

  20. Peer Group Formation in Young Children: Perception. Final Report.

    Science.gov (United States)

    Edelman, Murray S.

    This study is an attempt to integrate two theoretical approaches in child development: ethology and cognitive theory. An ethological approach suggests that children structure their social world hierarchically and are emotionally involved in perceiving and participating in interactions involving dominance. It is through this involvement that…

  1. Serum Zinc Level in Children with Febrile Convulsion and its Comparison with that of Control Group

    Directory of Open Access Journals (Sweden)

    Nahid Vahid Harandi

    2009-03-01

    Full Text Available Objective: Febrile convulsion is the most common disorder in childhood with good prognosis. There are different hypotheses about neurotransmitters and trace element (such as zinc changes in cerebrospinal fluid and serum, which can have a role in pathogenesis of febrile convulsion. The aim of the present prospective analytical case-control study was to determine whether there was any changes in serum zinc level in children with febrile convulsion during seizure.Methods: Ninety-two children aged 6 months to 5 years were divided into three groups: group A, 34 children with febrile convulsion, group B, 40 children having fever without convulsion, and group C, and 18 children with non-febrile convulsion. Serum zinc levels for the three groups were estimated by atomic absorption spectrophotometry (AAS. Data were analyzed to compare zinc level among the three groups using appropriate statistical tools employing SPSS 13.Findings: Serum zinc levels of groups A, B, and C had a mean value of 76.82±24.36mg/1, 90.12±14.63 mg/1 and 94.53±17.39 mg/l, respectively. Serum zinc level of group A was lower than those of the other two groups (P<0.006. It was also lower in group B than in group C (P<0.006.Conclusion: These findings revealed that serum zinc level decreases during infection; this decrease was more significant in patients with febrile convulsion.

  2. The indigo-children and the perception of this group of children in kindergarten

    OpenAIRE

    Jerko, Tina

    2016-01-01

    The purpose of this thesis is to present the concept of indigo children and investigate how the professionals in kindergartens recognize it or know about. The concept of indigo children is not scientifically proven, but there are several theories and records of indigo children. Children of this time are different from previous generations. They come to this world with a specific purpose and capabilities that are easily recognizable from their birth onwards. Various authors describe indig...

  3. Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation: A 10-year Review From a Tertiary Pediatric Hospital.

    Science.gov (United States)

    Nielsen, Maryke J; Claxton, Sarah; Pizer, Barry; Lane, Steven; Cooke, Richard P D; Paulus, Stéphane; Carrol, Enitan D

    2016-03-01

    Viridans Group Streptococci (VGS) are associated with high mortality rates in febrile neutropenia; yet there are no recent European pediatric studies to inform antimicrobial therapy. The aim of this study was to describe the characteristics, outcome, and resistance patterns of children with VGS bacteremia (VGSB) undergoing treatment of malignancy or hematopoietic stem cell transplant.Patients aged 0 to 18 years, admitted to a tertiary pediatric hemato-oncology center with VGSB, from 2003 to 2013, were included in the study. All data were collected retrospectively from medical records.A total of 54 bacteremic episodes occurred in 46 patients. The most common underlying diagnosis was relapsed acute lymphoblastic leukemia.Streptococcus mitis was the most frequent organism. A total of 30% of isolates were resistant to penicillin and 100% sensitive to vancomycin. There were 8 episodes (14.8%) of Viridans Group Streptococcal Shock Syndrome; 6 resulted in admission to intensive care and 3 of these patients died of multiorgan failure.The potentially fatal nature of VGSB is confirmed. The high risk in relapsed acute lymphoblastic leukemia is of note. Research is needed to develop risk-stratification scores that identify children at risk of Viridans Group Streptococcal Shock Syndrome to guide empirical antimicrobial therapy in febrile neutropenia. PMID:26945409

  4. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    Science.gov (United States)

    Vogel, Wendy H

    2016-01-01

    Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring. PMID:27249776

  5. A group-mediated psychotherapy with children: Clinical observation and assessment

    Directory of Open Access Journals (Sweden)

    Sara Cuticchio

    2014-09-01

    Full Text Available The study is based on clinical evaluation of a psychotherapy group for children, employing Sicilian puppets, objects as mediators, to reflect on significant moments and the dynamic processes of change during the therapy. TCM (Therapeutic Cycle Model, 1996, designed by Mergenthaler, is used to identify whether and how the assessment corresponds to the changes detected by observation of each subject and the group. During the 8 sessions of therapy, verbal productions of children and therapists were analyzed and compared. Keywords:Evaluation; Group therapy; Mediating object; Children 

  6. The formation of in-group favoritism and out-group prejudice in young children: are they distinct attitudes?

    Science.gov (United States)

    Aboud, Frances E

    2003-01-01

    Although standardized measures of prejudice reveal high levels of ethnocentric bias in the preschool years, it may reflect in-group favoritism or out-group prejudice. A measure that partially decouples the two attitudes was given to White children between 4 and 7 years of age to examine the reciprocal relation between and the acquisition and correlates of in-group and out-group attitudes. The two attitudes were reciprocally correlated in 1 sample from a racially homogeneous school but not in a 2nd sample from a mixed-race school. In-group favoritism did not appear until 5 years of age but then reached significant levels; it was strongly related to developing social cognitions. Out-group prejudice was weaker, but its targets suffer from comparison with the high favoritism accorded in-group members. PMID:12518808

  7. Inclusion, children's groups, music therapy: Music and communicative musicality

    DEFF Research Database (Denmark)

    Holck, Ulla; Jacobsen, Stine Lindahl

    2017-01-01

    Music has a rare ability to affect us directly. Pulse and rhythms make us move, and notes and harmonies inspire and express our inner emotions in a direct and immediate way that goes beyond what words or even other art forms can rarely achieve (Panksepp & Trevarthen, 2009). Music creates a...... delightful build-up of tension or soothes us, and its narrative character gives rise to mental imagery or memories. Music brings people together and helps build communities across languages and common divides. And – not least – music captures children’s immediate attention, so when the music starts, so do...... the children! Initially by rocking in time to the rhythm, and then with dance moves or spontaneous singing. In this chapter, we demonstrate how music and music activities can be used as a means of including vulnerable children in school or preschool settings. Based on experiences from music therapy...

  8. Children of mentally ill parents – a pilot study of a group intervention program

    Directory of Open Access Journals (Sweden)

    Hanna eChristiansen

    2015-10-01

    Full Text Available The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009 and adapted it for groups. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28, a Wait Control group (n = 9, and a control group of healthy children (n = 40. Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention children’s knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group and externalizing symptoms were reduced for this group as well. This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of children’s enhanced knowledge about parental psychopathology need to be explored in future studies.

  9. Goal-Orientated Group Intervention for Children with Developmental Coordination Disorder

    Science.gov (United States)

    Dunford, Carolyn

    2011-01-01

    This study measures the effectiveness of a goal-orientated group intervention using concentrated practice schedules for children with developmental coordination disorder (DCD). The study design is repeated measures. The sample comprises eight children with DCD, aged 7-11 years. Outcome measures are the Movement Assessment Battery for Children…

  10. Radio vs. Television: Their Cognitive Impact on Children of Different Socioeconomic and Ethnic Groups.

    Science.gov (United States)

    Greenfield, Patricia; Beagles-Roos, Jessica

    1988-01-01

    Reports on two studies which compared the impact of radio and television on children from different social classes and ethnic groups. Found that radio was more stimulating than television to the imagination (especially among white children) and that television led to greater overall recall of information. (ARH)

  11. Evaluation of Individual and Group Grief and Trauma Interventions for Children Post Disaster

    Science.gov (United States)

    Salloum, Alison; Overstreet, Stacy

    2008-01-01

    This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused…

  12. Aggression in Children with Autism Spectrum Disorders and a Clinic-Referred Comparison Group

    Science.gov (United States)

    Farmer, Cristan; Butter, Eric; Mazurek, Micah O.; Cowan, Charles; Lainhart, Janet; Cook, Edwin H.; DeWitt, Mary Beth; Aman, Michael

    2015-01-01

    A gap exists in the literature regarding aggression in autism spectrum disorders and how this behavior compares to other groups. In this multisite study, the "Children's Scale for Hostility and Aggression: Reactive/Proactive" and the Aggression subscale of the "Child Behavior Checklist" were rated for 414 children with autism…

  13. Normativity and Friendship Choices among Ethnic Majority- and Minority-Group Children

    Science.gov (United States)

    Leman, Patrick J.; Ben-Hmeda, Malak; Cox, Jo; Loucas, Christina; Seltzer-Eade, Sophia; Hine, Ben

    2013-01-01

    Two-hundred-and-fifty-eight White British (ethnic majority) and British South Asian (minority) children (5, 9 and 13 years old) chose potential friends from descriptions of peers who had traits and preferences that were either consistent (normative) or inconsistent (deviant) with ethnic group membership. White children chose peers from the ethnic…

  14. Illegitimate Participation? A Group of Young Minority Ethnic Children's Experiences of Early Childhood Education

    Science.gov (United States)

    Barron, Ian

    2009-01-01

    This paper seeks to explore how a group of children, the majority of whom were of minority ethnic heritage, experienced starting nursery school in a setting where the majority of staff were of white indigenous heritage. The nursery is in a small town in the north-west of England, and the children were aged three and four. Observations were carried…

  15. Does the EDI Measure School Readiness in the Same Way across Different Groups of Children?

    Science.gov (United States)

    Guhn, Martin; Gadermann, Anne; Zumbo, Bruno D.

    2007-01-01

    The present study investigates whether the Early Development Instrument (Offord & Janus, 1999) measures school readiness similarly across different groups of children. We employ ordinal logistic regression to investigate differential item functioning, a method of examining measurement bias. For 40,000 children, our analysis compares groups…

  16. Effects of Group Socialization Procedures on the Social Interactions of Preschool Children.

    Science.gov (United States)

    Brown, William H.; And Others

    1988-01-01

    Two studies investigated the effects of group socialization procedures (teachers discussed friendship and praised child-child social responding) on the social behavior of preschool children. Results indicated that the procedures were a practical and effective method for improving young children's social interaction during both structured games and…

  17. Logging On: Evaluating an Online Support Group for Parents of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Clifford, Tessen; Minnes, Patricia

    2013-01-01

    Twenty mothers participated in an online support group for parents of children with autism spectrum disorders. Twenty-five unrelated parents participated in a no-treatment control group. The participants completed online questionnaires prior to and following the 4-month support group, to evaluate changes in mood, anxiety, parenting stress, and…

  18. Food Group Preferences of Elementary School Children Participating in the National School Lunch Program

    Science.gov (United States)

    Cashman, Linda; Tripurana, Madhuri; Englund, Tim; Bergman, Ethan A.

    2010-01-01

    Purpose/Objectives: The purpose of the study was to assess the food group preferences of second through fifth grade children based on ethnic background, gender, and grade. Food group preferences were determined by the amount of various food groups consumed in meals served as part of the National School Lunch Program at selected schools. Research…

  19. Quality Care through Multi-Age Grouping of Children.

    Science.gov (United States)

    Prendergast, Leo

    2002-01-01

    Asserts that multi-age grouping in early childhood settings can and does work. Addresses four main hurdles to successful implementation: (1) laws and regulations that act as barriers; (2) health concerns; (3) overcoming educational values that conflict with those of the age-grouped classroom; and (4) staff misunderstanding of multi-age grouping…

  20. Epidemiological studies of dental caries in groups of Swedish children

    OpenAIRE

    Stecksén-Blicks, Christina

    1986-01-01

    In a cross-sectional study the extent and distribution of dental caries was studied in 817 children, 4, 8 and 13 years old in three areas inSweden. The importance of dietary habits, sugar intake, social conditions, professional dental care, oral hygiene and the use of fluorides on caries prevalence was analyzed. In a subsample, con­sisting of 88 8-year-olds and 91 13-year-olds the net caries increment during aone-year period was studied.In this longitudinal study, the salivary levels of lacto...

  1. An evaluation of the relationship between the quality of prophylactic cranial radiotherapy in childhood acute leukemia and institutional experience: a Quality Assurance Review Center-Pediatric Oncology Group study

    International Nuclear Information System (INIS)

    Purpose: The Pediatric Oncology Group Protocol 9404 was a prospective clinical trial of two forms of chemotherapy in childhood T-cell acute lymphoblastic leukemia and advanced stage T-cell lymphoblastic non-Hodgkin's lymphoma. The protocol called for prophylactic C1 whole brain external beam irradiation, 18 Gy in 2 Gy/fraction for 9 fractions. We hypothesized that a correlation would be found between the number of children irradiated on protocol by an institution and the compliance rate of that institution with radiotherapy quality assurance (QA) guidelines. We also hypothesized that QA compliance would improve as the study progressed. Methods and Materials: We scored the radiation dose as a minor deviation from protocol guidelines if the dose to the prescription point differed from the protocol by 6-10%, and a major deviation if it differed from protocol by >10%. Treatment volumes were scored as a minor deviation if the margins were less than specified or the fields were excessively large. A major deviation was defined as the transection of a potential leukemia-bearing volume such as would be caused by blocking the cribriform plate, optic nerve, or temporal lobe. When the treating physician submitted a treatment plan and simulator film at the initiation of therapy to the Quality Assurance Review Center (QARC), a rapid turn-around review of the plan and suggestions for improvement was provided. At the end of therapy, all simulator and port films were reviewed at the QARC. Results: We reviewed the data from 353 patients treated at 73 institutions in the United States, Canada, and Europe. Of these patients, 2% (n=7) were not assessable for QA because of incomplete information. Minor quality deviations were found in 27.7% of patients (n=98) and major deviations in 7.9% (n=28). The frequency of major deviations for institutions placing 1-4 patients on study was 11% vs. 5.5% for institutions placing ≥5 patients (p5 patients (p not significant). The frequency of major

  2. Mothers' perceptions of children's food behaviors: use of focus group interview study

    OpenAIRE

    Lee, Young-Mee; Kim, Jung-Hyun; Oh, Yu-jin; Lee, Min-June

    2008-01-01

    Children's food behaviors have been expressed in a various ways because of recent changes in their family environment. Thus, this study was performed to investigate in-depth qualitative research on the mother's perception on children's food behaviors by focused group interview. This study was designed in four steps of planning, collection of participants, process, and analysis. Participants for the focus group interview were recruited and sampled from households with elementary school student...

  3. Children's learning of number words in an indigenous farming-foraging group.

    Science.gov (United States)

    Piantadosi, Steven T; Jara-Ettinger, Julian; Gibson, Edward

    2014-07-01

    We show that children in the Tsimane', a farming-foraging group in the Bolivian rain-forest, learn number words along a similar developmental trajectory to children from industrialized countries. Tsimane' children successively acquire the first three or four number words before fully learning how counting works. However, their learning is substantially delayed relative to children from the United States, Russia, and Japan. The presence of a similar developmental trajectory likely indicates that the incremental stages of numerical knowledge - but not their timing - reflect a fundamental property of number concept acquisition which is relatively independent of language, culture, age, and early education. PMID:24766463

  4. Gaps in Oncology

    Science.gov (United States)

    The first plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study Original Version provides background for the curriculum and identifies gaps in current and desired comprehensive cancer care.

  5. Nanotechnology in Radiation Oncology

    OpenAIRE

    Wang, Andrew Z.; Tepper, Joel E.

    2014-01-01

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also wel...

  6. Profiles in Successful Group Piano for Children: A Collective Case Study of Children's Group-Piano Lessons

    Science.gov (United States)

    Pike, Pamela D.

    2013-01-01

    The purpose of this collective case study was to explore the best practices in beginning group-piano instruction. Four beginning and intermediate groups of piano students (N =20) were observed. Data were triangulated through in-class observation of students and teachers, teacher interviews and student questionnaires. The master teachers…

  7. An emergency department intervention to protect an overlooked group of children at risk of significant harm.

    LENUS (Irish Health Repository)

    Kaye, P

    2012-02-01

    BACKGROUND: Parental psychiatric disorder, especially depression, personality disorder and deliberate self-harm, is known to put children at greater risk of mental illness, neglect or physical, emotional and sexual abuse. Without a reliable procedure to identify children of parents presenting with these mental health problems, children at high risk of significant harm can be easily overlooked. Although deliberate self-harm constitutes a significant proportion of emergency presentations, there are no guidelines which address the emergency physician\\'s role in identifying and assessing risk to children of these patients. METHODS: A robust system was jointly developed with the local social services child protection team to identify and risk-stratify children of parents with mental illness. This allows us to intervene when we identify children at immediate risk of harm and to ensure that social services are aware of potential risk to all children in this group. The referral process was audited repeatedly to refine the agreed protocol. RESULTS: The proportion of patients asked by the emergency department personnel about dependent children increased and the quality of information received by the social services child protection team improved. CONCLUSIONS: All emergency departments should acknowledge the inadequacy of information available to them regarding patients\\' children and consider a policy of referral to social services for all children of parents with mental health presentations. This process can only be developed through close liaison within the multidisciplinary child protection team.

  8. Osteonecrosis - complication at oncological treatment in childhood

    International Nuclear Information System (INIS)

    Osteonecrosis is one of serious complications at oncological treatment of children. The etiopathogenesis has not been completely elucidated, mostly it has a multifactorial character. The incidence is in 1,5 - 9,3 % range. ON affects predominantly the weight bearing joints. It affects mostly the patients with acute lymphoblastic leukemia and those at adolescent age. The course of disease is unpredictable. The changes at early stages can be reversible, but at some patients the disease progresses and can lead to a disability. At Children oncology clinic of Children teaching hospital in Bratislava during the years 1992 - 2008 we identified 12 patients affected by ON out of 146 children with ALL (8,2 %), 1 out of 42 with NHL (2,4 %) and 1 out of 42 with HL (2,4 %). The age at diagnosis of malignity: 4y7m - 17y, the age at diagnosis ON: 10y5m - 19y. Further course: regression - 2 patients, stabilised state - 6 patients, progression - 3 patients. 3 patients were lost from our follow up. The treatment was conservative, with the exception of one patient, who had to undergo surgery due to the progression of disease. To avoid the risk of inducing ON during the treatment of oncological patient in childhood it is important to optimalize the therapeutical protocols and to diagnose this complication early. (author)

  9. Periscope protocol for focus groups for adults and kindergarten children

    DEFF Research Database (Denmark)

    Caroli, Margherita

    2010-01-01

    a certain phenomenon from the participants’ perspective. In Periscope the Focus Group Methodology (FGM) will be used as a supplement to the quantitative methods in order to obtaining background information on health behavior in the institutions as well as in the family. In addition it will be used...

  10. Group Counseling Elementary School Children Who Use Aggressive Behaviors.

    Science.gov (United States)

    Stewart, John; And Others

    1995-01-01

    Describes a group-counseling approach to teaching elementary school students social skills designed to reduce their use of aggressive behaviors in the school environment. Eight sessions are described that have activities designed to influence the affective and behavioral components of these behaviors. Several suggestions are described to assess…

  11. Psycho-oncology: Searching for practical wisdom?

    Science.gov (United States)

    Butlin, Helen

    2015-10-01

    The debate is vigorous in psycho-oncology about whether spiritual, existential, and psychosocial are the most comprehensive terms for academic research discourses investigating meaning and purpose. A call-to-action email from the International Society of Psycho-Oncology included the term soul. The current essay highlights the historical and contemporary uses of "soul" to suggest that the re-emergent soul signifies a tacit quest for an "intangible" that seems missing in current constructs of clinical domains reflected in the vigor of the debates. It is suggested that the re-emergence of the pre-Medieval meaning(s) of the notion of soul affirms a growing need for integrative paradigms on "being human" to guide psycho-oncology practitioners and their research. As a paradigmatic example, a clinical support group entitled Soul Medicine is described as employing the term soul to open up the more marginal discourses about experiences of illness arising from philosophical reflection, arts, humanities, and spirituality within a clinical oncology context. A link between soul and wisdom is suggested for further exploration with the view that phronesis ("the virtue of practical wisdom"), an emerging concept in health professional education research, is of ultimate value to the people psycho-oncology seeks to serve. This group holds that garnering wisdom from the expertise of those living with cancer should be a central aim of our field. PMID:26399749

  12. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    International Nuclear Information System (INIS)

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma

  13. Primary immune response to blood group antigens in burned children.

    Science.gov (United States)

    Bacon, N; Patten, E; Vincent, J

    1991-01-01

    Delayed hemolytic transfusion reactions (DHTRs) are generally attributed to an anamnestic immune response. Case reports of DHTRs due to a primary immune response are rare. Transfusion reactions occurring in patients on the pediatric burn unit from 1981 to September 1988 were reviewed, and additional information was obtained for patients for whom a DHTR was documented. Of 62 transfusion reactions, 11 were classified as a primary immune response (DHTR), with either a positive antibody screen, a positive direct antiglobulin test (DAT), or both. None of the 11 patients included in the study had been previously tranfused or pregnant. The average number of units transfused prior to antibody identification was 19. The average time elapsed between the first transfusion and antibody identification was 3.6 weeks. Anti-K and anti-E were the most frequently identified. Three patients had a decrease in hemoglobin (average 1.5 g/dL) and hematocrit at the time that a positive DAT was detected. Such changes could not be demonstrated for the remaining eight patients. The conclusion was that a DHTR may he caused by a primary immune response in burned children more often than expected, but DHTR signs and symptoms are often not apparent due to the complications of burn trauma. PMID:15946011

  14. Listening to Voices of Children with a Visual Impairment: A Focus Group Study

    Science.gov (United States)

    Khadka, Jyoti; Ryan, Barbara; Margrain, Tom H.; Woodhouse, J. Margaret; Davies, Nathan

    2012-01-01

    The purpose of the study was to identify the educational, social and leisure activities and issues that matter to school children and young people with a visual impairment and to compare their lifestyle with fully sighted counterparts. Thirteen focus groups were conducted and the groups were stratified by age, gender, visual status and school…

  15. The Effects of Social Skills Groups for Young Children with Social Delays

    Science.gov (United States)

    Koyama, Takanori

    2011-01-01

    This study was conducted as a program evaluation of an existing social skills program. A review of literature identified a limited number of empirical studies on group-based social skills training for young children with social delays. The purpose of this study was to examine the effects of social skills groups as well as the effects of homework…

  16. The Evolution of a Children's Domestic Violence Counseling Group: Stages and Processes

    Science.gov (United States)

    Thompson, E. Heather

    2011-01-01

    The purpose of this qualitative case study is to illuminate the lived experiences of 4 young children between 6 and 7 years old who witnessed domestic violence while revealing the complex relationship between group process and stage development in their 18-week counseling group. Data revealed that processes occurring between and among group…

  17. Forming identities in residential care for children: Manoeuvring between social work and peer groups

    DEFF Research Database (Denmark)

    Stokholm, Anja

    2009-01-01

    pedagogical work. This article challenges the implicit understanding that social work is the primary source of identity transformation and that peer group interaction is mainly an obstacle to overcome. On the contrary, this article argues that learning about the social dynamics of the children's group is a...

  18. Different Leaders: Emergent Organizational and Intellectual Leadership in Children's Collaborative Learning Groups

    Science.gov (United States)

    Mercier, Emma M.; Higgins, Steven E.; da Costa, Laura

    2014-01-01

    This paper presents two studies that examine emergent leadership in children's collaborative learning groups. Building on research that finds that leadership moves are distributed among group members during learning activities, we examined whether there were patterns in the distribution of moves, resulting in different types of emergent…

  19. Group Parent Training Combined with Follow-Up Coaching for Parents of Children with Developmental Delays

    Science.gov (United States)

    Barton, Erin E.; Lissman, Dana Cohen

    2015-01-01

    The purpose of this study was to examine the relation between group training using an abbreviated version of the Incredible Years parent training with family coaching and positive parenting practices. Two at-­risk mothers and their young children with disabilities participated in the study. Both mothers were enrolled in a group parent training…

  20. Zinc, ferritin, magnesium and copper in a group of Egyptian children with attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Mahmoud Magdy M

    2011-12-01

    Full Text Available Abstract Background Attention deficit hyperactivity disorder is a behavioral syndrome of childhood characterized by inattention, hyperactivity and impulsivity. There were many etiological theories showed dysfunction of some brain areas that are implicated in inhibition of responses and functions of the brain. Minerals like zinc, ferritin, magnesium and copper may play a role in the pathogenesis and therefore the treatment of this disorder. Objective This study aimed to measure levels of zinc, ferritin, magnesium and copper in children with attention deficit hyperactivity disorder and comparing them to normal. Methods This study included 58 children aged 5-15 years with attention deficit hyperactivity disorder attending Minia University Hospital from June 2008 to January 2010. They were classified into three sub-groups: sub-group I included 32 children with in-attentive type, sub-group II included 10 children with hyperactive type and sub-group III included 16 children with combined type according to the DSM-IV criteria of American Psychiatric Association, 2000. The control group included 25 apparently normal healthy children. Results Zinc, ferritin and magnesium levels were significantly lower in children with attention deficit hyperactivity disorder than controls (p value 0.04, 0.03 and 0.02 respectively, while copper levels were not significantly different (p value 0.9. Children with inattentive type had significant lower levels of zinc and ferritin than controls (p value 0.001 and 0.01 respectively with no significant difference between them as regards magnesium and copper levels (p value 0.4 and 0.6 respectively. Children with hyperactive type had significant lower levels of zinc, ferritin and magnesium than controls (p value 0.01, 0.02 and 0.02 respectively with no significant difference between them as regards copper levels (p value 0.9. Children with combined type had significant lower levels of zinc and magnesium than controls (p value 0

  1. Longitudinal effects of group music instruction on literacy skills in low-income children.

    Science.gov (United States)

    Slater, Jessica; Strait, Dana L; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2014-01-01

    Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development. PMID:25409300

  2. Longitudinal effects of group music instruction on literacy skills in low-income children.

    Directory of Open Access Journals (Sweden)

    Jessica Slater

    Full Text Available Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

  3. Visual acuity and refraction by age for children of three different ethnic groups in Paraguay

    Directory of Open Access Journals (Sweden)

    Marissa Janine Carter

    2013-04-01

    Full Text Available PURPOSE: To characterize refractive errors in Paraguayan children aged 5-16 years and investigate effect of age, gender, and ethnicity. METHODS:The study was conducted at 3 schools that catered to Mennonite, indigenous, and mixed race children. Children were examined for presenting visual acuity, autorefraction with and without cycloplegia, and retinoscopy. Data were analyzed for myopia and hyperopia (SE ≤-1 D or -0.5 D and ≥2 D or ≥3 D and astigmatism (cylinder ≥1 D. Spherical equivalent (SE values were calculated from right eye cycloplegic autorefraction data and analyzed using general linear modelling. RESULTS: There were 190, 118, and 168 children of Mennonite, indigenous and mixed race ethnicity, respectively. SE values between right/left eyes were nonsignificant. Mean visual acuity (VA without correction was better for Mennonites compared to indigenous or mixed race children (right eyes: 0.031, 0.090, and 0.102 logMAR units, respectively; P<0.000001. There were 2 cases of myopia in the Mennonite group (1.2% and 2 cases in the mixed race group (1.4% (SE ≤-0.5 D. The prevalence of hyperopia (SE ≥2 D was 40.6%, 34.2%, and 46.3% for Mennonite, indigenous and mixed race children. Corresponding astigmatism rates were 3.2%, 9.5%, and 12.7%. Females were slightly more hyperopic than males, and the 9-11 years age group was the most hyperopic. Mennonite and mixed race children were more hyperopic than indigenous children. CONCLUSIONS: Paraguayan children were remarkably hyperopic and relatively free of myopia. Differences with regard to gender, age, and ethnicity were small.

  4. Clinical practice and outcome of radiotherapy for esophageal cancer between 1999 and 2003. The Japanese Radiation Oncology Study Group (JROSG) survey

    International Nuclear Information System (INIS)

    The background of this study was to determine the clinical results of radiotherapy (RT) for esophageal cancer in Japan. A questionnaire-based survey was conducted for esophageal cancer treated by definitive RT between 1999 and 2003. Clinical results of definitive RT for patients were collected from 9 major institutions. Only patients with good performance status (PS 0-2) who received a total dose of 50 Gy or more were included. Patients were classified into three groups: (A) stage I, (B) resectable stages II-III, (C) unresectable stages III-IVA. For group A, all patients treated by RT alone or chemo-radiotherapy (CRT) were included. For groups B and C, only those treated by CRT were included. In total, 167 patients were included in group A, 239 in group B, and 244 in group C. Approximately half of the patients in group A were treated by CRT. The median total RT dose ranged from 60 to 66 Gy. The median and range of the 5-year overall survival rates were 56% (48-83%) for group A, 29% (12-52%) for group B, and 19% (0-31%) for group C, respectively. A wide disparity in overall survival rates was noted among the institutions. A significant correlation between the number of patients treated per year and the 5-year overall survival rate was noted for groups B and C (both p<0.05). Although the overall survival rates for stage I esophageal cancer were excellent, a significant disparity in survival rates was noted among the institutions for stage II-IVA tumors treated by CRT. (author)

  5. Frequency of the Group A Beta Hemolytic Streptococcus Infection in Children Presenting with Acute Tonsillopharyngitis

    OpenAIRE

    Özgül Yiğit; Nevin Cambaz; Emin Özkaya; Yeşim Coşkun; Nedim Samancı; Elif Ünver; Betül Sezgin

    2009-01-01

    Aim: The aim of this study was to evaluate the frequency of group A beta hemolytic streptococcus (GABHS) in children with tonsillopharyngitis and to assess their complaints and clinical findings.Materials and Method: A total of 420 children who presented to our outpatient department with acute tonsillopharyngitis were enrolled to the study. The clinical features of patients with positive throat cultures for GABHS were compared to those with negative culture results. Presence of fever (≥37.50C...

  6. Working with children from substance-affected families: the community-based group intervention TRAMPOLINE

    OpenAIRE

    Sonja Bröning; Diana Moesgen; Michael Klein; Rainer Thomasius

    2013-01-01

    Introduction: Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Frequently, they experience violence, abuse and neglect in their families. Therefore, they are an important target group for preventive efforts. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive...

  7. Resistance of group A beta Haemolytic streptococcus isolated from children with tonsillopharyngitis against commonly used antibiotics

    OpenAIRE

    Cüneyt Tayman; Alparslan Tonbul; Gül Güner Soylu; Halise Akça; Ferhat Çatal

    2011-01-01

    Objectives: We aimed to assess the antimicrobial susceptibility (penicillin, amoxicillin-clavulanate, amoxicillin and azithromycin), of A group beta haemolytic streptococci (AGBHS) isolated from children with tonsillopharyngitis.Materials and methods: AGBHS were isolated from throat swaps cultures according to CLSI criteria from children aged 5 to 15 years who applied to the Pediatric outpatient policlinics with complaints of high fever, sore throat and difficulty in swallowing. Antimicrobial...

  8. How curable is relapsed Wilms' tumour? The United Kingdom Children's Cancer Study Group.

    OpenAIRE

    Groot-Loonen, J.J.; Pinkerton, C. R.; Morris-Jones, P H; Pritchard, J.

    1990-01-01

    Three hundred and eighty one children with Wilms' tumour were treated on the United Kingdom Children's Cancer Study Group WT1 Study (1980/6). Seventy one patients relapsed during or after treatment, which included surgery and chemotherapy, with irradiation depending on stage and histology. Despite treatment with various combinations of chemotherapy, surgery, and radiotherapy there were only 17 survivors. For unfavourable histology, any stage, only two of 20 survive. We conclude that, after re...

  9. Longitudinal Effects of Group Music Instruction on Literacy Skills in Low-Income Children

    OpenAIRE

    Jessica Slater; Dana L Strait; Erika Skoe; Samantha O'Connell; Elaine Thompson; Nina Kraus

    2014-01-01

    Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English ...

  10. PET in oncology

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, Stefan (ed.) [HELIOS Klinikum Berlin-Buch, Berlin (Germany). Klinik fuer Nuklearmedizin

    2008-07-01

    In the management of oncologic diseases, modern imaging modalities contribute heavily to the decision of which form of treatment - local or systemic, surgical or interdisciplinary - will be most efficient. The addition of functional image information to conventional staging procedures helps improve the diagnostic pathway. The information needed for therapeutic management and for follow-up can be provided by correlative imaging such as positron emission tomography (PET) and computed tomography (CT) or PET/CT. This book is a comprehensive compilation of the accumulated knowledge on PET and PET/CT in oncology, covering the entire spectrum from solidly documented indications, such as staging and monitoring of lung and colorectal cancer, to the application of PET/CT in head and neck surgery, gynecology, radiation therapy, urology, pediatrics etc. It is aimed at nuclear medicine and radiology specialists as well as physicians interested in the possibilities and limitations of PET and PET/CT in oncology. (orig.)

  11. Effectiveness of Group Cognitive-Behavioral Therapy on Anxiety, Depression and Glycemic Control in Children with Type 1 Diabetes

    OpenAIRE

    Ahmadi, S.; Z Tabibi; A Mashhadi; P Eshraghi; F Faroughi; Ahmadi, P.

    2014-01-01

    Introduction: The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. Methods and Matherials: The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15) and control group (15)....

  12. American Society of Clinical Oncology

    Science.gov (United States)

    ... Media Policy Sponsor Policy Terms of Use American Society of Clinical Oncology Genitourinary Cancers Symposium Call for ... or cosponsored by ASCO View Event 13th Asian Society for Neuro-Oncology (ASNO) Meeting/9th COGNO Annual ...

  13. The AMORE Protocol for Advanced-Stage and Recurrent Nonorbital Rhabdomyosarcoma in the Head-and-Neck Region of Children: A Radiation Oncology View

    International Nuclear Information System (INIS)

    Purpose: A multidisciplinary approach, consisting of consecutive Ablative Surgery, MOld technique with afterloading brachytherapy and immediate surgical REconstruction (AMORE) applied after chemotherapy, was designed for children with rhabdomyosarcoma in the head-and-neck region. Analysis of the first 42 patients was performed. Methods and Materials: After macroscopically radical tumor resection, molds were constructed for each individual to fit into the surgical defect. The molds, made of 5-mm-thick layers of thermoplastic rubber, consisted of different parts. Flexible catheters were positioned between layers. After brachytherapy, the molds were removed. Surgical reconstruction was performed during the same procedure. Results: Dose to the clinical target volume varied from 40 to 50 Gy for the primary treatment (31 patients) and salvage treatment groups (11 patients). There were 18 females and 24 males treated from 1993 until 2007. Twenty-nine tumors were located in the parameningeal region, and 13 were located in the nonparameningeal region. Patient age at the time of AMORE was 1.2-16.9 years (average, 6.5 years). Follow-up was 0.2-14.5 years (average, >5.5 years). Eleven patients died, 3 with local recurrence only, 6 with local and distant disease, 1 died of distant metastases only, and 1 patient died of a second primary tumor. Overall 5-year survival rates were 70% for the primary treatment group and 82% for the salvage group. Treatment was well tolerated, and acute and late toxicity were mild. Conclusions: The AMORE protocol yields good local control and overall survival rates, and side effects are acceptable.

  14. Split-course radiation therapy of carcinoma of the base of the tongue: results of a prospective national collaborative clinical trial conducted by the Radiation Therapy Oncology Group

    International Nuclear Information System (INIS)

    One hundred forty-one patients with carcinoma of the base of tongue were randomized to receive either continuous course radiotherapy (6600 rad in 30/33 fractions over 7-8 weeks) or split course therapy (3000 rad in 10 fractions over 2 weeks, a three-week rest, 3000 rad in 10 fractions over 2 weeks). Both treatment groups tolerated the treatment well, but the continuous course group required more treatment modifications. The results of therapy, as judged by control of primary tumor, control of metastatic lymph nodes, time to failure and overall survival were comparable in the two treatment groups

  15. Morte digna da criança: percepção de enfermeiros de uma unidade de oncologia Muerte digna del niño: percepción de enfermeros de una unidad de oncología Dignified death for children: perceptions of nurses from an oncology unit

    Directory of Open Access Journals (Sweden)

    Luise Felix de Souza

    2013-02-01

    ógicas.The objective of this study was to identify the meaning of dignified death and the interventions employed by nurses in pediatric oncology to promote dignified death for children. We used Symbolic Interaction Theory as the theoretical framework and narrative research methods. The data were collected from eight nurses in the pediatric oncology unit of a public hospital in Sao Paulo through semi-structured interviews. The data analysis revealed five categories: feeling no autonomy in decision-making, caring for the family, offering physical comfort, valuing humanized care and learning to deal with death and dying. This study helps to extend the understanding of this process of care and postulates a theoretical framework that integrates the knowledge and actions that constitute care that transcends clinical and biological needs.

  16. A Phase 3 Trial of 2 Years of Androgen Suppression and Radiation Therapy With or Without Adjuvant Chemotherapy for High-Risk Prostate Cancer: Final Results of Radiation Therapy Oncology Group Phase 3 Randomized Trial NRG Oncology RTOG 9902

    International Nuclear Information System (INIS)

    Purpose: Long-term (LT) androgen suppression (AS) with radiation therapy (RT) is a standard treatment of high-risk, localized prostate cancer (PCa). Radiation Therapy Oncology Group 9902 was a randomized trial testing the hypothesis that adjuvant combination chemotherapy (CT) with paclitaxel, estramustine, and oral etoposide plus LT AS plus RT would improve overall survival (OS). Methods and Materials: Patients with high-risk PCa (prostate-specific antigen 20-100 ng/mL and Gleason score [GS] ≥7 or clinical stage ≥T2 and GS ≥8) were randomized to RT and AS (AS + RT) alone or with adjuvant CT (AS + RT + CT). CT was given as four 21-day cycles, delivered beginning 28 days after 70.2 Gy of RT. AS was given as luteinizing hormone-releasing hormone for 24 months, beginning 2 months before RT plus an oral antiandrogen for 4 months before and during RT. The study was designed based on a 6% improvement in OS from 79% to 85% at 5 years, with 90% power and a 2-sided alpha of 0.05. Results: A total of 397 patients (380 eligible) were randomized. The patients had high-risk PCa, 68% with GS 8 to 10 and 34% T3 to T4 tumors, and median prostate-specific antigen of 22.6 ng/mL. The median follow-up period was 9.2 years. The trial closed early because of excess thromboembolic toxicity in the CT arm. The 10-year results for all randomized patients revealed no significant difference between the AS + RT and AS + RT + CT arms in OS (65% vs 63%; P=.81), biochemical failure (58% vs 54%; P=.82), local progression (11% vs 7%; P=.09), distant metastases (16% vs 14%; P=.42), or disease-free survival (22% vs 26%; P=.61). Conclusions: NRG Oncology RTOG 9902 showed no significant differences in OS, biochemical failure, local progression, distant metastases, or disease-free survival with the addition of adjuvant CT to LT AS + RT. The trial results provide valuable data regarding the natural history of high-risk PCa treated with LT AS + RT and have implications for

  17. A Phase 3 Trial of 2 Years of Androgen Suppression and Radiation Therapy With or Without Adjuvant Chemotherapy for High-Risk Prostate Cancer: Final Results of Radiation Therapy Oncology Group Phase 3 Randomized Trial NRG Oncology RTOG 9902

    Energy Technology Data Exchange (ETDEWEB)

    Rosenthal, Seth A., E-mail: rosents@sutterhealth.org [Radiation Oncology, Sutter Cancer Centers, Roseville, California (United States); Hunt, Daniel [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Sartor, A. Oliver [Tulane University Medical Center, New Orleans, Louisiana (United States); Pienta, Kenneth J. [Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Gomella, Leonard [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Grignon, David [Indiana University, Bloomington, Indiana (United States); Rajan, Raghu [McGill University, Montreal, Quebec (Canada); Kerlin, Kevin J. [Community Clinical Oncology Program, Southeast Cancer Control Consortium, Inc, Winston-Salem, North Carolina (United States); Jones, Christopher U. [Radiation Oncology, Sutter Cancer Centers, Roseville, California (United States); Radiological Associates of Sacramento, Sacramento, California (United States); Dobelbower, Michael [University of Alabama at Birmingham Medical Center, Birmingham, Alabama (United States); Shipley, William U. [Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Zeitzer, Kenneth [Albert Einstein Medical Center, Bronx, New York (United States); Hamstra, Daniel A. [University of Michigan Medical Center, Ann Arbor, Michigan (United States); Donavanik, Viroon [Christiana Care Health Services, Inc, Wilmington, Delaware (United States); Rotman, Marvin [State University of New York Health Science Center–Brooklyn, Brooklyn, New York (United States); Hartford, Alan C. [Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (United States); Michalski, Jeffrey [Washington University, St. Louis, Missouri (United States); Seider, Michael [Akron City Hospital, Akron, Ohio (United States); Kim, Harold [Wayne State University, Detroit, Michigan (United States); and others

    2015-10-01

    Purpose: Long-term (LT) androgen suppression (AS) with radiation therapy (RT) is a standard treatment of high-risk, localized prostate cancer (PCa). Radiation Therapy Oncology Group 9902 was a randomized trial testing the hypothesis that adjuvant combination chemotherapy (CT) with paclitaxel, estramustine, and oral etoposide plus LT AS plus RT would improve overall survival (OS). Methods and Materials: Patients with high-risk PCa (prostate-specific antigen 20-100 ng/mL and Gleason score [GS] ≥7 or clinical stage ≥T2 and GS ≥8) were randomized to RT and AS (AS + RT) alone or with adjuvant CT (AS + RT + CT). CT was given as four 21-day cycles, delivered beginning 28 days after 70.2 Gy of RT. AS was given as luteinizing hormone-releasing hormone for 24 months, beginning 2 months before RT plus an oral antiandrogen for 4 months before and during RT. The study was designed based on a 6% improvement in OS from 79% to 85% at 5 years, with 90% power and a 2-sided alpha of 0.05. Results: A total of 397 patients (380 eligible) were randomized. The patients had high-risk PCa, 68% with GS 8 to 10 and 34% T3 to T4 tumors, and median prostate-specific antigen of 22.6 ng/mL. The median follow-up period was 9.2 years. The trial closed early because of excess thromboembolic toxicity in the CT arm. The 10-year results for all randomized patients revealed no significant difference between the AS + RT and AS + RT + CT arms in OS (65% vs 63%; P=.81), biochemical failure (58% vs 54%; P=.82), local progression (11% vs 7%; P=.09), distant metastases (16% vs 14%; P=.42), or disease-free survival (22% vs 26%; P=.61). Conclusions: NRG Oncology RTOG 9902 showed no significant differences in OS, biochemical failure, local progression, distant metastases, or disease-free survival with the addition of adjuvant CT to LT AS + RT. The trial results provide valuable data regarding the natural history of high-risk PCa treated with LT AS + RT and have implications for

  18. A randomized trial of diet and physical activity in women treated for stage II-IV ovarian cancer: Rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES): An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study.

    Science.gov (United States)

    Thomson, Cynthia A; Crane, Tracy E; Miller, Austin; Garcia, David O; Basen-Engquist, Karen; Alberts, David S

    2016-07-01

    Ovarian cancer is the most common cause of gynecological cancer death in United States women. Efforts to improve progression free survival (PFS) and quality of life (QoL) after treatment for ovarian cancer are necessary. Observational studies suggest that lifestyle behaviors, including diet and physical activity, are associated with lower mortality in this population. The Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES) NRG 0225 study is a randomized, controlled trial designed to test the hypothesis that a 24month lifestyle intervention will significantly increase PFS after oncological therapy for stage II-IV ovarian cancer. Women are randomized 1:1 to a high vegetable and fiber, low-fat diet with daily physical activity goals or an attention control group. Secondary outcomes to be evaluated include QoL and gastrointestinal health. Moreover an a priori lifestyle adherence score will be used to evaluate relationships between adoption of the diet and activity goals and PFS. Blood specimens are collected at baseline, 6, 12 and 24months for analysis of dietary adherence (carotenoids) in addition to mechanistic biomarkers (lipids, insulin, telomere length). Women are enrolled at NRG clinic sites nationally and the telephone based lifestyle intervention is delivered from The University of Arizona call center by trained health coaches. A study specific multi-modal telephone, email, and SMS behavior change software platform is utilized for information delivery, coaching and data capture. When completed, LIVES will be the largest behavior-based lifestyle intervention trial conducted among ovarian cancer survivors. PMID:27394382

  19. Dummy Run of Quality Assurance Program in a Phase 3 Randomized Trial Investigating the Role of Internal Mammary Lymph Node Irradiation in Breast Cancer Patients: Korean Radiation Oncology Group 08-06 Study

    International Nuclear Information System (INIS)

    Purpose: The Korean Radiation Oncology Group (KROG) 08-06 study protocol allowed radiation therapy (RT) technique to include or exclude breast cancer patients from receiving radiation therapy to the internal mammary lymph node (IMN). The purpose of this study was to assess dosimetric differences between the 2 groups and potential influence on clinical outcome by a dummy run procedure. Methods and Materials: All participating institutions were asked to produce RT plans without irradiation (Arm 1) and with irradiation to the IMN (Arm 2) for 1 breast-conservation treatment case (breast-conserving surgery [BCS]) and 1 mastectomy case (modified radical mastectomy [MRM]) whose computed tomography images were provided. We assessed interinstitutional variations in IMN delineation and evaluated the dose-volume histograms of the IMN and normal organs. A reference IMN was delineated by an expert panel group based on the study guidelines. Also, we analyzed the potential influence of actual dose variation observed in this study on patient survival. Results: Although physicians intended to exclude the IMN within the RT field, the data showed almost 59.0% of the prescribed dose was delivered to the IMN in Arm 1. However, the mean doses covering the IMN in Arm 1 and Arm 2 were significantly different for both cases (P<.001). Due to the probability of overdose in Arm 1, the estimated gain in 7-year disease-free survival rate would be reduced from 10% to 7.9% for BCS cases and 7.1% for MRM cases. The radiation doses to the ipsilateral lung, heart, and coronary artery were lower in Arm 1 than in Arm 2. Conclusions: Although this dummy run study indicated that a substantial dose was delivered to the IMN, even in the nonirradiation group, the dose differences between the 2 groups were statistically significant. However, this dosimetric profile should be studied further with actual patient samples and be taken into consideration when analyzing clinical outcomes according to IMN

  20. Dummy Run of Quality Assurance Program in a Phase 3 Randomized Trial Investigating the Role of Internal Mammary Lymph Node Irradiation in Breast Cancer Patients: Korean Radiation Oncology Group 08-06 Study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yoonsun [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jun Won [Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan [Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Su Ssan [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Ahn, Sung-Ja [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Hyung-Sik [Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan (Korea, Republic of); Kim, Dong Won [Department of Radiation Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Lee, Kyu Chan [Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Suh, Hyun Suk [Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Seoul (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Shin, Hyun Soo [Department of Radiation Oncology, Bundang CHA Hospital, School of Medicine, CHA University, Seongnam (Korea, Republic of); Kim, Yong Bae, E-mail: ybkim3@yuhs.ac [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Suh, Chang-Ok [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-02-01

    Purpose: The Korean Radiation Oncology Group (KROG) 08-06 study protocol allowed radiation therapy (RT) technique to include or exclude breast cancer patients from receiving radiation therapy to the internal mammary lymph node (IMN). The purpose of this study was to assess dosimetric differences between the 2 groups and potential influence on clinical outcome by a dummy run procedure. Methods and Materials: All participating institutions were asked to produce RT plans without irradiation (Arm 1) and with irradiation to the IMN (Arm 2) for 1 breast-conservation treatment case (breast-conserving surgery [BCS]) and 1 mastectomy case (modified radical mastectomy [MRM]) whose computed tomography images were provided. We assessed interinstitutional variations in IMN delineation and evaluated the dose-volume histograms of the IMN and normal organs. A reference IMN was delineated by an expert panel group based on the study guidelines. Also, we analyzed the potential influence of actual dose variation observed in this study on patient survival. Results: Although physicians intended to exclude the IMN within the RT field, the data showed almost 59.0% of the prescribed dose was delivered to the IMN in Arm 1. However, the mean doses covering the IMN in Arm 1 and Arm 2 were significantly different for both cases (P<.001). Due to the probability of overdose in Arm 1, the estimated gain in 7-year disease-free survival rate would be reduced from 10% to 7.9% for BCS cases and 7.1% for MRM cases. The radiation doses to the ipsilateral lung, heart, and coronary artery were lower in Arm 1 than in Arm 2. Conclusions: Although this dummy run study indicated that a substantial dose was delivered to the IMN, even in the nonirradiation group, the dose differences between the 2 groups were statistically significant. However, this dosimetric profile should be studied further with actual patient samples and be taken into consideration when analyzing clinical outcomes according to IMN

  1. Evaluation of the Community Group Programme for Children & Young People: final report

    OpenAIRE

    Nolas, Sevasti-Melissa; Neville, Lucy; Sanders-McDonagh, Erin

    2012-01-01

    The report presents findings from the evaluation of the Community Group Programme (CGP). The CGP is a 12-week psycho-educational, group work programme for children and young people who have experienced domestic violence. The Programme was developed in Canada and is being rolled out in England for the first time across 32 London boroughs. The programme is unique in working with children and their mothers concurrently and in a child-focused way. The study takes a theory-driven approach to evalu...

  2. Preliminary Toxicity Analysis of 3-Dimensional Conformal Radiation Therapy Versus Intensity Modulated Radiation Therapy on the High-Dose Arm of the Radiation Therapy Oncology Group 0126 Prostate Cancer Trial

    Energy Technology Data Exchange (ETDEWEB)

    Michalski, Jeff M., E-mail: jmichalski@radonc.wustl.edu [Department of Radiation Oncology Washington University Medical Center, St. Louis, Missouri (United States); Yan, Yan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Watkins-Bruner, Deborah [Emory University School of Nursing, Atlanta, Georgia (United States); Bosch, Walter R. [Department of Radiation Oncology Washington University Medical Center, St. Louis, Missouri (United States); Winter, Kathryn [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Galvin, James M. [Department of Radiation Oncology Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Department of Radiation Oncology Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, QC (Canada); Morton, Gerard C. [Department of Radiation Oncology Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON (Canada); Parliament, Matthew B. [Department of Oncology Cross Cancer Institute, Edmonton, AB (Canada); Sandler, Howard M. [Department of Radiation Oncology Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California (United States)

    2013-12-01

    Purpose: To give a preliminary report of clinical and treatment factors associated with toxicity in men receiving high-dose radiation therapy (RT) on a phase 3 dose-escalation trial. Methods and Materials: The trial was initiated with 3-dimensional conformal RT (3D-CRT) and amended after 1 year to allow intensity modulated RT (IMRT). Patients treated with 3D-CRT received 55.8 Gy to a planning target volume that included the prostate and seminal vesicles, then 23.4 Gy to prostate only. The IMRT patients were treated to the prostate and proximal seminal vesicles to 79.2 Gy. Common Toxicity Criteria, version 2.0, and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late morbidity scores were used for acute and late effects. Results: Of 763 patients randomized to the 79.2-Gy arm of Radiation Therapy Oncology Group 0126 protocol, 748 were eligible and evaluable: 491 and 257 were treated with 3D-CRT and IMRT, respectively. For both bladder and rectum, the volumes receiving 65, 70, and 75 Gy were significantly lower with IMRT (all P<.0001). For grade (G) 2+ acute gastrointestinal/genitourinary (GI/GU) toxicity, both univariate and multivariate analyses showed a statistically significant decrease in G2+ acute collective GI/GU toxicity for IMRT. There were no significant differences with 3D-CRT or IMRT for acute or late G2+ or 3+ GU toxicities. Univariate analysis showed a statistically significant decrease in late G2+ GI toxicity for IMRT (P=.039). On multivariate analysis, IMRT showed a 26% reduction in G2+ late GI toxicity (P=.099). Acute G2+ toxicity was associated with late G3+ toxicity (P=.005). With dose–volume histogram data in the multivariate analysis, RT modality was not significant, whereas white race (P=.001) and rectal V70 ≥15% were associated with G2+ rectal toxicity (P=.034). Conclusions: Intensity modulated RT is associated with a significant reduction in acute G2+ GI/GU toxicity. There is a trend for a

  3. ARGUMENTATION OF ACUTE RESPIRATORY VIRAL INFECTIONS NONSPECIFIC PREVENTION IN GROUPS OF CHILDREN

    Directory of Open Access Journals (Sweden)

    L. R. Ishrefova

    2016-01-01

    Full Text Available Acute respiratory viral infections (ARVI and influenza are among the topical problems of healthcare. The children’s morbidity index in preschool educational institutions in Krasnoselsky district of St. Petersburg in 2008–2014 varied from 1359.6 to 1768.5 per 1000 children attending these institutions. In general educational schools the morbidity index in the aforesaid period were 422.6–521.6 (p < 0.001. From 49.3 to 55.4% of children were vaccinated against influenza; from 3600 to 4700 children annually stayed unimmunized due to medical contraindications and parents’ refusals from prophylactic immunization. The research objective is clinical-epidemiological substantiation of effectiveness of application of Echinacea botanical medicine to reduce the ARVI morbidity and the rate of complications after the disease among children attending educational institutions. As a result of the research it was established that the ARVI morbidity index in the group of the children who received the Echinacea preparation was 76.8; in the comparison group it was 94.2 per 100 people (p < 0.01; RR = 0.80; CI = 0.7–0.9. The rate of complications (bronchitis, otitis, adenoiditis, pneumonia, sinusitis among the children who received the preparation was 2–4.8 times lower.

  4. Quality Assessment in Oncology

    International Nuclear Information System (INIS)

    The movement to improve healthcare quality has led to a need for carefully designed quality indicators that accurately reflect the quality of care. Many different measures have been proposed and continue to be developed by governmental agencies and accrediting bodies. However, given the inherent differences in the delivery of care among medical specialties, the same indicators will not be valid across all of them. Specifically, oncology is a field in which it can be difficult to develop quality indicators, because the effectiveness of an oncologic intervention is often not immediately apparent, and the multidisciplinary nature of the field necessarily involves many different specialties. Existing and emerging comparative effectiveness data are helping to guide evidence-based practice, and the increasing availability of these data provides the opportunity to identify key structure and process measures that predict for quality outcomes. The increasing emphasis on quality and efficiency will continue to compel the medical profession to identify appropriate quality measures to facilitate quality improvement efforts and to guide accreditation, credentialing, and reimbursement. Given the wide-reaching implications of quality metrics, it is essential that they be developed and implemented with scientific rigor. The aims of the present report were to review the current state of quality assessment in oncology, identify existing indicators with the best evidence to support their implementation, and propose a framework for identifying and refining measures most indicative of true quality in oncologic care.

  5. Quality Assessment in Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    The movement to improve healthcare quality has led to a need for carefully designed quality indicators that accurately reflect the quality of care. Many different measures have been proposed and continue to be developed by governmental agencies and accrediting bodies. However, given the inherent differences in the delivery of care among medical specialties, the same indicators will not be valid across all of them. Specifically, oncology is a field in which it can be difficult to develop quality indicators, because the effectiveness of an oncologic intervention is often not immediately apparent, and the multidisciplinary nature of the field necessarily involves many different specialties. Existing and emerging comparative effectiveness data are helping to guide evidence-based practice, and the increasing availability of these data provides the opportunity to identify key structure and process measures that predict for quality outcomes. The increasing emphasis on quality and efficiency will continue to compel the medical profession to identify appropriate quality measures to facilitate quality improvement efforts and to guide accreditation, credentialing, and reimbursement. Given the wide-reaching implications of quality metrics, it is essential that they be developed and implemented with scientific rigor. The aims of the present report were to review the current state of quality assessment in oncology, identify existing indicators with the best evidence to support their implementation, and propose a framework for identifying and refining measures most indicative of true quality in oncologic care.

  6. Parental interaction patterns in children with attention deficit hyperactive disorder and control group

    Directory of Open Access Journals (Sweden)

    Mojgan Karahmadi

    2007-07-01

    Full Text Available

    BACKGROUND: Parental communication patterns influence children's personality. This study investigated effects of parental interaction patterns on children with attention deficit hyperactive disorder (ADHD.
    METHODS: There were 50 male children, 7-12 years old, selected in two groups. The first group included students with ADHD referred to psychiatry clinics in Isfahan-based on diagnostic scale of DSM-IV (25 subjects. The second group involved healthy boys selected by random cluster multistage sampling from primary schools in five districts of Isfahan (25 subjects from September 2005 to March 2005. Schaffer and Edgerton parental interaction questionnaire was filled for them.
    RESULTS: Mean scores of parental interaction patterns in healthy children were all higher than those in ADHD children except for “aggression control” and “lack of aggressive attachment”.
    CONCLUSIONS: The severity of ADHD signs has negative relationship with parental "admission" and parental "control" patterns. It also has positive relationship with “lack of aggressive/attachment” and “aggressive/control” patterns.
    KEY WORDS: Parental interaction patterns, ADHD.

  7. Differences in Clinical and Laboratory Findings between Group D and Non-Group D Non-Typhoidal Salmonella Gastroenteritis in Children

    OpenAIRE

    Park, Heung Keun; Rhie, Kyuyol; Yeom, Jung Sook; Park, Ji Sook; Park, Eun Sil; Seo, Ji-Hyun; Lim, Jae Young; Park, Chan-Hoo; Woo, Hyang-Ok; Youn, Hee-Shang; Kang, Ki Ryeon; Park, Jung Je

    2015-01-01

    Purpose To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. Methods A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. Results From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients...

  8. Children sold for transplants: medical and legal aspects. Amnesty International--Danish Working Group for Children.

    Science.gov (United States)

    Fasting, U; Christensen, J; Glending, S

    1998-11-01

    Over the last few decades there has been a substantially higher percentage of successful organ transplants but also a significant imbalance between the demand for and the supply of organs, creating the basis for a highly profitable black market trade in human organs. Sometimes there are reports that children have been kidnapped, only to reappear later lacking one kidney, or that they simply disappear and are subsequently killed to have all their transplantable organs removed for profit. The European Union feels that there is a need for action and that it has a duty to act in this field, especially for ethical reasons. There is now established close co-operation between the various European transplant organizations. The legal protection of children with regard to organ transplantation is not specifically mentioned in the existing conventions because this issue was not foreseen at the time of their preparation. However, the issue is covered in a broader sense by more general provisions. There are endless rumours surrounding this area. Members of various organizations who travel in the suspected countries say that the trafficking in children who are sold for transplantation is well known, but it is too difficult and very dangerous to catch the people involved. We have to conclude that it has been impossible to prove or disprove the rumours, but they are consistent and we all, especially in the health care professions, have an obligation to be keenly aware of how and where organs are obtained. PMID:9856069

  9. Molecular imaging in oncology

    Energy Technology Data Exchange (ETDEWEB)

    Schober, Otmar; Riemann, Burkhard (eds.) [Universitaetsklinikum Muenster (Germany). Klinik fuer Nuklearmedizin

    2013-02-01

    Considers in detail all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. Examines technological issues and probe design. Discusses preclinical studies in detail, with particular attention to multimodality imaging. Presents current clinical use of PET/CT, SPECT/CT, and optical imagingWritten by acknowledged experts. The impact of molecular imaging on diagnostics, therapy, and follow-up in oncology is increasing significantly. The process of molecular imaging includes key biotarget identification, design of specific molecular imaging probes, and their preclinical evaluation, e.g., in vivo using small animal studies. A multitude of such innovative molecular imaging probes have already entered clinical diagnostics in oncology. There is no doubt that in future the emphasis will be on multimodality imaging in which morphological, functional, and molecular imaging techniques are combined in a single clinical investigation that will optimize diagnostic processes. This handbook addresses all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. The first section is devoted to technology and probe design, and examines a variety of PET and SPECT tracers as well as multimodality probes. Preclinical studies are then discussed in detail, with particular attention to multimodality imaging. In the third section, diverse clinical applications are presented, and the book closes by looking at future challenges. This handbook will be of value to all who are interested in the revolution in diagnostic oncology that is being brought about by molecular imaging.

  10. Dorsiflexor muscle-group thickness in children with cerebral palsy: Relation to cross-sectional area

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Magnusson, Peter; Jensen, Bente R; Sonne-Holm, Stig

    2009-01-01

    If the thickness and cross-sectional area of the dorsiflexor muscle group are related in children with cerebral palsy, measurements of muscle thickness may be used to monitor changes in muscle size due to training or immobilisation in these patients. We assessed the validity and reliability of...... measurements of dorsiflexor muscle-thickness using the cross-sectional area of the muscle group as the criterion-related muscle-size variable. Muscle thickness was measured using ultrasound, and cross-sectional area using MRI in nine children with spastic cerebral palsy (eight with hemiplegia). Test......-retest reliability of the muscle-thickness measurements was assessed in six healthy subjects. All measurements were made on both legs at 35% lower leg length. In the children with cerebral palsy, dorsiflexor muscle-thickness and cross-sectional area were well correlated (r;{2} = 0.778, P < 0.001), and the...

  11. SOCIAL RESPONSES IN HYPOTHETICAL SITUATIONS OF INTERPERSONAL TENSION, OF A GROUP OF CHILDREN INSTITUTIONALIZED FOR PHYSICAL ABUSE, AND A GROUP OF NON-ABUSED CHILDREN

    Directory of Open Access Journals (Sweden)

    CÉSAR REY

    2004-07-01

    Full Text Available This investigation had two objectives: a to compare the number of punitive and not punitive socialresponses reported toward three hypothetical situations of interpersonal tension, by a group of 39institutionalized for physical abuse children and girls, with that informed by a group of 34 not abusedchildren and girls inscribed to an educational institution, and b to compare the number of punitive andnot punitive responses that the physically abused children and girls referred in this situations. All thechildren had between eight and twelve age-years, among second and quarter educational degree and lowsocioeconomic levels. The three hypothetical situations of interpersonal tension were presented verballywith the support of six sheets (three for each sex and their responses were gathered in a quantitative waythrough the content analysis. The application of the test U of Mann Whitney didn’t throw significantdifferences among the two groups. Nevertheless, it was found a significant difference at intra-grouplevel, in accordance with the test of Wicolxon.

  12. Children of mentally ill parents—a pilot study of a group intervention program

    OpenAIRE

    Christiansen, Hanna; Anding, Jana; Schrott, Bastian; Röhrle, Bernd

    2015-01-01

    Objective: The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and ...

  13. Risk groups in children under six months of age using self-organizing maps.

    Science.gov (United States)

    Schilithz, A O C; Kale, P L; Gama, S G N; Nobre, F F

    2014-06-01

    Fetal and infant growth tends to follow irregular patterns and, particularly in developing countries, these patterns are greatly influenced by unfavorable living conditions and interactions with complications during pregnancy. The aim of this study was to identify groups of children with different risk profiles for growth development. The study sample comprised 496 girls and 508 boys under six months of age from 27 pediatric primary health care units in the city of Rio de Janeiro, Brazil. Data were obtained through interviews with the mothers and by reviewing each child's health card. An unsupervised learning, know as a self-organizing map (SOM) and a K-means algorithm were used for cluster analysis to identify groups of children. Four groups of infants were identified. The first (139) consisted of infants born exclusively by cesarean delivery, and their mothers were exclusively multiparous; the highest prevalences of prematurity and low birthweight, a high prevalence of exclusive breastfeeding and a low proportion of hospitalization were observed for this group. The second (247 infants) and the third (298 infants) groups had the best and worst perinatal and infant health indicators, respectively. The infants of the fourth group (318) were born heavier, had a low prevalence of exclusive breastfeeding, and had a higher rate of hospitalization. Using a SOM, it was possible to identify children with common features, although no differences between groups were found with respect to the adequacy of postnatal weight. Pregnant women and children with characteristics similar to those of group 3 require early intervention and more attention in public policy. PMID:24725333

  14. Facilitating support groups for siblings of children with neurodevelopmental disorders using audioconferencing: a longitudinal feasibility study

    OpenAIRE

    Gettings, Sheryl; Franco, Fabia; Santosh, Paramala

    2015-01-01

    Background: Siblings of children with chronic illness and disabilities are at increased risk of negative psychological effects. Support groups enable them to access psycho-education and social support. Barriers to this can include the distance they have to travel to meet face-to-face. Audio-conferencing, whereby three or more people can connect by telephone in different locations, is an efficient means of groups meeting and warrants exploration in this healthcare context. This study explored ...

  15. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute’s Comprehensive Research Needs Assessment

    International Nuclear Information System (INIS)

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  16. Anthropometric, environmental, and dietary predictors of elevated blood cadmium levels in Ukrainian children: Ukraine ELSPAC group

    International Nuclear Information System (INIS)

    No comprehensive data on sources or risk factors of cadmium exposure in Ukrainian children are available. In this we measured the blood levels of cadmium among 80 Ukrainian children and evaluated sources of exposure. A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted. We evaluated predictors of elevated blood cadmium using a multivariable logistic regression model. The model included socioeconomic data, parent occupation, environmental tobacco smoke, hygiene, body-mass index, and diet. Dietary habits were evaluated using the 1992 Block-NCI-HHHQ Dietary Food Frequency survey. Elevated cadmium was defined as blood levels in the upper quartile (>=0.25μg/L). The mean age for all 80 children was 36.6 months. Geometric mean cadmium level was 0.21μg/L (range=0.11-0.42μg/L; SD=0.05). Blood cadmium levels were higher among children taking zinc supplements (0.25 vs 0.21μg/L; P=0.032), children who ate sausage more than once per week (0.23 vs 0.20; P=0.007) and children whose fathers worked in a by-product coking industry (0.25 vs 0.21; P=0.056). In the multivariable model, predictors of elevated blood cadmium levels included zinc supplementation (adjusted OR=14.16; P<0.01), father working in a by-product coking industry (adjusted OR=8.50; P=0.03), and low body mass index (<14.5; adjusted OR=5.67; P=0.03). This is the first study to indicate a strong association between elevated blood cadmium levels and zinc supplementation in young children. Whole-blood cadmium levels observed in this group of Ukrainian children appear to be similar to those reported in other Eastern European countries

  17. Dreams of Deceased Children and Countertransference in the Group Psychotherapy of Bereaved Mothers: Clinical Illustration

    Science.gov (United States)

    Begovac, Branka; Begovac, Ivan

    2012-01-01

    This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group…

  18. Group Size and Organisational Conditions for Children's Learning in Preschool: A Teacher Perspective

    Science.gov (United States)

    Sheridan, Sonja; Williams, Pia; Pramling Samuelsson, Ingrid

    2014-01-01

    Background: There is a limited amount of research about group size in preschool, and how it impacts on teachers' working conditions and their ability to support children's learning and knowledge development in line with curriculum intentions. Purpose: From a perspective on quality, this article examines the organisational conditions for…

  19. The Effects of Group Composition, Information Content, and Sex-Role Orientation on Children's Memory.

    Science.gov (United States)

    Kay-Kostoulas, Katina

    A study was conducted to explore how second-grade children's memory for film characters' statements varies as a function of (1) group composition (the proportion of boys and girls in each film condition); (2) congruence level of film characters (incongruent and congruent sex-typed statements); and (3) subjects' own sex-role orientations…

  20. Parental Beliefs about Young Children's Socialization across US Ethnic Groups: Coexistence of Independence and Interdependence

    Science.gov (United States)

    Suizzo, Marie-Anne; Chen, Wan-Chen; Cheng, Chi-Chia; Liang, Angel S.; Contreras, Helen; Zanger, Dinorah; Robinson, Courtney

    2008-01-01

    This study compared dimensions of independence and interdependence in parents' beliefs about daily child-rearing practices across four ethnic groups. Two questionnaires were completed by 310 parents of preschool-age children, and three belief constructs were identified. "Conformity" was least valued by European Americans. "Autonomy" was equally…

  1. ArtBreak Group Counseling for Children: Framework, Practice Points, and Results

    Science.gov (United States)

    Ziff, Katherine; Ivers, Nathaniel N.; Shaw, Edward G.

    2016-01-01

    Child social/emotional development and mitigation of child stress are receiving continued emphasis in the literature. While choice-based group art studios have a long association with mental health, documentation on their potential for supporting children is limited. This article describes an elementary school counseling intervention designed to…

  2. A Psychoeducational School-Based Group Intervention for Socially Anxious Children

    Science.gov (United States)

    Vassilopoulos, Stephanos P.; Brouzos, Andreas; Damer, Diana E.; Mellou, Angeliki; Mitropoulou, Alexandra

    2013-01-01

    This study investigated the impact of a psychoeducational group for social anxiety aimed at elementary children. An 8-week psychoeducational program based on empirically validated risk factors was designed. Interventions included cognitive restructuring, anxiety management techniques, and social skills training. Pre-and posttest data from 3 groups…

  3. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hanbyoul [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, Byung-Ho [Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Cho, Chi-Heum [Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Byoung Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Ryu, Hee-Sug [Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, Soon Beom [Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul (Korea, Republic of); Kim, Jae-Hoon, E-mail: jaehoonkim@yuhs.ac [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-01

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m{sup 2} was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study.

  4. Multidrug chemotherapy (vincristine-bleomycin-methotrexate) followed by radiotherapy in inoperable carcinomas of the head and neck: preliminary report of a pilot study of the Radiation Therapy Oncology Group

    International Nuclear Information System (INIS)

    This is a preliminary report on the Radiation Therapy Oncology Group (RTOG) pilot study 77-08, of a combination of chemotherapy with vincristine-bleomycin-methotrexate, followed by radiotherapy, for inoperable carcinomas of the head and neck. The main objectives of the study were to determine toxicity and tumor control. Patients who were included had untreated carcinomas, with no distant metastases, and with adequate pulmonary, renal, and liver function. Forty patients were registered for the study. Chemotherapy started with vincristine--1.5 mgs/m2 (maximum of 2 mgs) by I.V. injection, followed by bleomycin drip for 48 hours (15 units/day), and then methotrexate (200 mgs/m2 divided in equal doses 6 hours apart) with folinic acid rescue. Eleven patients received one course of the stated chemotherapy; 28 were given two courses with one week rest period between them. Radical curative radiotherapy was started usually two weeks after chemotherapy. A surgical procedure was considered if the patient was found operable after receiving a dose of 5000 rad with continuous therapy or at 3000 rad with split-course therapy. The level of toxicity that resulted from this combined therapy was considered acceptable. The percentage of complete response of the primary tumor was 6% with chemotherapy; this increased to 46% after irradiation, and to 65% when surgery was added

  5. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    International Nuclear Information System (INIS)

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m2 was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study

  6. Clinical and dosimetric analysis of peculiarities of intellectual development, mental and behavioural disorders in children with oncological pathology of the thyroid gland

    International Nuclear Information System (INIS)

    A study of 116 children with thyroid cancer was conducted in 1995-1997. On the basis of the data obtained the three-level system of prophylaxis and correction of mental and behavioural disorders in the children suffering from thyroid cancer has been developed

  7. Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children

    International Nuclear Information System (INIS)

    Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs

  8. Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children

    Energy Technology Data Exchange (ETDEWEB)

    Pires, António, E-mail: pires1961@gmail.com; Martins, Paula [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Pereira, Ana Margarida [Laboratório de Fisiologia - Instituto Biomédico de Investigação da Luz e Imagem da Faculdade de Medicina da Universidade de Coimbra, Coimbra (Portugal); Silva, Patricia Vaz; Marinho, Joana [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Marques, Margarida [Laboratório de Estatística da Faculdade de Medicina da Universidade de Coimbra - Instituto Biomédico de Investigação da Luz e Imagem, Coimbra (Portugal); Castela, Eduardo [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Sena, Cristina; Seiça, Raquel [Laboratório de Fisiologia - Instituto Biomédico de Investigação da Luz e Imagem da Faculdade de Medicina da Universidade de Coimbra, Coimbra (Portugal)

    2015-04-15

    Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.

  9. Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group.

    Science.gov (United States)

    Schmitt, Claus Peter; Bakkaloglu, Sevcan A; Klaus, Günter; Schröder, Cornelis; Fischbach, Michel

    2011-07-01

    The purpose of this article is to provide recommendations on the choice of peritoneal dialysis (PD) fluids in children by the European Pediatric Dialysis Working Group. The literature on experimental and clinical studies with PD solutions in children and adults was analyzed together with consensus discussions within the group. A grading was performed based on the international KDIGO nomenclature and methods. The lowest glucose concentration possible should be used. Icodextrin may be applied once daily during the long dwell, in particular in children with insufficient ultrafiltration. Infants on PD are at risk of ultrafiltration-associated sodium depletion, while anuric adolescents may have water and salt overload. Hence, the sodium chloride balance needs to be closely monitored. In growing children, the calcium balance should be positive and dialysate calcium adapted according to individual needs. Limited clinical experience with amino acid-based PD fluids in children suggests good tolerability. The anabolic effect, however, is small; adequate enteral nutrition is preferred. CPD fluids with reduced glucose degradation products (GDP) content reduce local and systemic toxicity and should be preferred whenever possible. Correction of metabolic acidosis is superior with pH neutral bicarbonate-based fluids compared with single-chamber, acidic, lactate-based solutions. Prospective comparisons of low GDP solutions with different buffer compositions are still few, and firm recommendations cannot yet be given, except when hepatic lactate metabolism is severely compromised. PMID:21448787

  10. Children with Autism Spectrum Disorder and Social Skills Groups at School: A Randomized Trial Comparing Intervention Approach and Peer Composition

    Science.gov (United States)

    Kasari, Connie; Dean, Michelle; Kretzmann, Mark; Shih, Wendy; Orlich, Felice; Whitney, Rondalyn; Landa, Rebecca; Lord, Catherine; King, Bryan

    2016-01-01

    Background: Peer relationships improve for children with autism spectrum disorder (ASD) in clinic-based social skills groups but rarely generalize to real world contexts. This study compares child outcomes of two social skills interventions conducted in schools with children in Kindergarten through fifth grade. Method: Children with ASD were…

  11. Barriers to healthy eating: Findings from the focus groups with older people and children/adolescents

    DEFF Research Database (Denmark)

    Kazbare, Laura; Bech-Larsen, Tino

      Purpose: The aim of this study was to identify barriers to healthy eating among older people and children/adolescents. Method: Four focus groups; two with older people and two with children/adolescents were conducted in Denmark. The focus groups were moderated to discuss the experienced or...... potential behavioural change in terms of healthier eating, discussing pre-selected healthy and unhealthy food categories. The revised Social Cognitive Theory was used as a theoretical framework. Results: The study suggests that the main obstacles to change can be grouped into motivational and implementation...... barriers. The motivational barriers are unwillingness to change eating habits, satisfaction with current diets and misconception about their healthiness; relatively low health consciousness and unwillingness to become excessively health-oriented. Implementation barriers include remembering the change...

  12. Aggression in children with autism spectrum disorders and a clinic-referred comparison group

    OpenAIRE

    Farmer, Cristan; Butter, Eric; Mazurek, Micah O.; Cowan, Charles; Lainhart, Janet; Cook, Edwin H.; DeWitt, Mary Beth; Aman, Michael

    2014-01-01

    A gap exists in the literature regarding aggression in autism spectrum disorders (ASD) and how this behavior compares to other groups. In this multisite study, the Children’s Scale for Hostility and Aggression: Reactive/Proactive (C-SHARP) and the Aggression subscale of the Child Behavior Checklist (CBCL) were rated for 414 children with ASD (Autistic Disorder, 69%; PDD-NOS, 24%; Asperger’s Disorder, 7%) and 243 clinic-referred children without ASD, aged 1-21 years (mean age about 7). Partici...

  13. Radiopharmaceuticals in oncology

    International Nuclear Information System (INIS)

    Radiopharmaceuticals are generally made of an artificial radionuclide chemically bound to a molecule showing an affinity for a particular type of cells. In oncology, the radionuclide emits either photons for scintigraphic imaging, either beta or alpha particles for metabolic radiotherapy. The development of new radiopharmaceuticals is mostly hampered by the modifications of conformation and hence, of biological behavior, of the original molecule induced by its radiolabelling. The use of positron emitters can be a solution to this difficulty, but their short half-life generates serious management limitations. Radiopharmaceutical used in oncology are targeted toward the cellular and tissular tumorous abnormalities. They belong to different categories: membrane agents, metabolic substrates (such as fluorodeoxyglucose), receptors ligands, antibodies and other agents under development such as hypoxia, apoptosis and genes markers. (authors)

  14. A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma: A Korean radiation oncology group study (KROG 12-08)

    International Nuclear Information System (INIS)

    Purpose: To develop a nomogram predicting the risks of distant metastasis following postoperative adjuvant radiation therapy for early stage cervical cancer. Materials and methods: We reviewed the medical records of 1069 patients from ten participating institutions. Patients were divided into two cohorts: a training set (n = 748) and a validation set (n = 321). The demographic, clinical, and pathological variables were included in the univariate Cox proportional hazards analysis. Clinically established and statistically significant prognostic variables were utilized to develop a nomogram. Results: The model was constructed using four variables: histologic type, pelvic lymph node involvement, depth of stromal invasion, and parametrial invasion. This model demonstrated good calibration and discrimination, with an internally validated concordance index of 0.71 and an externally validated c-index of 0.65. Compared to FIGO staging, which showed a broad range in terms of distant metastasis, the developed nomogram can accurately predict individualized risks based on individual risk factors. Conclusions: The devised model offers a significantly accurate level of prediction and discrimination. In clinical practice it could be useful for counseling patients and selecting the patient group who could benefit from more intensive/further chemotherapy, once validated in a prospective patient cohort

  15. Prospective Evaluation of Quality of Life and Neurocognitive Effects in Patients With Multiple Brain Metastases Receiving Whole-Brain Radiotherapy With or Without Thalidomide on Radiation Therapy Oncology Group (RTOG) Trial 0118

    International Nuclear Information System (INIS)

    Purpose: Radiation Therapy Oncology Group (RTOG) 0118 randomized patients with multiple brain metastases to whole-brain radiotherapy (WBRT) ± thalidomide. This secondary analysis of 156 patients examined neurocognitive and quality of life (QOL) outcomes. Methods and Materials: Quality of life was determined with the Spitzer Quality of Life Index (SQLI). The Folstein Mini-Mental Status Exam (MMSE) assessed neurocognitive function. SQLI and MMSE were administered at baseline and at 2-month intervals. MMSE was scored with a threshold value associated with neurocognitive functioning (absolute cutoff level of 23) and with the use of corrections for age and educational level. Results: Baseline SQLI predicted survival. Patients with SQLI of 7-10 vs. <7 had median survival time (MST) of 4.8 vs. 3.1 months, p = 0.05. Both arms showed steady neurocognitive declines, but SQLI scores remained stable. Higher levels of neurocognitive decline were observed with age and education-level corrections. Of patients considered baseline age/educational level neurocognitive failures, 32% died of intracranial progression. Conclusions: Quality of life and neuropsychological testing can be prospectively administered on a Phase III cooperative group trial. The MMSE should be evaluated with adjustments for age and educational level. Baseline SQLI is predictive of survival. Despite neurocognitive declines, QOL remained stable during treatment and follow-up. Poor neurocognitive function may predict clinical deterioration. Lack of an untreated control arm makes it difficult to determine the contribution of the respective interventions (i.e., WBRT, thalidomide) to neurocognitive decline. The RTOG has developed a trial to study the role of preventative strategies aimed at forestalling neurocognitive decline in this population

  16. A POPULATION BASED STUDY OF REFRACTIVE ERRORS IN CHILDREN AMONG AGE GROUP OF 7-15 YEARS

    OpenAIRE

    Dhanya; Pandu; Sujatha; Pallavi; Srinivas

    2016-01-01

    INTRODUCTION Refractive error is the most common cause of visual impairment around the world and the second leading cause of treatable blindness. Very early detection and treatment of visual impairment in children results in a reduction in the number of school children with poor sight being uncorrected. AIM To study the prevalence of uncorrected refractive errors among children of 7-15 years of age group. MATERIALS AND METHODS A total of 958 children of a...

  17. Oncology and palliative care

    OpenAIRE

    Bausewein, Claudia; Hartenstein, R.

    2000-01-01

    Oncology developed as a discipline over the last decades. Treatment is concentrated on cure or palliation of the illness with the help of chemotherapy, radiotherapy or surgery. Palliative care has its origin in the hospice movement that started around 1960 in the UK. Centre of care is the patient and his family. Focus of care has moved from quantity to quality of life. Symptom control, communication, rehabilitation and care for the dying are main areas of palliative care. Palliative care and ...

  18. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  19. Anal sphincter conservation for patients with adenocarcinoma of the distal rectum: long-term results of radiation therapy oncology group protocol 89-02

    International Nuclear Information System (INIS)

    Purpose: To assess the outcome of a multi-institutional, national cooperative group study attempting functional preservation of the anorectum for patients with limited, distal rectal cancer. Methods and Materials: Between September 21, 1989 and November 1, 1992, a Phase II trial of sphincter-sparing therapy was conducted for patients with clinically mobile rectal cancers located below the pelvic peritoneal reflection. Protocol treatment was designed for patients who were, in the judgement of their attending surgeon, unsuitable for anal sphincter conservation in the context of anterior resection, and would have required abdominoperineal resection (APR) as conventional surgical therapy. Primary cancers were estimated to be 4 cm or less in largest clinical diameter, and occupied 40% or less of the rectal circumference. Chest radiography and computerized axial tomography (CT) of the abdomen and pelvis excluded patients with overt lymphatic or hematogenous metastases. Protocol surgery was intended to remove the primary cancer by en-bloc, transmural excision of an ellipse of rectal wall by transanal, transcoccygeal, or trans-sacral technique, while conserving the anal sphincter. Based on tumor size, T classification, grade, and adequacy of surgical margins, patients were allocated to one of three treatment assignments: observation, or adjuvant treatment with 5-fluorouracil (5-FU) and one of two different dose levels of local-regional radiation. After completion of protocol therapy, patients were observed with follow-up that included periodic general physical and rectal examination, determinations of CEA, abdominopelvic CT, chest radiography, and surveillance endoscopy. Sixty-five eligible and analyzable patients were registered. Results: With minimum follow-up of 5 years and median follow-up of 6.1 years, 11 patients have failed: 3 patients recurred local-regionally only, 3 patients had distant failure alone, and 5 patients manifested local-regional and distant failure

  20. Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with 131I anti-CEA--a Radiation Therapy Oncology Group Study

    International Nuclear Information System (INIS)

    Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and 131I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of 131I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy was delivered in 2-month cycles using antibody generated in different species of animals; rabbit, pig, monkey, and bovine. Toxicity was limited to hematologic toxicity and was manifested as thrombocytopenia and leukocytopenia (3.2% Grade IV for each according to RTOG toxicity criteria). Tumor remission evaluated by CT scan digitized tumor volume analysis indicated a 26.6% partial response (PR). Tumor remission by physical examination indicated a 33.3% remission rate (25.9% PR and 7.4% complete remission (CR]. The median survival for patients who responded was 15.2 months. The actuarial median survival for the entire group of patients (metastases and previous treatment) was 6.5 months. The longest partial remission is presently more than 4 years

  1. Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with /sup 131/I anti-CEA--a Radiation Therapy Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Stillwagon, G.B.; Order, S.E.; Klein, J.L.; Leichner, P.K.; Leibel, S.A.; Siegelman, S.S.; Fishman, E.K.; Ettinger, D.S.; Haulk, T.; Kopher, K.

    1987-05-01

    Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and /sup 131/I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of /sup 131/I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy was delivered in 2-month cycles using antibody generated in different species of animals; rabbit, pig, monkey, and bovine. Toxicity was limited to hematologic toxicity and was manifested as thrombocytopenia and leukocytopenia (3.2% Grade IV for each according to RTOG toxicity criteria). Tumor remission evaluated by CT scan digitized tumor volume analysis indicated a 26.6% partial response (PR). Tumor remission by physical examination indicated a 33.3% remission rate (25.9% PR and 7.4% complete remission (CR). The median survival for patients who responded was 15.2 months. The actuarial median survival for the entire group of patients (metastases and previous treatment) was 6.5 months. The longest partial remission is presently more than 4 years.

  2. Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: a report of radiation therapy oncology group 83-02

    International Nuclear Information System (INIS)

    Purpose: Seven percent of patients with high grade gliomas enrolled in RTOG 83-02 had mixed astrocytoma/oligodenroglial elements on central pathology review. It has often been assumed that the most aggressive histologic component of a tumor determines biologic behavior; however in this trial, the survival of patients who had mixed glioblastomas/oligodenrogliomas was significantly longer than that of patients with pure glioblastomas (GBM). We therefore evaluated the effect of an oligodendroglial component on the survival of patients who had anaplastic astrocytomas (AAF) treated in the same trial. Methods and Materials: One hundred nine patients who had AAF and 24 patients with mixed AAF/oligodendrogliomas (AAF/OL) were enrolled in a Phase I/II trial of randomized dose-escalation hyper fractioned radiotherapy plus BCNU. AAF/OL patients were older and more likely to have had more aggressive surgery than AAF patients. Other pretreatment characteristics were balanced between groups, as was assigned treatment. Results: The median survival time for AAF was 3.0 years versus 7.3 years for AAF/OL (p = 0.019). In a multivariate analysis, adjusting for extent of surgical resection and age, an oligodendroglial component was an independent prognostic factor for survival. Conclusion: The results support the concept that AAFs with an oligodendroglial component have a better prognosis than pure AAF tumors, similar to the effect seen among patients with glioblastoma multiforme tumors. This better survival outcome should be taken into consideration in the design and stratification of future trials. Additionally, in contrast to patients with GBMs, patients who have AAF/OL have the potential for prolonged survival; therefore, late sequelae of treatment (both radiation and chemotherapy) must be weighed more heavily in the benefits to risks analysis

  3. [Factitious diseases in oncology].

    Science.gov (United States)

    Reich, Michel; Clermont, Amélie; Amela, Éric; Kotecki, Nuria

    2015-12-01

    Factitious diseases and pathomimias and particularly Munchausen's syndrome, due to their rarity, are poorly diagnosed by medical teams working in oncology. Consequences can be serious and result in unadapted surgery or non justified implementation of chemotherapy and radiotherapy regimens. These patients simulate diseases in order to attract medical attention. They might become belligerent and are likely to promptly discharge themselves from hospital if they do not get the desired attention or are unmasked. With two following case reports and literature review, we would like to alert clinicians about difficulties encountered in diagnosis and management of factitious disorders. When faced with this diagnosis, the patient will tend to deny reality and break contact with the medical team who exposed him. Medical peregrinating behavior surrounded by conflicts with medical team, past psychiatric illness, history of working in the medical and paramedical field and social isolation can guide the diagnosis. Somaticians and especially surgeons working in the oncologic field must remain vigilant about this diagnosis and collaborate with either the psycho-oncologic team or the consultation-liaison psychiatric team. Some recommendations for medical professionals how to cope with these patients will be suggested. PMID:26597474

  4. Effect of Radiotherapy Techniques (IMRT vs. 3D-CRT) on Outcome in Patients With Intermediate-Risk Rhabdomyosarcoma Enrolled in COG D9803—A Report From the Children’s Oncology Group

    International Nuclear Information System (INIS)

    Purpose: To compare the dosimetric parameters of intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in patients with intermediate-risk rhabdomyosarcoma and to analyze their effect on locoregional control and failure-free survival (FFS). Methods and Materials: The study population consisted of 375 patients enrolled in the Children’s Oncology Group protocol D9803 study, receiving IMRT or 3D-CRT. Dosimetric data were collected from 179 patients with an available composite plan. The chi-square test or Fisher’s exact test was used to compare the patient characteristics and radiotherapy parameters between the two groups. The interval-to-event outcomes were estimated using the Kaplan-Meier method and compared using log–rank tests. Cox proportional hazards regression analysis was used to examine the effect of the treatment technique on FFS after adjusting for primary site and risk group. Results: The median follow-up time was 5.7 and 4.2 years for patients receiving 3D-CRT and IMRT, respectively. No differences in the 5-year failure of locoregional control (18% vs. 15%) or FFS (72% vs. 76%) rates were noted between the two groups. Multivariate analysis revealed no association between the two techniques and FFS. Patients with primary tumors in parameningeal sites were more likely to receive IMRT than 3D-CRT. IMRT became more common during the later years of the study. Patients receiving IMRT were more likely to receive >50 Gy, photon energy of ≤6 MV, and >5 radiation fields than those who received 3D-CRT. The coverage of the IMRT planning target volume by the prescription dose was improved compared with the coverage using 3D-CRT with similar target dose heterogeneity. Conclusions: IMRT improved the target dose coverage compared with 3D-CRT, although an improvement in locoregional control or FFS could not be demonstrated in this population. Future studies comparing the integral dose to nontarget tissue and late radiation

  5. A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: Follow-up of a gynecologic oncology group study

    International Nuclear Information System (INIS)

    Purpose: To investigate, in a phase III randomized trial, whether postoperative external-beam irradiation to the standard pelvic field improves the recurrence-free interval and overall survival (OS) in women with Stage IB cervical cancers with negative lymph nodes and certain poor prognostic features treated by radical hysterectomy and pelvic lymphadenectomy. Methods and Materials: Eligible patients had Stage IB cervical cancer with negative lymph nodes but with 2 or more of the following features: more than one third (deep) stromal invasion, capillary lymphatic space involvement, and tumor diameter of 4 cm or more. The study group included 277 patients: 137 randomized to pelvic irradiation (RT) and 140 randomized to observation (OBS). The planned pelvic dose was from 46 Gy in 23 fractions to 50.4 Gy in 28 fractions. Results: Of the 67 recurrences, 24 were in the RT arm and 43 were in the OBS arm. The RT arm showed a statistically significant (46%) reduction in risk of recurrence (hazard ratio [HR] = 0.54, 90% confidence interval [CI] = 0.35 to 0.81, p = 0.007) and a statistically significant reduction in risk of progression or death (HR = 0.58, 90% CI = 0.40 to 0.85, p = 0.009). With RT, 8.8% of patients (3 of 34) with adenosquamous or adenocarcinoma tumors recurred vs. 44.0% (11 of 25) in OBS. Fewer recurrences were seen with RT in patients with adenocarcinoma or adenosquamous histologies relative to others (HR for RT by histology interaction = 0.23, 90% CI = 0.07 to 0.74, p = 0.019). After an extensive follow-up period, 67 deaths have occurred: 27 RT patients and 40 OBS patients. The improvement in overall survival (HR = 0.70, 90% CI = 0.45 to 1.05, p = 0.074) with RT did not reach statistical significance. Conclusions: Pelvic radiotherapy after radical surgery significantly reduces the risk of recurrence and prolongs progression-free survival in women with Stage IB cervical cancer. RT appears to be particularly beneficial for patients with adenocarcinoma or

  6. Significance of PIK3CA Mutations in Patients with Early Breast Cancer Treated with Adjuvant Chemotherapy: A Hellenic Cooperative Oncology Group (HeCOG Study.

    Directory of Open Access Journals (Sweden)

    George Papaxoinis

    Full Text Available The PI3K-AKT pathway is frequently activated in breast cancer. PIK3CA mutations are most frequently found in the helical (exon 9 and kinase (exon 20 domains of this protein. The aim of the present study was to examine the role of different types of PIK3CA mutations in combination with molecular biomarkers related to PI3K-AKT signaling in patients with early breast cancer.Tumor tissue samples from 1008 early breast cancer patients treated with adjuvant chemotherapy in two similar randomized trials of HeCOG were examined. Tumors were subtyped with immunohistochemistry (IHC and FISH for ER, PgR, Ki67, HER2 and androgen receptor (AR. PIK3CA mutations were analyzed by Sanger sequencing (exon 20 and qPCR (exon 9 (Sanger/qPCR mutations. In 610 cases, next generation sequencing (NGS PIK3CA mutation data were also available. PIK3CA mutations and PTEN protein expression (IHC were analyzed in luminal tumors (ER and/or PgR positive, molecular apocrine carcinomas (MAC; ER/PgR negative / AR positive and hormone receptor (ER/PgR/AR negative tumors.PIK3CA mutations were detected in 235/1008 tumors (23% with Sanger/qPCR and in 149/610 tumors (24% with NGS. Concordance between the two methods was good with a Kappa coefficient of 0.76 (95% CI 0.69-0.82. Lobular histology, low tumor grade and luminal A tumors were associated with helical domain mutations (PIK3CAhel, while luminal B with kinase domain mutations (PIK3CAkin. The overall incidence of PIK3CA mutations was higher in luminal as compared to MAC and hormone receptor negative tumors (p = 0.004. Disease-free and overall survival did not significantly differ with respect to PIK3CA mutation presence and type. However, a statistically significant interaction between PIK3CA mutation status and PTEN low protein expression with regard to prognosis was identified.The present study did not show any prognostic significance of specific PIK3CA mutations in a large group of predominantly lymph-node positive breast cancer

  7. Gamma camera based FDG PET in oncology

    International Nuclear Information System (INIS)

    Positron Emission Tomography(PET) was introduced as a research tool in the 1970s and it took about 20 years before PET became an useful clinical imaging modality. In the USA, insurance coverage for PET procedures in the 1990s was the turning point, I believe, for this progress. Initially PET was used in neurology but recently more than 80% of PET procedures are in oncological applications. I firmly believe, in the 21st century, one can not manage cancer patients properly without PET and PET is very important medical imaging modality in basic and clinical sciences. PET is grouped into 2 categories; conventional (c) and gamma camera based (CB) PET. CBPET is more readily available utilizing dual-head gamma cameras and commercially available FDG to many medical centers at low cost to patients. In fact there are more CBPET in operation than cPET in the USA. CBPET is inferior to cPET in its performance but clinical studies in oncology is feasible without expensive infrastructures such as staffing, rooms and equipments. At Ajou university Hospital, CBPET was installed in late 1997 for the first time in Korea as well as in Asia and the system has been used successfully and effectively in oncological applications. Our was the fourth PET operation in Korea and I believe this may have been instrumental for other institutions got interested in clinical PET. The following is a brief description of our clinical experience of FDG CBPET in oncology

  8. Group Music Intervention Reduces Aggression and Improves Self-esteem in Children with Highly Aggressive Behavior: A Pilot Controlled Trial

    OpenAIRE

    Ae-Na Choi; Myeong Soo Lee; Jung-Sook Lee

    2008-01-01

    We investigated the effects of group music intervention on aggression and self-esteem in children with highly aggressive behavior. Forty-eight children were allocated to either a music intervention group or an untreated control group. The music intervention group received 50 min of music intervention twice weekly for 15 consecutive weeks. The outcome measures were Child Behavior Checklist Aggression Problems Scale (Parents), Child Aggression Assessment Inventory (Teachers) and Rosenberg Self-...

  9. Supportive care in radiation oncology

    International Nuclear Information System (INIS)

    The radiation therapist, concerned with the disease process and all the technical intricacies of treatment, has usually not been involved in managing the supportive aspects of caring for the patient. Yet, of the team of medical specialists and allied health personnel required in oncology, the radiation therapist is the one most responsible for overseeing the total care of the cancer patient. At times this might include emotional support, prevention and correction of tissue dysfunction, augmentation of nutrition, metabolic and electrolyte regulation, rehabilitation, and vocational support. This chapter is a brief overview of a considerable volume of literature that has occupied the interest of a rather small group of physicians, nutritionists, and psychologists. The discussion highlights the special management problems of the normal-tissue effects of radiation, the related nutritional aspects of cancer care, and certain emotional and pathologic considerations

  10. Conflict Competence of Preschool Children and its Relationship with the Sociometric Status of the Child in the Peer Group

    OpenAIRE

    Denisenkova N.S.,; Vyrotskova V.V.

    2015-01-01

    The purpose of the study was to investigate the conflict competence of children of preschool age and identification of its relationship with the child's sociometric status in the peer group. The hypothesis of the study was that there is a relationship between the sociometric status of preschoolers in the peer group and the strategy of their behavior in a conflict situation, a conflict of competence. The study involved children (41 children: 22 boys and 19 girls) aged 5-7 years, attending prep...

  11. Effects of the Use of Visual Strategies in Play Groups for Children with Autism Spectrum Disorders and Their Peers

    Science.gov (United States)

    Ganz, Jennifer B.; Flores, Margaret M.

    2008-01-01

    The purpose of this study was to investigate the impact of visual strategies with preschool children with autism spectrum disorders (ASD) and their peers during play group sessions. A changing-criterion design was implemented with three preschool-aged children with ASD while they participated in play groups with four typically-developing peers.…

  12. Helping the In-Group Feels Better: Children's Judgments and Emotion Attributions in Response to Prosocial Dilemmas

    Science.gov (United States)

    Weller, Drika; Lagattuta, Kristin Hansen

    2013-01-01

    Five- to 13-year-old European American children ("N" = 76) predicted characters' decisions, emotions, and obligations in prosocial moral dilemmas. Across age, children judged that characters would feel more positive emotions helping an unfamiliar child from the racial in-group versus out-group (African American), happier ignoring the needs of a…

  13. Food Group and Micronutrient Intake Adequacy among Children, Adults and Elderly Women in Greece

    Directory of Open Access Journals (Sweden)

    Yannis Manios

    2015-03-01

    Full Text Available The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9–13-year-old children; 40–60-year-old adults; and 50–75-year-old women were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05. Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor was not always met. Indicatively, 18.2%–44.1% and 4.2%–7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients.

  14. Food Group and Micronutrient Intake Adequacy among Children, Adults and Elderly Women in Greece

    Science.gov (United States)

    Manios, Yannis; Moschonis, George; Grammatikaki, Evangelia; Mavrogianni, Christina; van den Heuvel, Ellen GHM; Bos, Rolf; Singh-Povel, Cecile

    2015-01-01

    The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9–13-year-old children; 40–60-year-old adults; and 50–75-year-old women) were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05). Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor) was not always met. Indicatively, 18.2%–44.1% and 4.2%–7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients. PMID:25768954

  15. Difference between the attitudes towards minority groups among parents and their children

    Directory of Open Access Journals (Sweden)

    Mićević Jelena

    2005-01-01

    Full Text Available The aim of this research is to establish if there are differences between discrimination attitudes of parents and their children towards various marginal groups (the Chinese, Roma, the rich, the poor, persons of different sex, disabled persons. 849 persons were examined in this research: 310 of children and 539 of parents. The questionnaire of identical form for parents and their children was used to examine these discrimination attitudes. The questionnaire contains the open-type questions and it is the part of questionnaire used in the investigation project of wider range. Independent estimators in the scale from 1 to 6 quantified these qualitative results obtained on the basis of open-type questions, by determine the intensity of these attitudes (in negative direction. So-called Canonical discrimination analysis was used, out of statistical methods. The obtained results show that parents and their children statistically differ significantly in discrimination attitudes towards the Chinese, male persons and disabled persons. Children express discrimination attitudes towards male sex and towards disabled persons, but do not have considerable discrimination attitudes towards the Chinese, but parents express discrimination attitudes towards the Chinese, but do not have considerable discrimination attitudes towards the male sex and towards disabled persons.

  16. Grade Inflation in Medical Student Radiation Oncology Clerkships: Missed Opportunities for Feedback?

    International Nuclear Information System (INIS)

    Purpose: To test the hypothesis that medical student radiation oncology elective rotation grades are inflated and cannot be used to distinguish residency applicants. Methods and Materials: The records of 196 applicants to a single radiation oncology residency program in 2011 and 2012 were retrospectively reviewed. The grades for each rotation in radiation oncology were collected and converted to a standardized 4-point grading scale (honors, high pass, pass, fail). Pass/fail grades were scored as not applicable. The primary study endpoint was to compare the distribution of applicants' grades in radiation oncology with their grades in medicine, surgery, pediatrics, and obstetrics/gynecology core clerkships. Results: The mean United States Medical Licensing Examination Step 1 score of the applicants was 237 (range, 188-269), 43% had additional Masters or PhD degrees, and 74% had at least 1 publication. Twenty-nine applicants were graded for radiation oncology rotations on a pass/fail basis and were excluded from the final analysis. Of the remaining applicants (n=167), 80% received the highest possible grade for their radiation oncology rotations. Grades in radiation oncology were significantly higher than each of the other 4 clerkships studied (P<.001). Of all applicants, 195 of 196 matched into a radiation oncology residency. Higher grades in radiation oncology were associated with significantly higher grades in the pediatrics core clerkship (P=.002). However, other medical school performance metrics were not significantly associated with higher grades in radiation oncology. Conclusions: Although our study group consists of a selected group of radiation oncology applicants, their grades in radiation oncology clerkships were highly skewed toward the highest grades when compared with grades in other core clerkships. Student grading in radiation oncology clerkships should be re-evaluated to incorporate more objective and detailed performance metrics to allow for

  17. Grade Inflation in Medical Student Radiation Oncology Clerkships: Missed Opportunities for Feedback?

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Surbhi, E-mail: surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Swisher-McClure, Samuel [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sosnowicz, Stasha [University of Pennsylvania, Philadelphia, Pennsylvania (United States); Li, Jiaqi; Mitra, Nandita [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Berman, Abigail T.; Baffic, Cordelia; Vapiwala, Neha; Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2015-07-15

    Purpose: To test the hypothesis that medical student radiation oncology elective rotation grades are inflated and cannot be used to distinguish residency applicants. Methods and Materials: The records of 196 applicants to a single radiation oncology residency program in 2011 and 2012 were retrospectively reviewed. The grades for each rotation in radiation oncology were collected and converted to a standardized 4-point grading scale (honors, high pass, pass, fail). Pass/fail grades were scored as not applicable. The primary study endpoint was to compare the distribution of applicants' grades in radiation oncology with their grades in medicine, surgery, pediatrics, and obstetrics/gynecology core clerkships. Results: The mean United States Medical Licensing Examination Step 1 score of the applicants was 237 (range, 188-269), 43% had additional Masters or PhD degrees, and 74% had at least 1 publication. Twenty-nine applicants were graded for radiation oncology rotations on a pass/fail basis and were excluded from the final analysis. Of the remaining applicants (n=167), 80% received the highest possible grade for their radiation oncology rotations. Grades in radiation oncology were significantly higher than each of the other 4 clerkships studied (P<.001). Of all applicants, 195 of 196 matched into a radiation oncology residency. Higher grades in radiation oncology were associated with significantly higher grades in the pediatrics core clerkship (P=.002). However, other medical school performance metrics were not significantly associated with higher grades in radiation oncology. Conclusions: Although our study group consists of a selected group of radiation oncology applicants, their grades in radiation oncology clerkships were highly skewed toward the highest grades when compared with grades in other core clerkships. Student grading in radiation oncology clerkships should be re-evaluated to incorporate more objective and detailed performance metrics to allow for

  18. Standardizing Naming Conventions in Radiation Oncology

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  19. RTOG Sarcoma Radiation Oncologists Reach Consensus on Gross Tumor Volume and Clinical Target Volume on Computed Tomographic Images for Preoperative Radiotherapy of Primary Soft Tissue Sarcoma of Extremity in Radiation Therapy Oncology Group Studies

    Energy Technology Data Exchange (ETDEWEB)

    Wang Dian, E-mail: dwang@mcw.edu [Medical College of Wisconsin, Milwaukee, WI (United States); Bosch, Walter [Washington University, St. Louis, MO (United States); Roberge, David [McGill University, Montreal, Quebec (Canada); Finkelstein, Steven E. [Moffitt Cancer Center, Tampa, FL (United States); Petersen, Ivy; Haddock, Michael [Mayo Clinic, Rochester, MN (United States); Chen, Yen-Lin E.; Saito, Naoyuki G. [Roswell Park Cancer Institute, Buffalo, NY (United States); Kirsch, David G. [Duke University, Durham, NC (United States); Hitchcock, Ying J. [University of Utah, Salt Lake City, UT (United States); Wolfson, Aaron H. [University of Miami Miller School of Medicine, Miami, FL (United States); DeLaney, Thomas F. [Massachusetts General Hospital, Boston, MA (United States)

    2011-11-15

    Objective: To develop a Radiation Therapy Oncology Group (RTOG) atlas delineating gross tumor volume (GTV) and clinical target volume (CTV) to be used for preoperative radiotherapy of primary extremity soft tissue sarcoma (STS). Methods and Materials: A consensus meeting was held during the RTOG meeting in January 2010 to reach agreement about GTV and CTV delineation on computed tomography (CT) images for preoperative radiotherapy of high-grade large extremity STS. Data were presented to address the local extension of STS. Extensive discussion ensued to develop optimal criteria for GTV and CTV delineation on CT images. Results: A consensus was reached on appropriate CT-based GTV and CTV. The GTV is gross tumor defined by T1 contrast-enhanced magnetic resonance images. Fusion of magnetic resonance and images is recommended to delineate the GTV. The CTV for high-grade large STS typically includes the GTV plus 3-cm margins in the longitudinal directions. If this causes the field to extend beyond the compartment, the field can be shortened to include the end of a compartment. The radial margin from the lesion should be 1.5 cm, including any portion of the tumor not confined by an intact fascial barrier, bone, or skin surface. Conclusion: The consensus on GTV and CTV for preoperative radiotherapy of high-grade large extremity STS is available as web-based images and in a descriptive format through the RTOG. This is expected to improve target volume consistency and allow for rigorous evaluation of the benefits and risks of such treatment.

  20. Efficacy and tolerability of concurrent weekly low dose cisplatin during radiation treatment of localised muscle invasive bladder transitional cell carcinoma: A report of two sequential Phase II studies from the Trans Tasman Radiation Oncology Group

    International Nuclear Information System (INIS)

    Background and purpose: To determine the feasibility, toxicity, and clinical effectiveness of concurrent weekly cisplatin chemotherapy in conjunction with definitive radiation in the treatment of localised muscle invasive bladder cancer. Patients and methods: In January 1997 the Trans Tasman Radiation Oncology Group embarked on a Phase II study (TROG 97.01) of weekly cisplatin (35 mg/m2 x 7 doses) plus radiation to a dose of 63 Gy over 7 weeks. Following an interim toxicity analysis, the dose intensity of cisplatin was reduced to 6 cycles and the radiation schedule changed to 64 Gy over 6.5 weeks leading to the second study (TROG 99.06). A total of 113 patients were enrolled. Results: Acute grade 3 urinary toxicity occurred in 23% of the patients. Acute grade 4 pelvic toxicity was not seen. Thirty-eight patients (33%) experienced grade 3 or 4 cisplatin related toxicities with 15 patients (12%) requiring significant dose modification. The reduced dose intensity in Study 99.06 improved tolerability. Incidence of significant late morbidity was low (6%). Seventy-nine patients (70%) achieved complete remission at the 6 month cystoscopic assessment. Local invasive recurrence was seen in 11 of the 79 patients (14%). In 18 patients (16%) isolated superficial TCC/CIS were detected (6 months and beyond).The local control rate was 45% with a functional bladder being retained in 69 of the 113 patients (61%). RFS and DSS at 5 years were 33% and 50%, respectively. Conclusion: Our two sequential Phase II studies have shown that concurrent chemoradiation using weekly cisplatin in the management of localised invasive bladder TCC is feasible and reasonably well tolerated. This approach is currently being investigated further in a randomised study

  1. A Paired, Double-Blind, Randomized Comparison of a Moisturizing Durable Barrier Cream to 10% Glycerine Cream in the Prophylactic Management of Postmastectomy Irradiation Skin Care: Trans Tasman Radiation Oncology Group (TROG) 04.01

    International Nuclear Information System (INIS)

    Purpose: A previous, unblinded study demonstrated that an alcohol-free barrier film containing an acrylate terpolymer (ATP) was effective in reducing skin reactions compared with a 10% glycerine cream (sorbolene). The different appearances of these products precluded a blinded comparison. To test the acrylate terpolymer principle in a double-blinded manner required the use of an alternative cream formulation, a moisturizing durable barrier cream (MDBC); the study was conducted by the Trans Tasman Radiation Oncology Group (TROG) as protocol 04.01. Methods and Materials: A total of 333 patients were randomized; 1 patient was ineligible and 14 patients withdrew or had less than 7 weeks' observations, leaving 318 for analysis. The chest wall was divided into medial and lateral compartments, and patients were randomized to have MDBC applied daily to the medial or lateral compartment and sorbolene to the other compartment. Weekly observations, photographs, and symptom scores (pain and pruritus) were collected to week 12 or resolution of skin reactions if earlier. Skin dose was confirmed by centrally calibrated thermoluminescent dosimeters. Results: Rates of medial and lateral compartment Common Toxicity Criteria (CTC), version 3, greater than or equal to grade 3 skin reactions were 23% and 41%, but rates by skin care product were identical at 32%. There was no significant difference between MDBC and sorbolene in the primary endpoint of peak skin reactions or secondary endpoints of area-under-the-curve skin reaction scores. Conclusions: The MDBC did not reduce the peak skin reaction compared to sorbolene. It is possible that this is related to the difference in the formulation of the cream compared with the film formulation. Skin dosimetry verification and double blinding are essential for radiation skin care comparative studies

  2. Economic analysis of a phase III clinical trial evaluating the addition of total androgen suppression to radiation versus radiation alone for locally advanced prostate cancer (Radiation Therapy Oncology Group protocol 86-10)

    International Nuclear Information System (INIS)

    Purpose: To evaluate the cost-effectiveness of adding hormone therapy to radiation for patients with locally advanced prostate cancer, using a Monte Carlo simulation of a Markov Model. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 86-10 randomized patients to receive radiation therapy (RT) alone or RT plus total androgen suppression (RTHormones) 2 months before and during RT for the treatment of locally advanced prostate cancer. A Markov model was designed with Data Pro (TreeAge Software, Williamstown, MA). The analysis took a payer's perspective. Transition probabilities from one state of health (i.e., with no disease progression or with hormone-responsive metastatic disease) to another were calculated from published rates pertaining to RTOG 86-10. Patients remained in one state of health for 1 year. Utility values for each health state and treatment were obtained from the literature. Distributions were sampled at random from the treatment utilities according to a second-order Monte Carlo simulation technique. Results: The mean expected cost for the RT-only treatments was $29,240 (range, $29,138-$29,403). The mean effectiveness for the RT-only treatment was 5.48 quality-adjusted life years (QALYs) (range, 5.47-5.50). The mean expected cost for RTHormones was $31,286 (range, $31,058-$31,555). The mean effectiveness was 6.43 QALYs (range, 6.42-6.44). Incremental cost-effectiveness analysis showed RTHormones to be within the range of cost-effectiveness at $2,153/QALY. Cost-effectiveness acceptability curve analysis resulted in a >80% probability that RTHormones is cost-effective. Conclusions: Our analysis shows that adding hormonal treatment to RT improves health outcomes at a cost that is within the acceptable cost-effectiveness range

  3. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    International Nuclear Information System (INIS)

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  4. A Paired, Double-Blind, Randomized Comparison of a Moisturizing Durable Barrier Cream to 10% Glycerine Cream in the Prophylactic Management of Postmastectomy Irradiation Skin Care: Trans Tasman Radiation Oncology Group (TROG) 04.01

    Energy Technology Data Exchange (ETDEWEB)

    Graham, Peter H., E-mail: peter.graham@sesiahs.health.nsw.gov.au [Cancer Care Centre, St. George Hospital, Kogarah, New South Wales (Australia); Plant, Natalie; Graham, Jennifer L.; Browne, Lois [Cancer Care Centre, St. George Hospital, Kogarah, New South Wales (Australia); Borg, Martin [Department of Radiation Oncology, Royal Adelaide Hospital (Australia); Capp, Anne [Department of Radiation Oncology, Mater Hospital, Newcastle, New South Wales (Australia); Delaney, Geoff P. [Cancer Care Centre, Liverpool Hospital, Liverpool, New South Wales (Australia); Harvey, Jennifer [Mater Hospital, South Brisbane, Queensland (Australia); Kenny, Lisbeth [Royal Brisbane Hospital, Herston, Queensland (Australia); Francis, Michael [Andrew Love Cancer Centre, Geelong (Australia); Zissiadis, Yvonne [Department of Radiation Oncology, Royal Perth Hospital, Perth (Australia)

    2013-05-01

    Purpose: A previous, unblinded study demonstrated that an alcohol-free barrier film containing an acrylate terpolymer (ATP) was effective in reducing skin reactions compared with a 10% glycerine cream (sorbolene). The different appearances of these products precluded a blinded comparison. To test the acrylate terpolymer principle in a double-blinded manner required the use of an alternative cream formulation, a moisturizing durable barrier cream (MDBC); the study was conducted by the Trans Tasman Radiation Oncology Group (TROG) as protocol 04.01. Methods and Materials: A total of 333 patients were randomized; 1 patient was ineligible and 14 patients withdrew or had less than 7 weeks' observations, leaving 318 for analysis. The chest wall was divided into medial and lateral compartments, and patients were randomized to have MDBC applied daily to the medial or lateral compartment and sorbolene to the other compartment. Weekly observations, photographs, and symptom scores (pain and pruritus) were collected to week 12 or resolution of skin reactions if earlier. Skin dose was confirmed by centrally calibrated thermoluminescent dosimeters. Results: Rates of medial and lateral compartment Common Toxicity Criteria (CTC), version 3, greater than or equal to grade 3 skin reactions were 23% and 41%, but rates by skin care product were identical at 32%. There was no significant difference between MDBC and sorbolene in the primary endpoint of peak skin reactions or secondary endpoints of area-under-the-curve skin reaction scores. Conclusions: The MDBC did not reduce the peak skin reaction compared to sorbolene. It is possible that this is related to the difference in the formulation of the cream compared with the film formulation. Skin dosimetry verification and double blinding are essential for radiation skin care comparative studies.

  5. A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

    International Nuclear Information System (INIS)

    Background: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials: NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m2/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m2/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. Results: After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion: The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms

  6. The impact of concurrent granulocyte macrophage-colony stimulating factor on radiation-induced mucositis in head and neck cancer patients: A double-blind placebo-controlled prospective Phase III study by Radiation Therapy Oncology Group 9901

    International Nuclear Information System (INIS)

    Purpose: Based on early clinical evidence of potential mucosal protection by granulocyte-macrophage colony stimulating factor (GM-CSF), the Radiation Therapy Oncology Group conducted a double-blind, placebo-controlled, randomized study to test the efficacy and safety of GM-CSF in reducing the severity and duration of mucosal injury and pain (mucositis) associated with curative radiotherapy (RT) in head-and-neck cancer patients. Methods and Materials: Eligible patients included those with head-and-neck cancer with radiation ports encompassing >50% of oral cavity and/or oropharynx. Standard RT ports were used to cover the primary tumor and regional lymphatics at risk in standard fractionation to 60-70 Gy. Concurrent cisplatin chemotherapy was allowed. Patients were randomized to receive subcutaneous injection of GM-CSF 250 μg/m2 or placebo 3 times a week. Mucosal reaction was assessed during the course of RT using the National Cancer Institute Common Toxicity Criteria and the protocol-specific scoring system. Results: Between October 2000 and September 2002, 130 patients from 36 institutions were accrued. Nine patients (7%) were excluded from the analysis, 3 as a result of drug unavailability. More than 80% of the patients participated in the quality-of-life endpoint of this study. The GM-CSF did not cause any increase in toxicity compared with placebo. There was no statistically significant difference in the average mean mucositis score in the GM-CSF and placebo arms by a t test (p = 0.4006). Conclusion: This placebo-controlled, randomized study demonstrated no significant effect of GM-CSF given concurrently compared with placebo in reducing the severity or duration of RT-induced mucositis in patients undergoing definitive RT for head-and-neck cancer

  7. A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

    Energy Technology Data Exchange (ETDEWEB)

    Sperduto, Paul W., E-mail: psperduto@mropa.com [Metro MN CCOP, Minneapolis, Minnesota (United States); Wang, Meihua [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Robins, H. Ian [University of Wisconsin Medical School Cancer Center, Madison, Wisconsin (United States); Schell, Michael C. [Wilmot Cancer Center, University of Rochester, Rochester, New York (United States); Werner-Wasik, Maria [Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Komaki, Ritsuko [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Buyyounouski, Mark K. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Khuntia, Deepak [University of Wisconsin Hospital, Madison, Wisconsin (United States); Demas, William [Akron City Hospital, Akron, Ohio (United States); Shah, Sunjay A. [Christiana Care Health Services, Inc, CCOP, Newark, Delaware (United States); Nedzi, Lucien A. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Perry, Gad [The Ottawa Hospital Cancer Centre, Ottawa, Ontario (Canada); Suh, John H. [Cleveland Clinic Foundation, Cleveland, Ohio (United States); Mehta, Minesh P. [Northwestern Memorial Hospital, Chicago, Illinois (United States)

    2013-04-01

    Background: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials: NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m{sup 2}/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m{sup 2}/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. Results: After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion: The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms.

  8. Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

    International Nuclear Information System (INIS)

    Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum

  9. Using group therapy to support eating disordered mothers with their children: the relevance for primary care

    OpenAIRE

    Barnett, Sarah; Buckroyd, Julia; Windle, Karen

    2006-01-01

    Eating disorders are a crippling and disabling condition. If they become chronic, the emotional, physical and social effects are substantial. The death rate is the highest of all psychiatric illnesses so the need to find prevention strategies is urgent. This research project has three aims, primary prevention of an eating disorder for the child, helping the mother recover and developing a protocol for a group to be used in primary care. Children of mothers with an eating disorder, are a prove...

  10. Social skills group training for children and adolescents with autism spectrum disorder

    OpenAIRE

    Choque Olsson, Nora

    2016-01-01

    The overall aim of this thesis was to examine the efficacy and effectiveness of social skills group training (SSGT) in children and adolescents with high functioning autism spectrum disorder (HFASD) and psychiatric comorbidity. Prior to the trial, a systematic review was conducted on the effectiveness of randomized controlled trial (RCT) of SSGT. In addition, evaluation of two tools (Developmental Disabilities Children’s Global Assessment Scale [DD-CGAS] and the OSU Autism C...

  11. Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children

    Directory of Open Access Journals (Sweden)

    António Pires

    2015-04-01

    Full Text Available Introduction: Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. Objectives: To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. Methods: We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. Results: There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001, the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001 and mean common carotid artery intima-media thickness (r=0.378; p=<0.001. In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. Conclusions: These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.

  12. [What is new in pediatric oncology?].

    Science.gov (United States)

    Oberlin, O; Brugières, L; Patte, C; Kalifa, C; Vassal, G; Valteau-Couanet, D; Hartmann, O

    2000-08-01

    The significant progress made in pediatric oncology during recent years has been due to a major breakthrough in the field of molecular biology and the introduction of new therapeutic strategies that take into account both the quality and the duration of life. Molecular biology has already been instrumental in more fully categorizing the 'small round-cell tumor' group, and in reclassifying the 'Ewing family' tumors. It also provides a valuable tool for the prognostic evaluation of neuroblastomas through the analysis of the N-myc oncogene. In addition, it has permitted the identification of the Li-Fraumeni syndrome of predisposition to cancer in the child, thereby raising the problematical ethical issue of communicating relevant information to subjects at risk. Two examples illustrate innovative strategic concepts: 1) Burkitt's lymphoma, or an example of the successful de-intensification of treatment; and 2) brain tumors in young children, regarding which the desire to improve the quality of life has led to innovative attempts to replace radiotherapy by chemotherapy. Considerable progress has been made in the field of neuropsychology, thereby permitting an improved assessment of disorders and a better management of rehabilitation programs. New anti-cancer agents and also chemo- and radiotherapy that spare healthy tissue are also being developed. Gene therapy and molecular biology will play a major role in future therapeutic strategies; and are now at the preclinical trial stage. This significant overall progress leads to a reconsideration of the organizational approach toward treatment of the pediatric patient population suffering from cancer, and a critical assessment of disease management, which should take into account not only the technical aspects of the disease but also familial and social considerations. PMID:10985189

  13. The Radiation Therapy Oncology in the context of oncological practice

    International Nuclear Information System (INIS)

    This work is about the radiation therapy oncology in the context of oncological practice. The radiotherapy is a speciality within medicine that involves the generation, application and dissemination of knowledge about the biology, causes, prevention and treatment of the cancer and other pathologies by ionising radiation

  14. Seroprevalence of hepatitis A virus infection in different age groups of children

    Directory of Open Access Journals (Sweden)

    Yogendra Singh Verma

    2014-01-01

    Full Text Available Context: Hepatitis A is one of the most common causes of hepatitis in the pediatric age group and the most common cause of fulminant hepatic failure (FHF among children in India. Hepatitis A is a waterborne disease. High endemicity obviates the need for vaccine in the community. Aims: We studied 116 children in the outpatient department (OPD to know the seroprevalence of hepatitis A virus (HAV, total antibodies, and the effect of various demographic and water sanitation variables on it. Settings and Design: Children attending the pediatric OPD with minor problems in a medical college hospital were chosen for this study. It is a descriptive, cross-sectional, and seroepidemiologic investigative study. Materials and Methods: Blood samples of randomly selected children were collected and competitive enzyme-linked immunosorbent assay (ELISA test was done for the detection of total anti-HAV antibodies, [both immunoglobulin M (IgM and immunoglobulin G (IgG], using a commercially available ELISA kit. "Dia.Pro" (Diagnostic Bioprobes srl via Columella n° 31 20128 Millano, Italy. Statistical Analysis Used: Statistical analysis was performed by the chi-square test using Epi Info software 3.5.4 version (2012 [Center for disease control and prevention (CDC, Atlanta, Georgia (USA]. Results: Seroprevalence in children from the upper social class was 54.5% versus 87.2% in the lower social class (P = 0.00075. 90.9% of the children with rural background were seropositive compared to 77.1% of children with urban background. The mother′s education above and below secondary level had a seropositivity for HAV in children up to 69.23% and 87.1%, respectively. The method of water treatment using boiled water, mechanical filtration, filtration plus ultraviolet (UV light treatment, and no treatment had a seropositivity of 50.0%, 83.33%, 37.5%, and 84%, respectively, (P = 0.0036. Seropositivity was the highest when the water source was municipal bore well pipeline (88

  15. Effectiveness of Group Cognitive-Behavioral Therapy on Anxiety, Depression and Glycemic Control in Children with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Somaye Ahmadi

    2014-06-01

    Full Text Available Introduction: The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. Methods and Matherials: The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15 and control group (15. The experimental group was undergone eight 2-hour sessions of cognitive-behavioral training. Before and after the intervention, the Multidimensional Anxiety Scale for Children, which included four components of social anxiety, physical symptoms, harm avoidance, and separation anxiety, and Children Depression Inventory was administrated in both groups. Results: The findings from the covariance analysis test revealed that depression and anxiety and glycemic control in experimental group was controlled at post-test and depression score in experimental group compared to the control group at post-test was decreased. The findings from the multivariate covariance analysis test between components of, physical symptoms, harm avoidance, separation anxiety, and social anxiety revealed meaningful differences between the two groups in social anxiety post-test score. Conclusions: According to the article, cognitive behavior therapy can be effective for depression, anxiety, and blood sugar control in children.

  16. Effectiveness of Group Cognitive Bbehavioral Therapy on Anxiety, Depression and Glycemic Control in Children with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    S Ahmadi

    2014-04-01

    Full Text Available The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15 and control group (15. The experimental group was undergone eight 2-hour sessions of cognitive-behavioral training. Before and after the intervention, the Multidimensional Anxiety Scale for Children, which included four components of social anxiety, physical symptoms, harm avoidance, and separation anxiety, and Children Depression Inventory was administrated in both groups. The findings from the covariance analysis test revealed that depression and anxiety and glycemic control in experimental group was controlled at post-test and depression score in experimental group compared to the control group at post-test was decreased. The findings from the multivariate covariance analysis test between components of, physical symptoms, harm avoidance, separation anxiety, and social anxiety revealed meaningful differences between the two groups in social anxiety post-test score. Thus, cognitive behavior therapy can be effective for depression, anxiety, and blood sugar control in children.

  17. Educators Views about the Inclusion of the Children with Special Educational Needs in the Regular Groups of the Kindergarten

    OpenAIRE

    Sivevska, Despina; Bocvarova, Jadranka

    2014-01-01

    Today, the inclusion of children with special educational needs in the formal forms of education has been more prevailing. The kindergarten, as a form of care and education of the pre-school children, has not been left out of the process of inclusion of this group of children. This paper examines the views of the educators for the inclusion of children with special educational needs in the regular groups of kindergarten. The accent is placed on the differences in the views of the educators on...

  18. Importance of nutrition in pediatric oncology

    Directory of Open Access Journals (Sweden)

    P C Rogers

    2015-01-01

    Full Text Available A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and survivorship. This article briefly describes this perspective of nutrition within a cancer control context and is a summary of the presentation at the “1st International SIOP-PODC Workshop on Nutrition in Children with Cancer” held in Mumbai.

  19. Impact of Music on Pediatric Oncology Outpatients

    OpenAIRE

    Kemper, Kathi J; Hamilton, Craig A; McLean, Thomas W.; LOVATO, JAMES

    2008-01-01

    Music is widely used to enhance well-being. We wished to assess music’s effect on pediatric oncology outpatients. Patients who had leukemia and were in maintenance or consolidation outpatient treatment served as their own control at two visits. At visit 1, children rested for 20 min; at visit 2, for 20 min they listened to music designed to increase vitality and improve heart rate variability (HRV). At both visits, parents completed before and after treatment visual analog scales (VAS) of the...

  20. Behavioral Group Therapy Effect on Bam Earthquake Related PTSD Symptoms in Children: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Y Fakour

    2006-05-01

    Full Text Available Background: In children and adolescents physical and psychological integrity threatening occur after disasters, whereby post traumatic stress disorder (PTSD may be the first reaction. Psychological debriefing is a way for prevention and reducing PTSD symptoms. Many studies have shown the efficacy of behavioral therapy in treatment of post-traumatic stress disorder. Few evidence is available for using these techniques in combination for prevention and treatment of PTSD symptoms. This study compared the efficacy of psychological debriefing and cognitive behavioral group therapy combination on Bam earthquake related PTSD symptoms in children with a control group. Methods: In a control trial, we evaluated the efficacy of one session psychological debriefing and three sessions of group behavioral therapy in Bam earthquake adolescent survivors with PTSD symptoms and compared it with a control group. The mean age of participants was 9.07 (SD=1.7 years and no one had sever PTSD or other psychiatric disorder that needed pharmacological interventions. Before and after interventions we evaluated PTSD symptoms by use of K-SADS questionnaire and compared them with the control group. Results: The study included 100 persons, of whom 20 persons were excluded during intervention because of migration. The mean values of total PTSD symptoms and the symptoms of re-experience and avoidance were reduced after interventions. This reduction was statistically significant only for symptoms of re-experience. In control group the mean values of PTSD symptoms increased during study which was statistically significant. The two groups showed statistically significant differences of symptom reduction in total PTSD symptoms, re-experience and avoidance. No difference was detected for hyper arousal. Conclusion: Psychological debriefing and group behavioral therapy may have preventive effect on PTSD symptoms and may reduce symptoms of re-experience.

  1. Cancer in human immunodeficiency virus-infected children : A case series from the Children's Cancer Group and the National Cancer Institute

    NARCIS (Netherlands)

    Granovsky, MO; Mueller, BU; Nicholson, HS; Rosenberg, PS; Rabkin, CS

    1998-01-01

    Purpose: To describe the spectrum of malignancies in human immunodeficiency virus (HIV)-infected children and the clinical outcome of patients with these tumors. Methods: We retrospectively surveyed the Children's Cancer Group (CCG) and the National Cancer institute (NCI) for cases of cancer that oc

  2. [Dignity therapy in oncology].

    Science.gov (United States)

    Ripamonti, Carla Ida

    2016-04-01

    In oncology, little is known about dignity, dignity-related distress and the issues that influence the sense of dignity for patients. Dignity is personal, subject to changes depending on the experience and the path of life. In oncology some patients feel that their dignity is directly related to the disease, to physical and emotional symptoms, to the highest level of physical and cognitive autonomy and to the continuity of the self. Patient dignity inventory (PDI) is a validate tool designed to measure various sources of dignity-related distress among patients nearing the end of life and serve as a screening tool to assess a broad range of issues that influence the sense of dignity. Dignity therapy is a novel focused psychotherapy consisting in a brief semi-structured interview, audio-recorded and transcribed in order to obtain the "generativity document". The patients are invited to tell about their life history, and to leave words of guidance and offer instructions to pass along to their son, daughters, husband, wife, parents, others. The generativity document is the result of process of emotional and existential care for the patients and a gift for everybody will receive it. PMID:27093325

  3. [Current model of breakfast for different age groups: children, a adolescents and adults].

    Science.gov (United States)

    Núñez, C; Cuadrado, C; Carbajal, A; Moreiras, O

    1998-01-01

    The objective of the present work is to assess the current breakfast model in different age groups: children between the ages of 6 and 12 years (n = 54); adolescents between the ages of 13 and 17 years (n = 174); and adults, older than 18 years of age (n = 252). For this a questionnaire has been designed that follows the standards of that used for a similar study by our team in 1984 on a sample of 1350 individuals. The modified and amplified questionnaire included open and closed questions about: the omission of breakfast and its causes, foods that are a part of breakfast, the most frequent types and the variations, the role of the second breakfast, the number of fasting hours since dinner, the time spent of breakfast, and the subjective opinion regarding the importance or not of having breakfast. 98.95% answer yes to the question do you have breakfast, but only 9% eats a nutritionally correct breakfast, one defined as that breakfast that supplies 20% of the total energy and includes foods from at least four different groups. All the children included some form of milk product in their breakfast. The adolescents consumed the lowest proportion of cereals (19.4%) and the highest proportion of pastries (24.2%). The percentage of adults who drink coffee with milk (57%) and sugar (37.7%) is significantly higher than that it the other two groups. Bread (37.7%), pastries (28.3%) and cookies (26.1%) are the solid foods eaten most by the adults. The children spend the longest time on breakfast. 35.9% of the sample varies their breakfast, 43.1% never does, and 21% does so sometimes. The average time elapsed between dinner and breakfast is 10.5 +/- 1.2 hours. It is advisable to have a more nutritionally balanced breakfast, including different foods from at least four groups, and including a greater variety in the menus. PMID:9780752

  4. The effects of live music groups versus an educational children's television program on the emergent literacy of young children.

    Science.gov (United States)

    Register, Dena

    2004-01-01

    Research suggests that music is beneficial in teaching both social and academic skills to young children. The purpose of this study was to examine the effects of a music therapy program designed to teach reading skills versus the "Between the Lions" television program on the early literacy behaviors of Kindergarten children from a low socioeconomic background. Subjects (n = 86) were children, aged 5-7 years, enrolled in one of four different Kindergarten classes at a public elementary school in Northwest Florida. Each class was assigned one of four treatment conditions: Music/Video (sequential presentation of each condition), Music-Only, Video-Only, and no contact Control group. Growth in early literacy skills was measured using the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) and 3 subtests of the Test of Early reading Ability-3rd edition (TERA-3). Teachers' perceptions of classroom literacy behaviors were measured using a pre and poststudy survey. This study also compared on- and off-task behavior of students during video versus music conditions. Results of the 7 subtests measuring early literacy were varied. The Music/Video and Music-Only groups achieved the highest increases in mean scores from pre to posttest on 4 of the 7 subtests. Students in the Video-Only group scored significantly better on the phonemic segmentation portion of the DIBELS than peers in the Music/Video condition. Furthermore, strong correlations were found between the Letter Naming, Initial Sounds Fluency tests, and total raw score of the TERA-3 tests for both pre and posttesting. Additionally, graphic analysis of mean off-task behavior per session indicated that students were more off-task during both video conditions (video alone and video portion of Music/Video condition) than during the music conditions. Off-task behavior was consistently lower during music sessions for the duration of the study. This study confirmed that music increases the on-task behavior of students

  5. Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach

    OpenAIRE

    Sharif Ishak, Sharifah Intan Zainun; Shohaimi, Shamarina; Kandiah, Mirnalini

    2013-01-01

    The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food g...

  6. Treatment response in oncology

    International Nuclear Information System (INIS)

    Full text: Currently, the evaluation of response to therapy in Oncology consists of determination of changes in size of lesions measurable by structural imaging, notably computerized tomography. These criteria, formalized using RECIST (Response Evaluation Criteria in Solid Tumors), are the current standard for evaluation (http://www3.cancer. gov/dip/RECIST.htm). An increasing body of evidence suggests that functional changes in tumors precede structural changes, and that methodologies that measure such changes may be able to evaluate the potential of therapy, allowing for better and earlier selection of these potentially cytotoxic therapies. Nuclear Medicine imaging is distinguished by its ability to determine functional characteristics. These include: 1. Receptor status - for example, the presence of sodium iodide symporters detected by radioiodine or pertechnetate imaging, the presence of somatostatin or norepinephrine receptors by pentetreotide or metaiodobenzylguanidine (mIBG) imaging respectively. Such imaging can help guide appropriate therapies with iodine-131, somatostatin analogues (radiolabeled or otherwise) or iodine-131 labeled mIBG. 2. Metabolic status - for example, glycolytic status (with fluorine-18 labeled fluorodeoxyglucose); amino acid metabolism (e.g. using carbon-11 labeled methionine), or tumor proliferation (using radiolabeled thymidine or deoxyuridine). These methods have advantages over structural imaging because in the vast majority of tumors, changes in the functional or molecular status of tumors are seen earlier than are structural changes. 3. Overall cellular status - these imaging agents are still in their early development but hold great promise for the determination of cellular viability. Annexin imaging is the archetype of such imaging modalities that predict the overall fate of the cell, in this instance its entry into the apoptotic pathway. This review will highlight the uses of functional imaging using radiotracers in all three

  7. Variability in the Inter-Group Attitudes of White Children: What We Can Learn from Their Ethnic Identity Labels

    Science.gov (United States)

    Brown, Christia Spears; Spatzier, Agnieszka; Tobin, Mollie

    2010-01-01

    The current study examined the ethnic identity of White (N = 120), Latino (N = 87), and African-American (N = 65) children and early adolescents (aged = 9-14 years), with an emphasis on whether the specific ethnic label White children used to describe themselves might reflect differences in their inter-group attitudes and whether those differences…

  8. Exploring Responses to Transformative Group Therapy for Orphaned Children in the Context of Mass Orphaning in Botswana

    Science.gov (United States)

    Thamuku, Masego; Daniel, Marguerite

    2013-01-01

    In the context of AIDS, the Botswana Government has adopted a group therapy program to help large numbers of orphaned children cope with bereavement. This study explores the effectiveness of the therapy and examines how it interacts with cultural attitudes and practices concerning death. Ten orphaned children were involved in five rounds of data…

  9. Building Emotion and Affect Regulation (BEAR): Preliminary Evidence from an Open Trial in Children's Residential Group Homes in Singapore

    Science.gov (United States)

    Pat-Horenczyk, R.; Shi, C. Sim Wei; Schramm-Yavin, S.; Bar-Halpern, M.; Tan, L. J.

    2015-01-01

    Background: The Building Emotion and Affect Regulation (BEAR) program is a theory-based group intervention for enhancing resilience in children, with a focus on strengthening emotion regulation. The BEAR is a 6-session protocol for children aged 7-12 who have been subject to traumatic life events. Objective: This paper presents the guiding…

  10. "Friends in Need": Designing and Implementing a Psychoeducational Group for School Children from Drug-Involved Families.

    Science.gov (United States)

    Dore, Martha M.; Nelson-Zlupko, Lani; Kaufman, Eda

    1999-01-01

    Discusses design and use of a model curriculum for latency-aged children in schools located in communities where drug use is pervasive. Results show that children affected by family drug use have workable strategies and skills for coping with aversive environments. Responsiveness of group participants to structure, predictability, and affirmation…

  11. Randomized trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05)

    International Nuclear Information System (INIS)

    Background and purpose: Despite numerous randomized trials investigating radiotherapy (RT) fractionation schedules for painful bone metastases, there are very few data on RT for bone metastases causing pain with a neuropathic component. The Trans-Tasman Radiation Oncology Group undertook a randomized trial comparing the efficacy of a single 8 Gy (8/1) with 20 Gy in 5 fractions (20/5) for this type of pain. Materials and methods: Eligible patients had radiological evidence of bone metastases from a known malignancy with no change in systemic therapy within 6 weeks before or anticipated within 4 weeks after RT, no other metastases along the distribution of the neuropathic pain and no clinical or radiological evidence of cord/cauda equina compression. All patients gave written informed consent. Primary endpoints were pain response within 2 months of commencement of RT and time to treatment failure (TTF). The hypothesis was that 8/1 is at least as effective as 20/5 and the planned sample size was 270 patients. Results: Between February 1996 and December 2002, 272 patients were randomized (8/1:20/5=137:135) from 15 centres (Australia 11, New Zealand 3, UK 1). The commonest primary cancers were lung (31%), prostate (29%) and breast (8%); index sites were spine (89%), rib (9%), other (2%); 72% of patients were males and the median age was 67 (range 29-89). The median overall survival (95% CI) for all randomized patients was 4.8 mo (4.2-5.7 mo). The intention-to-treat overall response rates (95% CI) for 8/1 vs 20/5 were 53% (45-62%) vs 61% (53-70%), P=0.18. Corresponding figures for complete response were 26% (18-34%) vs 27% (19-35%), P=0.89. The estimated median TTFs (95% CI) were 2.4 mo (2.0-3.3 mo) vs 3.7 mo (3.1-5.9 mo) respectively. The hazard ratio (95% CI) for the comparison of TTF curves was 1.35 (0.99-1.85), log-rank P=0.056. There were no statistically significant differences in the rates of re-treatment, cord compression or pathological fracture by arm

  12. Low Interrater Reliability in Grading of Rectal Bleeding Using National Cancer Institute Common Toxicity Criteria and Radiation Therapy Oncology Group Toxicity Scales: A Survey of Radiation Oncologists

    International Nuclear Information System (INIS)

    Purpose: To measure concordance among genitourinary radiation oncologists in using the National Cancer Institute Common Toxicity Criteria (NCI CTC) and Radiation Therapy Oncology Group (RTOG) grading scales to grade rectal bleeding. Methods and Materials: From June 2013 to January 2014, a Web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes in which patients received radiation therapy and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participants were also asked whether they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1-2 vs high grades 3-4) was also assessed, using the κ statistic for multiple respondents. Results: Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC 0.52, 95% confidence interval [CI] 0.47-0.58) when using NCI CTC and fair using the RTOG scale (ICC 0.28, 95% CI 0.20-0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (P<.0001). Using the dichotomous scale, we observed moderate agreement (κ = 0.42, 95% CI 0.40-0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (κ = 0.19, 95% CI 0.17-0.21). Conclusion: Low interrater reliability was observed among radiation oncologists grading rectal bleeding using 2 common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability and avoid ambiguity in both

  13. Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

    Energy Technology Data Exchange (ETDEWEB)

    Gondi, Vinai, E-mail: vgondi@chicagocancer.org [Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Bruner, Deborah W. [Nell Hodgson Woodfull School of Nursing, Emory University, Atlanta, Georgia (United States); Meyers, Christina A. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wolfson, Aaron [University of Miami School of Medicine, Miami, Florida (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Sun, Alexander Y. [Princess Margaret Hospital, Toronto, ON (Canada); Choy, Hak [University of Texas Southwestern Moncreif Cancer Center, Fort Worth, Texas (United States); Movsas, Benjamin [Henry Ford Health System, Detroit, Michigan (United States)

    2013-07-15

    Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum.

  14. A Phase II Comparative Study of Gross Tumor Volume Definition With or Without PET/CT Fusion in Dosimetric Planning for Non–Small-Cell Lung Cancer (NSCLC): Primary Analysis of Radiation Therapy Oncology Group (RTOG) 0515

    International Nuclear Information System (INIS)

    Background: Radiation Therapy Oncology Group (RTOG) 0515 is a Phase II prospective trial designed to quantify the impact of positron emission tomography (PET)/computed tomography (CT) compared with CT alone on radiation treatment plans (RTPs) and to determine the rate of elective nodal failure for PET/CT-derived volumes. Methods: Each enrolled patient underwent definitive radiation therapy for non–small-cell lung cancer (≥60 Gy) and had two RTP datasets generated: gross tumor volume (GTV) derived with CT alone and with PET/CT. Patients received treatment using the PET/CT-derived plan. The primary end point, the impact of PET/CT fusion on treatment plans was measured by differences of the following variables for each patient: GTV, number of involved nodes, nodal station, mean lung dose (MLD), volume of lung exceeding 20 Gy (V20), and mean esophageal dose (MED). Regional failure rate was a secondary end point. The nonparametric Wilcoxon matched-pairs signed-ranks test was used with Bonferroni adjustment for an overall significance level of 0.05. Results: RTOG 0515 accrued 52 patients, 47 of whom are evaluable. The follow-up time for all patients is 12.9 months (2.7–22.2). Tumor staging was as follows: II = 6%; IIIA = 40%; and IIIB = 54%. The GTV was statistically significantly smaller for PET/CT-derived volumes (98.7 vs. 86.2 mL; p < 0.0001). MLDs for PET/CT plans were slightly lower (19 vs. 17.8 Gy; p = 0.06). There was no significant difference in the number of involved nodes (2.1 vs. 2.4), V20 (32% vs. 30.8%), or MED (28.7 vs. 27.1 Gy). Nodal contours were altered by PET/CT for 51% of patients. One patient (2%) has developed an elective nodal failure. Conclusions: PET/CT-derived tumor volumes were smaller than those derived by CT alone. PET/CT changed nodal GTV contours in 51% of patients. The elective nodal failure rate for GTVs derived by PET/CT is quite low, supporting the RTOG standard of limiting the target volume to the primary tumor and involved nodes.

  15. Higher Biologically Effective Dose of Radiotherapy Is Associated With Improved Outcomes for Locally Advanced Non–Small Cell Lung Carcinoma Treated With Chemoradiation: An Analysis of the Radiation Therapy Oncology Group

    International Nuclear Information System (INIS)

    Purpose: Patients treated with chemoradiotherapy for locally advanced non–small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity. Methods and Materials: This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA-NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10, and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with chi-squared statistics, and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray’s proportional hazard models were used for OS and LRF, respectively, to test the associations between BED and tBED adjusted for other covariates. Results: A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%, respectively. The 2-year and 5-year LRF rates were 46% and 52%, respectively. The BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p < 0.0001). A 1-Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival; this is another way of expressing the finding that the pool-adjusted hazard ratio for survival as a function of BED was 0.96. Similarly, a 1-Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control; this is another way of expressing the finding that the pool-adjusted hazard ratio as a function of tBED was 0.97. Conclusions: Higher radiotherapy dose intensity is associated with improved local-regional control

  16. Low Interrater Reliability in Grading of Rectal Bleeding Using National Cancer Institute Common Toxicity Criteria and Radiation Therapy Oncology Group Toxicity Scales: A Survey of Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Huynh-Le, Minh-Phuong [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Zhang, Zhe [Department of Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Tran, Phuoc T.; DeWeese, Theodore L. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Song, Daniel Y., E-mail: dsong2@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

    2014-12-01

    Purpose: To measure concordance among genitourinary radiation oncologists in using the National Cancer Institute Common Toxicity Criteria (NCI CTC) and Radiation Therapy Oncology Group (RTOG) grading scales to grade rectal bleeding. Methods and Materials: From June 2013 to January 2014, a Web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes in which patients received radiation therapy and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participants were also asked whether they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1-2 vs high grades 3-4) was also assessed, using the κ statistic for multiple respondents. Results: Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC 0.52, 95% confidence interval [CI] 0.47-0.58) when using NCI CTC and fair using the RTOG scale (ICC 0.28, 95% CI 0.20-0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (P<.0001). Using the dichotomous scale, we observed moderate agreement (κ = 0.42, 95% CI 0.40-0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (κ = 0.19, 95% CI 0.17-0.21). Conclusion: Low interrater reliability was observed among radiation oncologists grading rectal bleeding using 2 common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability and avoid ambiguity in both

  17. A Phase II Comparative Study of Gross Tumor Volume Definition With or Without PET/CT Fusion in Dosimetric Planning for Non-Small-Cell Lung Cancer (NSCLC): Primary Analysis of Radiation Therapy Oncology Group (RTOG) 0515

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Jeffrey, E-mail: jbradley@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Bae, Kyounghwa [Department of Statistics, RTOG, Philadelphia, PA (United States); Choi, Noah [Massachusetts General Hospital, Boston, MA (United States); Forster, Ken [H. Lee Moffitt Cancer Center, Tampa, FL (United States); Siegel, Barry A. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Brunetti, Jacqueline [Holy Name Medical Center, Teaneck, NJ (United States); Purdy, James [University of California at Davis, Davis, CA (United States); Faria, Sergio [McGill University, Montreal (Canada); Vu, Toni [Centre Hospitalier Universitaire de Montreal, Hospital Notre Dame, Montreal (Canada); Thorstad, Wade [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Choy, Hak [University of Texas Southwestern, Dallas, TX (United States)

    2012-01-01

    Background: Radiation Therapy Oncology Group (RTOG) 0515 is a Phase II prospective trial designed to quantify the impact of positron emission tomography (PET)/computed tomography (CT) compared with CT alone on radiation treatment plans (RTPs) and to determine the rate of elective nodal failure for PET/CT-derived volumes. Methods: Each enrolled patient underwent definitive radiation therapy for non-small-cell lung cancer ({>=}60 Gy) and had two RTP datasets generated: gross tumor volume (GTV) derived with CT alone and with PET/CT. Patients received treatment using the PET/CT-derived plan. The primary end point, the impact of PET/CT fusion on treatment plans was measured by differences of the following variables for each patient: GTV, number of involved nodes, nodal station, mean lung dose (MLD), volume of lung exceeding 20 Gy (V20), and mean esophageal dose (MED). Regional failure rate was a secondary end point. The nonparametric Wilcoxon matched-pairs signed-ranks test was used with Bonferroni adjustment for an overall significance level of 0.05. Results: RTOG 0515 accrued 52 patients, 47 of whom are evaluable. The follow-up time for all patients is 12.9 months (2.7-22.2). Tumor staging was as follows: II = 6%; IIIA = 40%; and IIIB = 54%. The GTV was statistically significantly smaller for PET/CT-derived volumes (98.7 vs. 86.2 mL; p < 0.0001). MLDs for PET/CT plans were slightly lower (19 vs. 17.8 Gy; p = 0.06). There was no significant difference in the number of involved nodes (2.1 vs. 2.4), V20 (32% vs. 30.8%), or MED (28.7 vs. 27.1 Gy). Nodal contours were altered by PET/CT for 51% of patients. One patient (2%) has developed an elective nodal failure. Conclusions: PET/CT-derived tumor volumes were smaller than those derived by CT alone. PET/CT changed nodal GTV contours in 51% of patients. The elective nodal failure rate for GTVs derived by PET/CT is quite low, supporting the RTOG standard of limiting the target volume to the primary tumor and involved nodes.

  18. Importance of Introducing Simple Drama Games to Kindergarten Children of the First Age Group

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    Šinko Sabina

    2013-04-01

    Full Text Available This article discusses the importance of introducing simple drama games to kindergarten children of the first age group. Based on the knowledge and experience of experts from countries where such games are played and used in kindergartens on a daily basis, we can clearly talk about a positive impact they have on child's cognitive, emotional, social, and motor development. As examples of good practice, we showcase the findings of theses by students of Preschool Education at the Faculty of Education in Maribor.

  19. Hodgkin's Lymphoma in Children and Adolescents: A Saint Petersburg Hodgkin's Lymphoma Group Study

    OpenAIRE

    Kulyova, Svetlana A.; Kolygin, Boris A.

    2011-01-01

    Purpose. Prospective analysis of the efficacy of the original protocol SPbHL-05 was performed. Patients and Methods. Sixty patients with Hodgkin's lymphoma (HL) aged less than 18 years old were treated in accordance with SPbHL-05 from January 2000, to July 2009. In induction chemotherapy we used VBVP and ABVD schedules followed by involved-field radiotherapy. Fourteen patients (23,3%) with 0–2 adverse factors (the favourable group) received two cycles of chemotherapy (VBVP), 25 children (41,7...

  20. Mathematical oncology 2013

    CERN Document Server

    Gandolfi, Alberto

    2014-01-01

    With chapters on free boundaries, constitutive equations, stochastic dynamics, nonlinear diffusion–consumption, structured populations, and applications of optimal control theory, this volume presents the most significant recent results in the field of mathematical oncology. It highlights the work of world-class research teams, and explores how different researchers approach the same problem in various ways. Tumors are complex entities that present numerous challenges to the mathematical modeler. First and foremost, they grow. Thus their spatial mean field description involves a free boundary problem. Second, their interiors should be modeled as nontrivial porous media using constitutive equations. Third, at the end of anti-cancer therapy, a small number of malignant cells remain, making the post-treatment dynamics inherently stochastic. Fourth, the growth parameters of macroscopic tumors are non-constant, as are the parameters of anti-tumor therapies. Changes in these parameters may induce phenomena that a...

  1. Pediatric oncologic emergencies

    International Nuclear Information System (INIS)

    Oncologic emergencies arise in three ways: disease or therapy induced cytopenias; a space occupying lesion causing pressure on or obstruction of surrounding tissues; or leukemia or tumors creating life-threatening metabolic or hormonal problems. Knowledge of presenting signs and symptoms of these emergencies are essential in pediatric oncologic nursing. Neutropenia opens the door for all manner of infections, but the most life threatening is septicemia progressing to shock. A variety of organisms can cause septic shock in the neutropenic patient, but episodes are most often due to gram-negative organisms and the endotoxins they release. Shock, while still compensated, may present with a elevated or subnormal temperature, flushed, warm, dry skin, widening pulse pressure, tachycardia, tachypnoea and irritability, but without medical intervention will progress to hypo tension, cool, clammy extremities, decreased urinary out- put, and eventually to bradycardia and cardiogenic shock. Another emergency in the cytopenia category is bleeding as a result of thrombocytopenia. Of greatest concern is intracranial hemorrhage that may occur at platelet counts of less than 5,000/mm3. Space-occupying lesions of the chest may produce superior vena cava syndrome (SVGS), pleural and pericardial effusions, and cardiac tamponade. SVGS is most often caused by non-Hodgkin's lymphoma (NHL) and presents as cough, hoarseness, dyspnea, orthopnea and chest pain. Signs include swelling, plethora, cyanosis, edema of conjunctiva and wheezing. Pleural and pericardial effusions present with respiratory or cardiac distress as does cardiac tamponade. Abdominal emergencies arise because of inflammation, mechanical obstruction, hemorrhage (often from steroid induced ulcers), and perforation. Pain is the most common presenting symptom, although vital sign alterations, fever, blood in vomitus or stool, abdominal distension and cessation of flatus are also important components of the acute abdomen

  2. Sounding Bridges – An Intergenerational Music Therapy Group With Persons With Dementia and Children and Adolescents in Psychiatric Care

    OpenAIRE

    Cornelia Hessenberg; Wolfgang Schmid

    2013-01-01

    In this article an intergenerational music therapy group including persons with dementia and children and adolescents in psychiatric care will be introduced. The special feature of this group is that people with dementia and children and adolescents in psychiatric care come together to make music. Young and old participants share important life issues such as the experience of a stigmatizing illness, or not being able to live in their familiar environment any more. The promotion of social ski...

  3. A cross-sectional study of food group intake and C-reactive protein among children

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    Moore Lynn L

    2009-10-01

    Full Text Available Abstract Background C-reactive protein (CRP, a marker of sub-clinical inflammation, is a predictor of future cardiovascular diseases. Dietary habits affect serum CRP level however the relationship between consumption of individual food groups and CRP levels has not been established. Methods This study was designed to explore the relation between food intake and CRP levels in children using data from the cross-sectional 1999-2002 National Health and Nutrition Examination Surveys. CRP level was classified as low, average or high (3.0 mg/L, respectively. Adjusted mean daily intakes of dairy, grains, fruit, vegetables, and meat/other proteins in each CRP category were estimated using multivariate analysis of covariance modeling. The effect modification by age (5-11 years vs. 12-16 years, gender and race/ethnicity was explored. We examined whether total or central body fat (using BMI Z-scores and waist circumference explained any of the observed associations. Results A total of 4,010 children and adolescents had complete information on diet, CRP and all covariates of interest and were included in the analyses. Individuals with high CRP levels had significantly lower intake of grains (p Conclusion Children and adolescents with higher CRP levels had significantly lower intakes of grains and vegetables. The associations between selected childhood dietary patterns and CRP levels seem largely mediated through effects on body composition.

  4. International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

    Energy Technology Data Exchange (ETDEWEB)

    Mayr, Nina A., E-mail: ninamayr@uw.edu [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Hu, Kenneth S. [Department of Radiation Oncology, Beth Israel Medical Center, New York, New York (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Wall, Terry J. [St. Luke' s Cancer Institute, Kansas City, Missouri (United States); Amendola, Beatriz E. [Innovative Cancer Institute, Miami, Florida (United States); Calaguas, Miriam J. [Department of Radiation Oncology, St. Luke' s Medical Center, Quezon City (Philippines); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Yue, Ning J. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Rengan, Ramesh [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Williams, Timothy R. [Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, Florida (United States)

    2014-07-01

    In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups.

  5. International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

    International Nuclear Information System (INIS)

    In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups

  6. Pulmonary Functions in Normal School Children in the Age Group of 6-15 Years in North India

    OpenAIRE

    Dhooria, Gurdeep S.; Puneet A. Pooni; Daljit Singh; Sandeep Budhiraja

    2010-01-01

    Objective:Lung function tests have become an integral part of assessment of pulmonary disease. As few studies on pulmonary function tests have been carried out in young children in India, the study was carried out in normal urban and rural school children in Ludhiana district of North India to determine pulmonary functions in the age group 6-15 years and to find its correlation with regards to age, sex, height and weight. Methods:The study group included 600 normal children between 6-15 years...

  7. Nutritional Status of a Group of Children Under Five Suffering from Malaria in a Timor Leste District

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    Anagalys Ortega Alvelay

    2011-03-01

    Full Text Available Background: Malaria is a health problem in underdeveloped countries. The child population is particularly vulnerable. Objective: to determine the nutritional status of children under five suffering from malaria who attended a clinic in Timor Leste. Method: a descriptive, correlational study was conducted. The sample consisted of 435 children under five years old, diagnosed with malaria, who attended consultation from June 2008 to July 2009. Nutritional status was evaluated. A medical history demographic, socioeconomic and Plasmodium type data was obtained. Results: 254 children (58.4% were in the group from 2 to 4 years old. Most children (415, 95.4% had no toilet or piped water in their homes. The average number of people living in the house is 8.3; 5.6 per room. Females were predominant with 50.3%, as well as rural children 402 (92.4%. Most children (84.6% are undernourished. Statistical relationship was found between nutritional status and age (X2 = 7.44, df = 1, p = 0.01 and nutritional status and sex (X2 = 14.37, df = 1, p = 0, 01. A higher frequency of moderate malnutrition was observed in children with malaria (41; 61.2%. Plasmodium vivax was highly frequent, being present in 299 children (68.7%. Conclusion: children from 0 to 1 year of age are 2 to 4 times more likely to experience malnutrition. Females are between 2 and 5 times more likely to be undernourished than other children with malaria.

  8. Exercise Promotion in Geriatric Oncology.

    Science.gov (United States)

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals. PMID:27484061

  9. Radiation oncology physics: A handbook for teachers and students

    International Nuclear Information System (INIS)

    Radiotherapy, also referred to as radiation therapy, radiation oncology or therapeutic radiology, is one of the three principal modalities used in the treatment of malignant disease (cancer), the other two being surgery and chemotherapy. In contrast to other medical specialties that rely mainly on the clinical knowledge and experience of medical specialists, radiotherapy, with its use of ionizing radiation in the treatment of cancer, relies heavily on modern technology and the collaborative efforts of several professionals whose coordinated team approach greatly influences the outcome of the treatment. The radiotherapy team consists of radiation oncologists, medical physicists, dosimetrists and radiation therapy technologists: all professionals characterized by widely differing educational backgrounds and one common link - the need to understand the basic elements of radiation physics, and the interaction of ionizing radiation with human tissue in particular. This specialized area of physics is referred to as radiation oncology physics, and proficiency in this branch of physics is an absolute necessity for anyone who aspires to achieve excellence in any of the four professions constituting the radiotherapy team. Current advances in radiation oncology are driven mainly by technological development of equipment for radiotherapy procedures and imaging; however, as in the past, these advances rely heavily on the underlying physics. This book is dedicated to students and teachers involved in programmes that train professionals for work in radiation oncology. It provides a compilation of facts on the physics as applied to radiation oncology and as such will be useful to graduate students and residents in medical physics programmes, to residents in radiation oncology, and to students in dosimetry and radiotherapy technology programmes. The level of understanding of the material covered will, of course, be different for the various student groups; however, the basic

  10. Topics in clinical oncology. 15

    International Nuclear Information System (INIS)

    The monograph comprising primarily papers on topical subjects of oncology and cancer research, contains also a selection of papers presented at the 2. Congress of the Czechoslovak Society of Nuclear Medicine and Radiation Hygiene. Seven papers were selected on behalf of their subject related to clinical oncology. All of them were iputted in INIS; five of them deal with the scintiscanning of the skeleton of cancer patients, one with radioimmunodetection of tumors, and one with radionuclide lymphography. (A.K.)

  11. Radiation Oncology reviewer acknowledgement 2015

    International Nuclear Information System (INIS)

    The editorial team of Radiation Oncology would like to thank all our reviewers who have contributed to the journal in 2015. Without the participation of skilful reviewers, no academic journal could succeed, and we are grateful to the committed individuals who have given their time and expertise to the peer review of manuscripts for Radiation Oncology. We look forward to your continued support in 2016

  12. Moderating effects of group status, cohesion, and ethnic composition on socialization of aggression in children's peer groups.

    Science.gov (United States)

    Shi, Bing; Xie, Hongling

    2014-09-01

    We explored the effects of 3 group features (i.e., status, cohesion, and ethnic composition) on socialization processes of aggression in early adolescents' natural peer social groups. Gender differences in these effects were also determined. A total of 245 seventh-grade individuals belonging to 65 peer groups were included in the analyses. All 3 group features moderated the strength of group socialization on physical aggression with the exception of group status on girls' physical aggression. Stronger socialization of physical aggression occurred in higher status, more cohesive, or ethnically more homogeneous groups. In contrast, only group cohesion moderated the strength of group socialization on social aggression among girls. These findings suggest that somewhat different processes may be involved in peer group influences on different forms of aggression. Future intervention and prevention efforts for adolescent aggression should consider peer group membership and group features simultaneously. PMID:25046125

  13. Quality-adjusted survival analysis of malignant glioma. Patients treated with twice-daily radiation (RT) and carmustine: a report of radiation therapy oncology group (RTOG) 83-02

    International Nuclear Information System (INIS)

    Purpose: To quantify the quality of life of malignant glioma patients treated on a randomized Phase I/II trial of twice-daily radiation therapy (RT) and carmustine, using a modified quality adjusted survival (QAS) model, and to compare the QAS among assigned treatment arms. Materials and Methods: The Radiation Therapy Oncology Group (RTOG) accrued 786 malignant glioma patients to a Phase I/II randomized dose escalation trial of twice-daily RT with carmustine from 1983 to 1989. Patients were randomized to one of four arms of hyperfractionated RT in 1.2 Gy twice daily (BID) fractions (64.8 Gy, 72.0 Gy, 76.8 Gy, or 81.6 Gy) or to either of two accelerated hyperfractionated RT arms in 1.6 Gy BID fractions (48.0 or 54.4 Gy). Although preliminary toxicity and survival data have been published, little information is available regarding the quality of these patients' lives during and following such therapy. QAS is a refinement of the methodology for assessing survival quality among breast cancer patients receiving adjuvant chemotherapy. The QAS method allows for inclusion of both improvement and decline in neurologic functional status. Patients were scored by the presence or absence of 15 neurologic signs and symptoms at on-study and at every follow-up. Within each category were gradations of severity, with the quality survival time (Q-TIME) adjusted according to any changes in these neurologic findings. The summation of all changes in signs and symptoms were weighted by 1/15th and incorporated into the QAS model as QAS = Q-TIME - TOX - RRX. TOX was the time spent with treatment-related toxicities, and RRX was the time spent in recovery from subsequent therapy. Results: Of 747 evaluable patients, the average QAS time was 18.5 months. The average QAS for the hyperfractionated arms of 64.8 Gy, 72.0 Gy, 76.8 Gy, and 81.6 Gy were 15.6, 20.8, 10.0, and 13.7 months, respectively. For the accelerated hyperfractionated RT arms of 48.0 and 54.4 Gy, the average QAS times were 13

  14. JUSTIFICATION OF THE EXISTENCE OF PREPARATORY GROUPS IN SPECIAL SCOOLS FOR CHILDREN LIGHTLY HANDICAPPED

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    Aneta ANDONAKIS

    1997-03-01

    Full Text Available Researches about child’s intellectual development in the psychology has started in the 19th century and the first step has been made by Tiedemann in “ Observation of the development of the mental abilities of the children”. His work caused a great interest in the circles of doctors and psychologists. Their interpretation of intelligence was different, but the most acceptable is the performance of complicated activities for getting knowledge and skills and getting over the obstacles in the development of the person”.The social ability do not correspond with the intelligence. The two aspects are tested and a complete picture of their functioning can be seen. The developmental principle is determined from general to the separate as functionally connected.In the period when a child does not accept the higher level of intelligence and thinking , in relation to which are effectuated by sense-motor activities, than we say that a child is mentally handicapped. The widest approach of the educational system should be treated as a functional, institutional and organizational, that takes part in the realization of the social aims and tasks.Not getting into viewing of the curriculum's and programs for preparatory groups in the preeducational period, we may say that the justification for the existence of these group in the regular schools, is maturation of the perceptive motor coordination and learning. With the maturing the function of the "ego" is increasing.As a child adapts better he can learn better, and the maturity comes sooner. In this way these groups are justified.Mentally handicapped child has not the opportunity to attend an organized prepared education which provides:-forming of the speech, self-control, which can be achieved in the process of learning through a direct contact with other children;· regulation of the lateralization through re-education of the psycho-motor abilities, and in general neuro-motor experienced maturation

  15. The effective comparison between emotion-focused cognitive behavioral group therapy and cognitive behavioral group therapy in children with separation anxiety disorder

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    Afrooz Afshari

    2014-01-01

    Full Text Available Background: Emotion-focused cognitive behavioral therapy (ECBT is a new form of CBT with emotion regulation components. This form of treatment is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious children. This study observed and compared the effectiveness of CBT and ECBT on anxiety symptoms; sadness and anger management; and cognitive emotion regulation strategies in children with separation anxiety disorder (SAD. Materials and Methods: This study is a randomized clinical trial. Subjects were 30 children from 9 to 13-years-old (15 girls and 15 boys with diagnosis of SAD, being randomly assigned to CBT, ECBT, and control groups (five girls and five boys in each group. Subject children in CBT group participated in 10-h weekly sessions within Coping Cat manual; whereas, subject children in ECBT group contributed in 12-h weekly sessions within ECBT. The control group received no treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED; child and parent forms, Children′s Emotion Management Scale (CEMS; anger and sadness forms, and Cognitive Emotion Regulation Questionnaire (CERQ tests administered to all subjects in pretest, posttest, and the follow-up measurement (3 months later. Analysis of covariance (ANCOVA repeated measure and Kruskal-Wallis were applied to analyze data by Statistical Package for Social Sciences (SPSS software package (v. 20. Results: CBT and ECBT; demonstrated no significant difference in reducing separation anxiety and total anxiety symptoms from parent and children′s reports. ECBT effectively increased anger coping and decreased negative cognitive strategies and dysregulation of anger in children, both in posttest and follow-up. Also, ECBT reduced sadness dysregulation and increased sadness coping, though these significant advantages were lost in 3 months later follow-up. CBT reduced negative cognitive strategies in follow-up and increased sadness coping

  16. A POPULATION BASED STUDY OF REFRACTIVE ERRORS IN CHILDREN AMONG AGE GROUP OF 7-15 YEARS

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    Dhanya

    2016-03-01

    Full Text Available INTRODUCTION Refractive error is the most common cause of visual impairment around the world and the second leading cause of treatable blindness. Very early detection and treatment of visual impairment in children results in a reduction in the number of school children with poor sight being uncorrected. AIM To study the prevalence of uncorrected refractive errors among children of 7-15 years of age group. MATERIALS AND METHODS A total of 958 children of age group 7-15 years were examined during a time period of 1 year from June 2014 to May 2015. The examination included visual acuity, slit lamp examination, auto refractometer, keratometry, A-Scan Biometry and fundoscopic examination. Patients were then taken to assess the refractive error under the cycloplegic effect of 1% homatropine by streak retinoscopy. Hyperopia was defined as spherical power of >+2.00 D, Myopia as -0.50 D. RESULTS Visual impairment (VA of 6/12 or worse in better eye was present in 8.14% of the children examined. The prevalence of myopia, hypermetropia and astigmatism was 4.70%, 1.24%, 2.2% respectively, Myopia was commonly seen in older age group children. CONCLUSION Refractive error was the main cause of visual impairment in children between 7-15 years. Myopia was the most common refractive error particularly in older children. Uncorrected refractive errors among children have a considerable impact on learning and their academic achievement. Diagnosis and correction of refractive error is the most effective form of eye care. As it is an easily treatable cause of visual impairment, effective strategies should be developed to eliminate refractive error in children.

  17. Micronutrients in Oncological Intervention

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    Uwe Gröber

    2016-03-01

    Full Text Available Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%–90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that treatment is tolerated better—with an increase in patient compliance and a lower rate of treatment discontinuations—when micronutrients, such as selenium, are added as appropriate to the patient’s medication. Nutritional supplementation tailored to an individual’s background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician.

  18. Tyrosine kinome sequencing of pediatric acute lymphoblastic leukemia: a report from the Children's Oncology Group TARGET Project | Office of Cancer Genomics

    Science.gov (United States)

    TARGET researchers sequenced the tyrosine kinome and downstream signaling genes in 45 high-risk pediatric ALL cases with activated kinase signaling, including Ph-like ALL, to establish the incidence of tyrosine kinase mutations in this cohort. The study confirmed previously identified somatic mutations in JAK and FLT3, but did not find novel alterations in any additional tyrosine kinases or downstream genes. The mechanism of kinase signaling activation in this high-risk subgroup of pediatric ALL remains largely unknown.

  19. Primary Children's Management of Themselves and Others in Collaborative Group Work: "Sometimes It Takes Patience…"

    Science.gov (United States)

    Kershner, Ruth; Warwick, Paul; Mercer, Neil; Kleine Staarman, Judith

    2014-01-01

    We focus on children's approaches to managing group work in classrooms where collaborative learning principles are explicit. Small groups of 8-10 year olds worked on collaborative science activities using an interactive whiteboard. Insubsequent interviews, they spoke of learning to "be patient" and "wait", for multiple…

  20. Garden Counseling Groups and Self-Esteem: A Mixed Methods Study with Children with Emotional and Behavioral Problems

    Science.gov (United States)

    Swank, Jacqueline M.; Shin, Sang Min

    2015-01-01

    This research study focused on the use of a garden group counseling intervention to address the self-esteem of children with emotional and behavioral problems. The researchers found higher self-esteem among participants (N = 31) following the gardening group. Additionally, participants discussed feeling calm and happy and learning to working…

  1. Group Music Intervention Reduces Aggression and Improves Self-Esteem in Children with Highly Aggressive Behavior: A Pilot Controlled Trial

    Directory of Open Access Journals (Sweden)

    Ae-Na Choi

    2010-01-01

    Full Text Available We investigated the effects of group music intervention on aggression and self-esteem in children with highly aggressive behavior. Forty-eight children were allocated to either a music intervention group or an untreated control group. The music intervention group received 50 min of music intervention twice weekly for 15 consecutive weeks. The outcome measures were Child Behavior Checklist Aggression Problems Scale (Parents, Child Aggression Assessment Inventory (Teachers and Rosenberg Self-esteem Scale. After 15 weeks, the music intervention group showed significant reduction of aggression and improvement of self-esteem compared with the control group. All outcome measures were significantly lower in the music intervention group than prior to treatment, while there was no change in the control group. These findings suggest that music can reduce aggressive behavior and improve self-esteem in children with highly aggressive behavior. Music intervention is an easily accessible therapy for children and as such may be an effective intervention for aggressive behavior. Further more, objective and replicable measures are required from a randomized controlled trial with a larger sample size and active comparable control.

  2. EVALUATION OF THE PSYCHO-EMOTIONAL FACTOR IN A GROUP OF CHILDREN WITH AUDITIVE DISABILITIES

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    Carmen SAVIN

    2013-12-01

    Full Text Available Introduction. Approaching of patients with general and, mainly, auditive disabilities requires specific methods of behavioural and therapeutical management, on short-, medium- and long-term period. Scope. Quantification of the psycho-emotional reactions of childern suffering from auditive disabilities in the stomatological office, compara‑ tively with those with normal keenness of hearing. Mate‑ rials and method. The experiments were performed on a group of 207 children, with the limit of chronological age between 6 - 11 years, 120 of them registered with auditive disabilities and 87 – with normal keeness of hearing. The Raven Test of Progressive Matrices and the questionnaire were employed as investigation methods. Results. The mean age of the subjects considered in the study was of 9 years, with a standard deviation of 1.4. A statistically sig‑ nificant association was established between the moment of their addressing the stomatologist and the presence of the auditive-type disability (r=0.87, p=0.00321, 95%CI. Most of the children (69% with normal keenness of hea‑ ring come to the stomatological office alone, only rarely being accompanied by friends or parents, whereas those with sensorial auditive disabilities are usually accompa‑ nied by parents, professors or educators (67.5%. Discus‑ sion. Explanations on the stomatological treatment to be applied, details on its stages may prepare an adequate reaction from the part of the child-patient. The statistically significant differences observed, as a function of their audi‑ tive disabilities, among the accompanied children may be explained exactly by this situation, causing in itself a higher dependence and need of support from the part of the others, especially for exceeding the barriers that may prevent a normal communication. Conclusions. An adequate approaching of the child – affected or not with auditive disabilities – may model his attitudes and beha‑ viour during the

  3. Relative position of the mandibular foramen in different age groups of children: A radiographic study

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    Poonacha K

    2010-09-01

    Full Text Available Objectives: To assess the relative position of the mandibular foramen (MF and to evaluate the measurement of gonial angle (GoA and its relationship with distances between different mandibular borders in growing children between 3 and 13years of dental age. Materials and methods: The radiographs were traced to arrive at six linear and two angular measurements from which the relative position of the MF was assessed and compared in different age groups to determine the growth pattern of the mandible and changes in the location of the MF. Results: The distances between the MF and the anterior plane of the ramus were greater than that between MF and posterior plane of the ramus through all stages. There was a maximum increase in the vertical dimensions of the mandible compared with the horizontal dimensions, particularly in the late mixed dentition period. Conclusion: The mandible and its growth did not alter the position of the MF, both vertically and horizontally, in relation to different landmarks, and more obtuse GoA indicated an increased growth potential of the mandible. This has major implications in the inferior alveolar nerve block technique when used in children.

  4. Pulmonary valve balloon valvuloplasty compared across three age groups of children

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    Ghaffari S

    2012-05-01

    Full Text Available Shamsi Ghaffari,1 Mohammed Reza Ghaffari,2 Ali Reza Ghaffari,3 Somaie Sagafy11Department of Pediatric Cardiology, Cardiovascular Research Center, 2Department of Tuberculosis and Lung Research, 3Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, IranAbstract: The aim of this study was to investigate the characteristics and outcomes of treating pulmonary stenosis with percutaneous valvuloplasty, and to compare them among three childhood age groups. All children under 15 years of age who had undergone pulmonary valve balloon valvuloplasty in Madani Heart Center from 2005–2009 were enrolled in this study. Data were analyzed using IBM SPSS software (SPSS, Inc, Chicago, IL. Mean (± standard deviation age of patients was 55.5 ± 47.4 months. Two-thirds of the subjects had moderate pulmonary valve stenosis. Balloon valvuloplasty failed in nearly one-fifth of the treated patients. There were 17 failures and two cases of mortality, descriptively less frequent among children >5 years; however, the observed difference was not statistically significant. Mild pulmonary valve insufficiency was a common finding.Keywords: childhood cardiology, pulmonary stenosis, percutaneous valvuloplasty

  5. Frequency of the Group A Beta Hemolytic Streptococcus Infection in Children Presenting with Acute Tonsillopharyngitis

    Directory of Open Access Journals (Sweden)

    Özgül Yiğit

    2009-06-01

    Full Text Available Aim: The aim of this study was to evaluate the frequency of group A beta hemolytic streptococcus (GABHS in children with tonsillopharyngitis and to assess their complaints and clinical findings.Materials and Method: A total of 420 children who presented to our outpatient department with acute tonsillopharyngitis were enrolled to the study. The clinical features of patients with positive throat cultures for GABHS were compared to those with negative culture results. Presence of fever (≥37.50C, axilary, vomiting, coryza, sore throat, cough, abdominal pain, tenderness of cervical lymph nodes, and tonsillopharyngitis were recorded. Results: The mean age of the patients was 6.5±3.4 years (range, 1 to 14 years. The positive throat culture rate for GABHS was 22.62% (95 of 420 patients. It was found that fever, sore throat, cough, abdominal pain and tender cervical lymph nodes were significantly more frequent in patients with positive throat culture for GABHS than those with negative result for GABHS.Conclusion: GABHS should be firstly considered in patients presenting with symptoms of fever, sore throat, cough, abdominal pain and tenderness of cervical lymph nodes. (Journal of Current Pediatrics 2009; 7: 13-7

  6. Racist victimization among children in The Netherlands: the effect of ethnic group and school

    OpenAIRE

    Verkuyten, Maykel; Thijs, Jochem

    2003-01-01

    Using data from a nation-wide study, this article examines the extent of racist victimization among Dutch, Turkish, Moroccan and Surinamese children (10-13 years) in The Netherlands. The responses indicate that ethnic minority children are more often victim of racist name-calling and social exclusion than are Dutch children. Furthermore, Turkish children are more likely to face racism than Surinamese and Moroccan children. Using multilevel analysis, the effects of multicultural education and ...

  7. Injury Rates in Shotokan Karate in Children and Adolescent Age Groups

    Directory of Open Access Journals (Sweden)

    AA Lashgari

    2003-07-01

    Full Text Available This study is designed to determine the injury rate in Iranian Shotokan karate championships in children and adolescent age groups. All of the injuries were recorded in national competition in 2004. Details of ages, weight, year of karate experience and kind and location of injuries were obtained. Thirty injuries were recorded in this competition. The overall rate of injury was 0.25 per bout and 0.29 per competitor. Fourteen (43.7% injuries were to the limbs, 31.3% to the head and neck and 25% to the trunk. Only four competitors were unable to continue fighting as a result of their injuries, one of them due to fracture.

  8. The integration of research and care in pediatric oncology: implications for review and consent

    OpenAIRE

    Dekking, S.A.S.

    2016-01-01

    The large majority of children with cancer participate in medical research. This varies from observational studies, to laboratory research on different types of tissue, to drug research, to supportive care studies. As such, pediatric oncology is a field where treatments are often provided in the research context, thereby integrating research with care. This thesis evaluates the challenges and advantages that come with the integration of research and care in pediatric oncology. The first part ...

  9. Moderating Effects of Group Status, Cohesion, and Ethnic Composition on Socialization of Aggression in Children's Peer Groups

    Science.gov (United States)

    Shi, Bing; Xie, Hongling

    2014-01-01

    We explored the effects of 3 group features (i.e., status, cohesion, and ethnic composition) on socialization processes of aggression in early adolescents' natural peer social groups. Gender differences in these effects were also determined. A total of 245 seventh-grade individuals belonging to 65 peer groups were included in the analyses.…

  10. Adenoid and tonsil surgeries in children: How relevant is pre-operative blood grouping and cross-matching?

    OpenAIRE

    Lucky Onotai; Opubo da Lilly-Tariah

    2013-01-01

    Background: As a part of pre-operative evaluation, several otolaryngologists group and cross-match blood routinely for children undergoing adenoid and tonsil surgeries. This practice has generated several debates either in support or against this practice. The aim of this study is to critically evaluate the incidence of post-tonsillectomy (with or without adenoidectomy) bleeding and blood transfusions in otherwise healthy children with adenoid/tonsil pathologies conducted in the University of...

  11. Efficacy and Moderators of a Family Group Cognitive-Behavioral Preventive Intervention for Children of Depressed Parents

    OpenAIRE

    Compas, Bruce E.; Forehand, Rex; Thigpen, Jennifer; HARDCASTLE, EMILY; Garai, Emily; McKee, Laura; Keller, Gary; DUNBAR, JENNIFER P.; Watson, Kelly H.; Rakow, Aaron; Bettis, Alexandra; Reising, Michelle; Cole, David; Sterba, Sonya

    2015-01-01

    Building on an earlier study (Compas et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported in a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2-, 6-, 12-, 18- and 24-months after baseline. Significant effects favoring the FGCB intervention over a written information (WI) comparison condition were fo...

  12. Cobalamin and folate deficiencies among children in the age group of 12-59 months in India

    OpenAIRE

    Umesh Kapil; GS Toteja; Ajeet Singh Bhadoria

    2015-01-01

    Background: Anemia is a major public health problem among children under 5 years of age in India. Cobalamin and folate deficiencies play an important role in the etiology of anemia. This study was done to assess the prevalence of cobalamin and folate deficiencies among children in the age group of 12-59 months. Methods: A community-based cross-sectional study was conducted. A total of 470 children were included. Non-fasting venous blood samples were collected from each child for the estima...

  13. Incidence and clinical characteristics of group A rotavirus infections among children admitted to hospital in Kilifi, Kenya.

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    D James Nokes

    2008-07-01

    Full Text Available BACKGROUND: Rotavirus, predominantly of group A, is a major cause of severe diarrhoea worldwide, with the greatest burden falling on young children living in less-developed countries. Vaccines directed against this virus have shown promise in recent trials, and are undergoing effectiveness evaluation in sub-Saharan Africa. In this region limited childhood data are available on the incidence and clinical characteristics of severe group A rotavirus disease. Advocacy for vaccine intervention and interpretation of effectiveness following implementation will benefit from accurate base-line estimates of the incidence and severity of rotavirus paediatric admissions in relevant populations. The study objective was to accurately define the incidence and severity of group A rotavirus disease in a resource-poor setting necessary to make informed decisions on the need for vaccine prevention. METHODS AND FINDINGS: Between 2002 and 2004 we conducted prospective surveillance for group A rotavirus infection at Kilifi District Hospital in coastal Kenya. Children 2% of children are admitted to hospital with group A rotavirus diarrhoea in the first 5 y of life. This translates into over 28,000 vaccine-preventable hospitalisations per year across Kenya, and is likely to be a considerable underestimate. Group A rotavirus diarrhoea is associated with acute life-threatening metabolic derangement in otherwise healthy children. Although mortality is low in this clinical research setting this may not be generally true in African hospitals lacking rapid and appropriate management.

  14. The opinion of clinical staff regarding painfulness of procedures in pediatric hematology-oncology: an Italian survey

    OpenAIRE

    Cesaro Simone; Frigo Anna C; Sainati Laura; Benini Franca; Po' Chiara; Farina Maria I; Agosto Caterina

    2011-01-01

    Abstract Background Beliefs of caregivers about patient's pain have been shown to influence assessment and treatment of children's pain, now considered an essential part of cancer treatment. Painful procedures in hematology-oncology are frequently referred by children as the most painful experiences during illness. Aim of this study was to evaluate professionals' beliefs about painfulness of invasive procedures repeatedly performed in Pediatric Hemato-Oncology Units. Methods Physicians, nurse...

  15. Establishment of the Asia Oncology Nursing Society (AONS

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    Kazuko Onishi

    2014-06-01

    Full Text Available Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS. They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN, the Multinational Association of Supportive Care in Cancer (MASCC and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17 th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

  16. Establishment of the Asia Oncology Nursing Society (AONS

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2014-01-01

    Full Text Available Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS. They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN, the Multinational Association of Supportive Care in Cancer (MASCC and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17 th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

  17. Impact of radiation research on clinical trials in radiation oncology

    International Nuclear Information System (INIS)

    The authors present an outline review of the history of the formation of the cooperative group called International Clinical Trials in Radiation Oncology (ICTRO), and the following areas are briefly discussed together with some projections for the direction of clinical trials in radiation oncology into the 1990s:- radiosensitizers, radioprotectors, and their combination, drug-radiation interactions, dose/time/fractionation, hyperthermia, biological response modifiers and radiolabelled antibodies, high LET, particularly neutron therapy, large field irradiation and interoperative irradiation, research studies on specific sites. (U.K.)

  18. Impact of Hearing Loss on Daily Life Style and Schooling among Children between 5 and 15 Years Age-Group

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    Hiteshree C Patel, Mohua Moitra, Anjali Modi, Jaymin Contractor, S L Kantharia

    2014-01-01

    Full Text Available Background: “Hearing”- one of the five special senses with which a human is gifted. At times, due to variety of reasons, this sense is impaired. Hearing impairment of any degree has a profound effect on children. It delays development of speech, slows educational progress and leads to being stigmatized. Objectives: To document the impact of hearing loss in daily life style and schooling of children between 5 and 15 years age-group. Materials & methods: This was cross- sectional study done in Children between 5 and 15 years age-group with hearing loss, coming to an ENT OPD, New Civil Hospital, Surat during the period of 1st August 2011 to 31 July 2012. Results: A total of 246 children were studied. Mean age of the study population was 9±3.46 years. Most common impactin life of children with hearing loss was that “they were not admitted to school by their parents” (31.3%. Among them, 84.4% had congenital deafness and 15.6% had acquired deafness. This difference was statistically significant. (p= 0.002, x2= 8.63. As per parents’ perception, academic performance of the children was significantly associated with type of school (normal Vs deaf & mute school” (p< 0.001. Conclusion: Most common impact was that “children being not admitted to school” and “children were lagging behind in studies”. Among the congenitally deaf children, the quality of life was significantly better in those who attended these special schools (p<0.001.

  19. The communication, speech and gesture of a group of hearing-impaired children

    OpenAIRE

    Hoskin, J.; Herman, R

    2001-01-01

    The communication skills, speech and gesture of 20 hearing-impaired children were assessed. The children were all being educated in a school using an oral/aural approach. Assessment result comparison indicated the importance of assessing gesture and speech separately for these children and comparing the use of both skills. More informal and formal assessment of gesture and the tools to complete this task effectively are needed to ensure that these children's communication skills are described...

  20. The seroprevalence of Kaposi′s sarcoma associated herpes virus and human herpes virus-6 in pediatric patients with cancer and healthy children in a Turkish pediatric oncology center

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    Nurdan Tacyildiz

    2014-01-01

    Full Text Available Background: Many studies have tried to be establish a pathogenic role for human herpesvirus-6 and -8 (HHV-6, HHV-8 in malignant diseases, but whether these viruses plays a role in these pathologies remains unclear. HHV-6 and HHV-8 seropositivity were shown in a healthy population. There is no published data in Turkey about seroprevalence of these viruses. We aimed to determine the seroprevalence of HHV-6 and HHV-8 in pediatric cancer patients and to compare with healthy Turkish children′s viral seroprevalence. Patients and Methods: Ninety-three pediatric cancer patients and 43 age-matched healthy children were included in the study. All sera were screened for antibodies to HHV-6 and HHV-8 by ELISA. Results: HHV-8 immunoglobulin G (IgG was positive in 3.3% of lymphoma patients, in 4.8% of acute lymphoblastic leukemia (ALL patients, in 4.8% of retinoblastoma patients and in 7% of healthy children. There was no significant difference in HHV-8 seroprevelance between these groups. HHV-6 seroprevalence was 81% in ALL patients, 70% in lymphoma group, 81% in retinoblastoma patients and 69.8% in healthy children. Although there was no significant difference in HHV-6 prevalence between healthy children and pediatric cancer patients, HHV-6 seropositivity tended to be higher in retinoblastoma patients under age of 4 years (odds ratio: 2.925. Conclusion: HHV-6 seroprevalence was higher than HHV-8 seropositivity in our study. Viral studies related HHV-6 seroprevelance in retinoblastoma patients would be useful to clarify if there is any etiological association between HHV-6 and retinoblastoma.

  1. Comprehensive Oncologic Emergencies Research Network (CONCERN)

    Science.gov (United States)

    The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.

  2. 76 FR 61713 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-10-05

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of..., are in late stage development for an adult oncology indication, or in late stage development...

  3. 75 FR 66773 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-10-29

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... were either recently approved by FDA or, are in late stage development for an adult oncology...

  4. 78 FR 63224 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-10-23

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... late stage development for various adult oncology indications. The subcommittee will consider...

  5. 77 FR 57095 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-09-17

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... plans for four products that are in development for an adult oncology indication. The subcommittee...

  6. Evaluation of Banana Hypersensitivity Among a Group of Atopic Egyptian Children: Relation to Parental/Self Reports

    OpenAIRE

    El-Sayed, Zeinab A; El-Ghoneimy, Dalia H.; El-Shennawy, Dina; Nasser, Manar W.

    2013-01-01

    Purpose To evaluate the frequency of banana sensitization and allergy among a group of atopic Egyptian children in relation to parental/self reports. Methods This is a case-control study included 2 groups of allergic children with and without history of banana allergy, each included 40 patients. They were subjected to skin prick test (SPT) using commercial banana allergen extract and prick-prick test (PPT) using raw banana, in addition to measuring the serum banana-specific IgE. Oral banana c...

  7. Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review

    OpenAIRE

    NASEHI, Mohammad Mehdi; SAKHAEI, Roya; Moosazadeh, Mahmood; ALIRAMZANY, Maryam

    2015-01-01

    How to Cite This Article: Nasehi MM, Sakhaei R, Moosazadeh M, Aliramzany M. Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review. Iran J Child Neurol. 2015 Winter;9(1):17-24 .AbstractObjectiveSeveral factors are involved in the etiology of febrile seizure (FS), among themis zinc (Zn), which has been discussed in various studies. The present systematic review compares Zn levels in children with FS and a control group.Materials & ...

  8. Elderly patients with colorectal cancer are oncologically undertreated

    DEFF Research Database (Denmark)

    Bojer, A. S.; Roikjær, Ole

    2015-01-01

    2011 in the Danish Colorectal Cancer Group (DCCG) database. According to age ≤75 and >75 years multivariate logistic regression analysis was used on treatment decisions: surgery, referral to an oncologist and oncologic treatment. Independent variables were age, ASA score, tumorlocation, stage, gender...... odds ratio for referral to an oncologist (OR 0.624, p < 0.0001) and for oncological treatment if referred (OR 0.218, p < 0.0001). Being an elderly patient with stage III or IV CRC OR was 0.233 for referral- and for receiving treatment by an oncologist OR was 0.210 (p < 0.0001 for both), after adjusting...... for possible confounders. Conclusion: Based on age elderly patients are on a lesser extent referred to an oncologist and get oncologic treatment less frequently. Surgically the elderly are not undertreated....

  9. What children know about communication : a language biographical approach of the heterogeneity of plurilingual groups

    NARCIS (Netherlands)

    Le Pichon-Vorstman, E.M.M.

    2010-01-01

    What do children know about communication? In the increasingly globalized world we live in, nowadays children more often come into contact with multiple languages at different ages and in variable contexts. Consequently, children may at times be required to communicate in situations in which they la

  10. Radiotherapy in paediatric oncology

    International Nuclear Information System (INIS)

    Full text: Radiation therapy has always been one of the most powerful tools in the fight against childhood cancer. Since the middle of the last century, we have known that most paediatric tumours are exquisitely sensitive to radiation. The early application of radiotherapy alone led to the first cures of retinoblastoma, Hodgkin lymphoma, as well as certain sarcomas and brain tumours. The generous application of radiation in conjunction with chemotherapy led to further extraordinary increases in survival rates for leukemias, Wilms tumour, sarcomas, and other paediatric malignancies. Over the past 40 years, the overall cure rate for childhood cancer has climbed from 25% to 75% in the USA. With this success, however, came the knowledge that radiation can be associated with significant late effects. We now have a much better understanding of both the benefits and risks of using radiation to treat children as we seek to optimize and refine its role in curative therapy. Leukemias constitute approximately one third of paediatric cancer diagnoses and most of these patients are successfully treated with chemotherapy alone. Central nervous system (CNS) radiation is still recommended for patients at highest risk of CNS failure and total body radiation is useful for the small percentage of patients who require bone marrow transplant. Brain tumours also make up almost one-third of paediatric neoplasms and children with most kinds of brain tumours will require high dose radiotherapy. Many of the other types of paediatric tumours (Wilms, neuroblastoma, sarcomas, etc.) also require radiotherapy as part of curative treatment. There have been considerable advances in radiation technology including three dimensional planning, intensity modulated radiation therapy, and protons. Individual paediatric patients may or may not benefit from advanced technologies based on numerous patient and disease related factors. Examples will be illustrated. We must also be mindful of economic and

  11. THE IMPORTANCE OF DANCE GROUPS IN CHILDREN'S CLUBS FOR DEVELOPING THE PUPILS' MOTOR SKILLS

    Directory of Open Access Journals (Sweden)

    Tatiana DOBRESCU

    2012-07-01

    Full Text Available Dancing, like all physical activities, develops important psycho-motor qualities. The systematic andorganized practice of dancing influences in a positive manner the harmonious development of the body, improving thesuppleness and the coordination, educating the creativity and artistic imagination, and influencing the human psyche.The starting point in choosing this theme was my personal belief that dance methods could exert beneficial effects onthe pupils' skills during leisure time activities. With this paper I hope to contribute to making people aware of theeffects dance has on the teen-age girls’ psycho-motor skills. The aim of this paper was to optimize the training lessonin a sportive dance club by using specific means and adequate musical accompaniment. In developing this research, Istarted from the following hypothesis: Presumably, the selection of operational models and applying them with amusical accompaniment contributes to influencing the skills of the pupils in the dance sections of children's clubsbelonging to education institutions with extracurricular activity. The research was conducted throughout the academicyear 2010-2011 at the Children's Club in Suceava. Starting from the fact that dancing is a method less promoted in thehigh school age instructional activity, I believed I should start checking the applicative intervention on a group of 15female students between 15 and 17 years old. Most tests, both the ones using marks expressed by numbers, and theones using marks expressed by words, recorded progresses in the final testing, in comparison with the initial one,which means that the proposed models were effective on the studied pupils, thus the hypothesis being confirmed.

  12. Pulmonary Functions in Normal School Children in the Age Group of 6-15 Years in North India

    Directory of Open Access Journals (Sweden)

    Gurdeep S. Dhooria

    2010-03-01

    Full Text Available Objective:Lung function tests have become an integral part of assessment of pulmonary disease. As few studies on pulmonary function tests have been carried out in young children in India, the study was carried out in normal urban and rural school children in Ludhiana district of North India to determine pulmonary functions in the age group 6-15 years and to find its correlation with regards to age, sex, height and weight. Methods:The study group included 600 normal children between 6-15 years age from different urban and rural schools in the region. A preformed questionnaire was interviewed and detailed general physical and systemic examination was done. Pulmonary function tests were measured by using Micromedical Gold standard fully computerized portable auto spirometer (Superspiro Cat No. SU 6000. Findings:The present study shows, all the three independent variables (age, weight and height have linear positive correlation with lung function parameters, both for boys and girls. Lung function values in boys were significantly higher as compared to that of girls. Urban children had higher lung function parameters than rural children except IRV, FEF25%. Among all anthropometric parameters, height was the most independent variable with maximum coefficient of correlation. Conclusion:Equations derived from the present study for estimation of the expected values of lung function will help to interpret the observed lung function values in children of North India.

  13. Pulmonary Functions in Normal School Children in the Age Group of 6-15 Years in North India

    Directory of Open Access Journals (Sweden)

    Sandeep Budhiraja

    2010-03-01

    Full Text Available Objective:Lung function tests have become an integral part of assessment of pulmonary disease. As few studies on pulmonary function tests have been carried out in young children in India, the study was carried out in normal urban and rural school children in Ludhiana district of North India to determine pulmonary functions in the age group 6-15 years and to find its correlation with regards to age, sex, height and weight.Methods:The study group included 600 normal children between 6-15 years age from different urban and rural schools in the region. A preformed questionnaire was interviewed and detailed general physical and systemic examination was done. Pulmonary function tests were measured by using Micromedical Gold standard fully computerized portable auto spirometer (Superspiro Cat No. SU 6000.Findings:The present study shows, all the three independent variables (age, weight and height have linear positive correlation with lung function parameters, both for boys and girls. Lung function values in boys were significantly higher as compared to that of girls. Urban children had higher lung function parameters than rural children except IRV, FEF25%. Among all anthropometric parameters, height was the most independent variable with maximum coefficient of correlation.Conclusion:Equations derived from the present study for estimation of the expected values of lung function will help to interpret the observed lung function values in children of North India.

  14. Habit reversal training and educational group treatments for children with tourette syndrome: A preliminary randomised controlled trial.

    Science.gov (United States)

    Yates, Rachel; Edwards, Katie; King, John; Luzon, Olga; Evangeli, Michael; Stark, Daniel; McFarlane, Fiona; Heyman, Isobel; İnce, Başak; Kodric, Jana; Murphy, Tara

    2016-05-01

    Quality of life of children with Tourette Syndrome (TS) is impacted greatly by its symptoms and their social consequences. Habit Reversal Training (HRT) is effective but has not, until now, been empirically evaluated in groups. This randomised controlled trial evaluated feasibility and preliminary efficacy of eight HRT group sessions compared to eight Education group sessions. Thirty-three children aged 9-13 years with TS or Chronic Tic Disorder took part. Outcomes evaluated were tic severity and quality of life (QoL). Tic severity improvements were found in both groups. Motor tic severity (Yale Global Tic Severity Scale) showed greatest improvements in the HRT group. Both groups showed a strong tendency toward improvements in patient reported QoL. In conclusion, group-based treatments for TS are feasible and exposure to other children with tics did not increase tic expression. HRT led to greater reductions in tic severity than Education. Implications, such as cost-effectiveness of treatment delivery, are discussed. PMID:27037483

  15. The Radiation oncology practice standards trial

    International Nuclear Information System (INIS)

    Full text: In 2008 the Commonwealth Government approved funding of up to $1.4 million for radiation oncology practice standards (the standards) to be drafted, trialled, finalised and published. A Tripartite Standards Committee comprising representatives from the Royal Australian and New Zealand College of Radiologists (RANZCR), Australian Insti tute of Radiography (AIR) and Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) coordinated and managed the drafting of the standards. Following public consultation in September 2008, the draft standards were endorsed for trjalling by the Radiation Oncology Reform Implementation Committee (RORIC) of the Australian Health Ministers' Advisory Council (AHMAC). In June 2009 the National Association of Testing Authorities, Australia (NATA) was engaged by the Department of Health and Ageing to conduct a trial of the draft standards by collecting feedback on their implementability with a representative sample of radiation oncology facilities. The trial formally commenced in January 20 I 0 and data is being collected via an on-line questionnaire, follow up site visits and a focus group meeting. The results will be used to establish baseline data on compliance and to assess the costs of compliance. A steering committee comprising representatives from the Tripartite Standards Committee is assisting the Commonwealth to oversight the project. The standards trial is due for completion by the end of 20 I 0, subject to facilities completing all components of the trial in the required time. The outcomes of the trial will inform a revision of the standards by the Tripartite Standards Committee for finalisation and publication. At this time consideration will be given to the tools required by facilities to assist their longer term use within the sector. This may include how compliance with the standards might be assessed. This presentation will describe the process and findings to date and describe the next steps

  16. A study of idiom comprehension in children with semantic-pragmatic difficulties. Part II: Between-groups results and discussion.

    Science.gov (United States)

    Kerbel, D; Grunwell, P

    1998-01-01

    Using a play-based methodology and a symptom checklist, this study investigated idiom comprehension in 26 children aged between 6-11 who were considered to have semantic-pragmatic difficulties. This group was compared with two groups of mainstream children and a group of children with (other) language disorders not primarily of a semantic or pragmatic nature. The results indicate that the children with semantic-pragmatic difficulties did, as a group, demonstrate significantly fewer appropriate idiomatic interpretations and significantly more inappropriate interpretations than did any of the other three groups. However, the higher level of inappropriate scores in the semantic-pragmatic difficulties group reflected a large number of 'fuzzy' actions rather than significantly higher rates of literality. This may indicate an awareness among these children that the literal meaning is inappropriate in the absence of adequate idiom vocabulary. It may also reflect difficulty in retrieving known idioms from memory and/or in selecting the most appropriate meaning from several possibilities in context. Despite relative weakness, the children with semantic-pragmatic difficulties displayed appropriate interpretations considerably more often than they evidenced inappropriate ones. Within-group analysis reveals that the children diagnosed with Asperger syndrome or high-functioning autism performed less well than did those diagnosed with 'semantic-pragmatic disorder'. Nevertheless, both of these subgroups encompassed a considerable range of comprehension ability with regard to the 12 common idioms tested. Analysis of the play task performance and symptom checklist suggests that this variation probably reflects differences in the critical semantic and pragmatic skills underpinning idiom comprehension. These include flexibility of thought, theory of mind, attention to context, prosody and overall coherence, as well as the ability to integrate world knowledge and current contextual

  17. Understanding neighborhood environment related to Hong Kong children's physical activity: a qualitative study using nominal group technique.

    Directory of Open Access Journals (Sweden)

    Gang He

    Full Text Available BACKGROUND: Relationships between the neighborhood environment and children's physical activity have been well documented in Western countries but are less investigated in ultra-dense Asian cities. The aim of this study was to identify the environmental facilitators and barriers of physical activity behaviors among Hong Kong Chinese children using nominal group technique. METHODS: Five nominal groups were conducted among 34 children aged 10-11 years from four types of neighborhoods varying in socio-economic status and walkability in Hong Kong. Environmental factors were generated by children in response to the question "What neighborhood environments do you think would increase or decrease your willingness to do physical activity?" Factors were prioritized in order of their importance to children's physical activity. RESULTS: Sixteen unique environmental factors, which were perceived as the most important to children's physical activity, were identified. Factors perceived as physical activity-facilitators included "Sufficient lighting", "Bridge or tunnel", "Few cars on roads", "Convenient transportation", "Subway station", "Recreation grounds", "Shopping malls with air conditioning", "Fresh air", "Interesting animals", and "Perfume shop". Factors perceived as physical activity-barriers included "People who make me feel unsafe", "Crimes nearby", "Afraid of being taken or hurt at night", "Hard to find toilet in shopping mall", "Too much noise", and "Too many people in recreation grounds". CONCLUSIONS: Specific physical activity-related environmental facilitators and barriers, which are unique in an ultra-dense city, were identified by Hong Kong children. These initial findings can inform future examinations of the physical activity-environment relationship among children in Hong Kong and similar Asian cities.

  18. The effect of short term neo-adjuvant androgen deprivation on erectile function in patients treated with external beam radiotherapy for localised prostate cancer: an analysis of the 4- versus 8-month randomised trial (Irish Clinical Oncology Research Group 97-01).

    LENUS (Irish Health Repository)

    Daly, Patricia E

    2012-07-01

    Erectile dysfunction is a common consequence of external beam radiotherapy (EBRT) for prostate cancer. The addition of neo-adjuvant androgen deprivation (NAD) has an indeterminate additive effect. We examined the long-term effect on erectile function (EF) of two durations (4 months: arm 1 and 8 months: arm 2) of NAD prior to radiation (RT) for patients with localised prostate cancer from the Irish Clinical Oncology Research Group (ICORG 97-01) 4- versus 8-month trial. In this study we aimed to (1) analyse the overall effect on EF of NAD in an EBRT population, (2) compare the probability of retained EF over time in an EBRT population treated with either 4 or 8 months of NAD and (3) identify any variables such as risk group and age which may have an additive detrimental effect. This analysis provides unique long term follow up data.

  19. Exploring the impact of group work and mentoring for multiple heritage children's self-esteem, well-being and behaviour.

    Science.gov (United States)

    Phillips, David; Hagan, Teresa; Bodfield, Emma; Woodthorpe, Kate; Grimsley, Mike

    2008-05-01

    Findings are reported from a study of an innovative Multiple Heritage Service in Sheffield (UK) which provides, inter alia, individual mentoring for young people and school-based group sessions on cultural heritage, dealing with racism and enhancing well-being. Group work, undertaken between November 2005 and December 2006, was evaluated by a before/after design with 43 children aged from 8 to 15 attending five different groups (response rate 77%), using three well-established and validated measures. There were improvements on the Rosenberg Self-esteem Scale from 31.4 to 33.0 (P = 0.005) with more improvement among younger children and boys (P = 0.004 and P = 0.001); and well-being as measured by the GHQ12 improved from 1.5 to 0.8 (P = 0.111) with more improvement among older children (P = 0.026). On the third measure of problem behaviour (the Strengths and Difficulties Questionnaire), there was an improvement from 12.4 to 12.1 (P = 0.716), but there was no improvement at all for girls. Mentoring was evaluated by telephone interviews between June and October 2006 with 14 mothers whose children had just completed, or were nearing completion of, mentoring (response rate 70%). Overall, the mothers' evaluations were highly positive: two-thirds commended the service on the positive impact on their children's well-being and happiness (including all the mothers of daughters); a half reported positive impacts on identity; mothers commended the positive role model effect same-sex mentors had on their children's behaviour; but only a third said mentoring had boosted their children's self-esteem. PMID:18328052

  20. The prevalence of allergic diseases in an unselected group of 6-year-old children. The DARC birth cohort study

    DEFF Research Database (Denmark)

    Kjaer, Henrik Fomsgaard; Eller, Esben; Høst, Arne; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

    2008-01-01

    This study determines the prevalence of atopic dermatitis, asthma, rhinoconjunctivitis, food hypersensitivity and urticaria and the frequency of sensitization in children with and without clinical allergic disease. In an ongoing prospective non-interventional birth cohort study of 562 unselected...... children, 404 children were subjected to interview, clinical examination, lung function measurements and allergy testing at 6 yr of age. Sensitization measured by skin prick test (SPT) and specific immunoglobulin E (S-IgE) was determined for 24 different allergens. The 1-yr period prevalence of atopic......% and 55% (defined as SPT >/=3 mm and/or S-IgE >/=0.35 kU/l for at least one allergen). Symptoms were linked to sensitization for 44% in the asthma group and 42% in the rhinoconjunctivitis group, whereas sensitization could not be linked to worsening of the eczema in any cases of atopic dermatitis...

  1. Application of PET-CT imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Pediatric oncology is one of the important cause of children death. PET-CT, which can provide functional and anatomical images in the same scanning session, has a high sensitivity and specialty in the diagnosis of tumors. During the examination of children, careful preparation and individualized dosage are the keys to make it. PET-CT has a great value in making the personal therapy strategy during the clinical activity, including staging, grading, evaluation of therapy, and the items of prognosis and follow-up. (authors)

  2. Paediatric radiation oncology in the care of childhood cancer: A position paper by the International Paediatric Radiation Oncology Society (PROS).

    Science.gov (United States)

    Kortmann, Rolf-Dieter; Freeman, Carolyn; Marcus, Karen; Claude, Line; Dieckmann, Karin; Halperin, Edward; Esiashvili, Natia; Paulino, Arnold; Mahajan, Anita; Seiersen, Klaus; Ahern, Verity; Ricardi, Umberto; Carrie, Christian

    2016-05-01

    Paediatric malignancies are a challenge for the radiation oncologist due to their rarity, the great variety of histological types, and the complexity of treatment concepts that evolve over time. The Paediatric Radiation Oncology Society (PROS) is the only internationally operating society for paediatric radiation oncology. The objectives of PROS are to set a world-wide standard of excellence with respect to radiation oncology aspects in curing children and adolescents with cancer, to provide a forum for communication between radiation oncologists, and to exchange information with all professionals involved in the management of paediatric and adolescent cancer. Challenges include the need to promote education and support practice in low and middle income countries (LMIC) as well as the cost and availability of modern treatment technologies for all but most especially these countries. Collaborations with other societies that include for example the education programmes provided jointly with ESTRO, and the upgraded technical platform of the PROS web site offer new possibilities to enhance the efficacy of PROS in education and support of paediatric radiation oncology practice world-wide. PROS has made an important contribution to the management of childhood malignancies over the past decade and new and developing collaborations between PROS and other societies or organizations will ultimately lead to a reduction in world-wide health care inequalities. PMID:27106553

  3. A randomised trial comparing Habit Reversal and psycho-education treatment groups for children with Tourette Syndrome

    OpenAIRE

    Yates, Rachel

    2014-01-01

    The quality of life of children with Tourette Syndrome, a neurodevelopmental condition characterised by chronic tics, is impacted greatly by both the symptoms themselves and their social consequences. Habit Reversal Therapy, a behavioural therapy for tic management, has substantial empirical support in its individual form, but this approach has never been investigated in a group format. Group based delivery of Habit Reversal Therapy could increase access to therapy, improve the cost-effective...

  4. Exploring the impact of group work and mentoring for multiple heritage children's self-esteem, well-being and behaviour

    OpenAIRE

    Phillips, D; Hagan, T.; Bodfield, E.; Woodthorpe, K.; Grimsley, M

    2008-01-01

    Findings are reported from a study of an innovative Multiple Heritage Service in Sheffield (UK) which provides, inter alia, individual mentoring for young people and school-based group sessions on cultural heritage, dealing with racism and enhancing well-being. Groupwork, undertaken between November 2005 and December 2006, was evaluated by a before/after design with 43 children aged from eight to fifteen attending five different groups (response rate 77 per cent), using three well-establishe...

  5. [History of Oncology in Slovakia].

    Science.gov (United States)

    Ondruš, D; Kaušitz, J

    2016-01-01

    The history of oncology in Slovakia is closely linked to the history of St. Elizabeth Hospital, which was set up in the mid-18th century by nuns of the St. Elizabeth Order in Bratislava. In the first half of the 20th century, a unit was set up in the hospital dedicated to diagnosis and treatment of cancer. Shortly after World War II, the unit was turned into the Institute for Cancer Research and Treatment. In 1950, St. Elizabeth Hospital was nationalized, and the Cancer Research Institute of the Slovak Academy of Science and the Institute of Clinical Oncology were located there as centers for oncological diagnosis and treatment. After the restitution of church property in the early 1990s, the hospital was returned to the Order of St. Elizabeth, which set up the St. Elisabeth Cancer Institute in the hospital premises in January of 1996. This year marks the 20th anniversary of this institute in its new premises and the 85th anniversary of the Institute of Radiumtherapy founded in Bratislava, and thus the establishment of institutional healthcare for cancer patients in Slovakia is the reason for balancing. We present a view of the consecutive changes in the organization, space and staff of the Institute and evaluate the impact of celebrities on medicine who developed oncology as a clinical, scientific and educational discipline in Bratislava and in other cities and regions of Slovakia. PMID:27296401

  6. Challenge of pediatric oncology in Africa.

    Science.gov (United States)

    Hadley, Larry G P; Rouma, Bankole S; Saad-Eldin, Yasser

    2012-05-01

    The care of children with malignant solid tumors in sub-Saharan Africa is compromised by resource deficiencies that range from inadequate healthcare budgets and a paucity of appropriately trained personnel, to scarce laboratory facilities and inconsistent drug supplies. Patients face difficulties accessing healthcare, affording investigational and treatment protocols, and attending follow-up. Children routinely present with advanced local and metastatic disease and many children cannot be offered any effective treatment. Additionally, multiple comorbidities, including malaria, tuberculosis, and HIV when added to acute on chronic malnutrition, compound treatment-related toxicities. Survival rates are poor. Pediatric surgical oncology is not yet regarded as a health care priority by governments struggling to achieve their millennium goals. The patterns of childhood solid malignant tumors in Africa are discussed, and the difficulties encountered in their management are highlighted. Three pediatric surgeons from different regions of Africa reflect on their experiences and review the available literature. The overall incidence of pediatric solid malignant tumor is difficult to estimate in Africa because of lack of vital hospital statistics and national cancer registries in most of countries. The reported incidences vary between 5% and 15.5% of all malignant tumors. Throughout the continent, patterns of malignant disease vary with an obvious increase in the prevalence of Burkitt lymphoma (BL) and Kaposi sarcoma in response-increased prevalence of HIV disease. In northern Africa, the most common malignant tumor is leukemia, followed by brain tumors and nephroblastoma or neuroblastoma. In sub-Saharan countries, BL is the commonest tumor followed by nephroblastoma, non-Hodgkin lymphoma, and rhabdomyosarcoma. The overall 5-years survival varied between 5% (in Côte d'Ivoire before 2001) to 34% in Egypt and up to 70% in South Africa. In many reports, the survival rate of

  7. The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

    Science.gov (United States)

    Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

    2008-01-01

    Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

  8. Self-Reported Needs and Expectations of Parents of Children with Autism Spectrum Disorders Who Participate in Support Groups

    Science.gov (United States)

    Papageorgiou, Vaya; Kalyva, Efrosini

    2010-01-01

    Many parents of children with autism spectrum disorders (ASD) participate in support groups, but very few studies have explored their motives to do so. The present study aims to explore the self-reported needs and expectations that parents express according to their gender and education and according to the age and gender of their child with ASD.…

  9. Differential Therapeutic Outcomes of Community-Based Group Interventions for Women and Children Exposed to Intimate Partner Violence

    Science.gov (United States)

    McWhirter, Paula T.

    2011-01-01

    Two community-based group therapies, emotion focused versus goal oriented, are compared among women exposed to intimate partner violence (n = 46) and their children (n = 48) aged between 6 and 12 years. A series of repeated measures analyses are employed to evaluate the effects of time from baseline to postintervention following random assignment.…

  10. Group-Based Preference Assessment for Children and Adolescents in a Residential Setting: Examining Developmental, Clinical, Gender, and Ethnic Differences

    Science.gov (United States)

    Volz, Jennifer L. Resetar; Cook, Clayton R.

    2009-01-01

    This study examines developmental, clinical, gender, and ethnic group differences in preference in residentially placed children and adolescents. In addition, this study considers whether residentially placed youth prefer stimuli currently being used as rewards as part of a campuswide token economy system and whether youth would identify preferred…

  11. Improving Social Competence in Children with Autism Spectrum Disorders through a Combined-Strategy Group Intervention: A Pilot Study

    Science.gov (United States)

    Sotelo, Marlene

    2009-01-01

    This applied dissertation investigated whether a combined-strategy group intervention improved social competence among children with autism spectrum disorders. Individuals with autism spectrum disorders exhibit deficits in social behaviors that may negatively impact all aspects of their lives. Social competence for individuals with autism spectrum…

  12. Conflict Competence of Preschool Children and its Relationship with the Sociometric Status of the Child in the Peer Group

    Directory of Open Access Journals (Sweden)

    Denisenkova N.S.,

    2015-02-01

    Full Text Available The purpose of the study was to investigate the conflict competence of children of preschool age and identification of its relationship with the child's sociometric status in the peer group. The hypothesis of the study was that there is a relationship between the sociometric status of preschoolers in the peer group and the strategy of their behavior in a conflict situation, a conflict of competence. The study involved children (41 children: 22 boys and 19 girls aged 5-7 years, attending preparatory groups in kindergartens in Moscow (in 2011-2013. The study was conducted using an experimental technique "Desk of cooperation" (M. Madsen, aimed at the study of conflict competence, the sociometric technique "Two Houses" (modification by R.I. Govorova, and a survey of educators aimed at identifying the status position in the preschool group peers. According to the survey, we can say that there are qualitative differences in the strategies of behavior in the conflict that children with different sociometric status choose.

  13. The Socialization Process of Street Children in the Youth Gangs and Groups of Organized Crime in Local Community. Preliminary Report

    Directory of Open Access Journals (Sweden)

    Małgorzata Michel

    2013-12-01

    Full Text Available This article includes the research report on the socialization process of children in the street, youth gangs, and organized criminal groups in local communities. The author has analysed the signs and communication codes located on walls in local communities. This is very important to the socialization process of the youth street gangs.

  14. The use of group dynamics strategies to enhance cohesion in a lifestyle intervention program for obese children

    Directory of Open Access Journals (Sweden)

    Petrella Robert

    2009-07-01

    Full Text Available Abstract Background Most research pertaining to childhood obesity has assessed the effectiveness of preventative interventions, while relatively little has been done to advance knowledge in the treatment of obesity. Thus, a 4-week family- and group-based intervention utilizing group dynamics strategies designed to increase cohesion was implemented to influence the lifestyles and physical activity levels of obese children. Methods/Design This paper provides an overview of the rationale for and implementation of the intervention for obese children and their families. Objectives of the intervention included the modification of health behaviors and cohesion levels through the use of group dynamics strategies. To date, a total of 15 children (7 boys and 8 girls, mean age = 10.5 and their families have completed the intervention (during the month of August 2008. Physiological and psychological outcomes were assessed throughout the 4-week intervention and at 3-, 6-, and 12-month follow-up periods. Discussion It is believed that the information provided will help researchers and health professionals develop similar obesity treatment interventions through the use of evidence-based group dynamics strategies. There is also a need for continued research in this area, and it is our hope that the Children's Health and Activity Modification Program (C.H.A.M.P. will provide a strong base from which others may build.

  15. [Oral health status in children with intellectual disability living in organized groups].

    Science.gov (United States)

    Avraamova, O G; Pakhomova, Yu V

    2016-01-01

    The aim of the study was to assess oral health status in in children with intellectual disability (ID) living in Moscow Orphanage №15. The study involved 91 children aged 12 (39 children) and 15 (52 children). Caries incidence and DMFT index, periodontal disease incidence, OHI-S and PMA index, malocclusions incidence were assessed at baseline examination. Caries incidence in 12 and 15 y.o. was moderate (53.85% and 56.0%, correspondingly), as well as DMFT (2.77±0.52 и 2.94±0.53 correspondingly). In 2 children with rumination syndrome all teeth were affected by caries and these children received dental treatment under general anesthesia 7 times during last 60 months. Periodontal disease incidence in 12 and 15 y.o. was 89.74% и 86.58%, correspondingly with very high OHI-S indicating unsatisfactory oral hygiene. Malocclusions incidence was 95% and 98%, correspondingly. Thus the main oral problem in children with ID is periodontal disease and poor oral hygiene. Differentiated oral hygiene education approach according to children's physical and intellectual abilities should be considered. Children with rumination syndrome should be addressed by neurologist prior to dental treatment which needs more radical approach. PMID:27367200

  16. Comparison of cognition abilities between groups of children with specific learning disability having average, bright normal and superior nonverbal intelligence

    Directory of Open Access Journals (Sweden)

    Karande Sunil

    2005-03-01

    Full Text Available BACKGROUND: Specific learning disabilities (SpLD viz. dyslexia, dysgraphia and dyscalculia are an important cause of academic underachievement. Aims: To assess whether cognition abilities vary in children with SpLD having different grades of nonverbal intelligence. SETTING: Government recognized clinic in a medical college. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: Ninety-five children with SpLD (aged 9-14 years were assessed. An academic achievement of two years below the actual grade placement on educational assessment with a Curriculum-Based test was considered diagnostic of SpLD. On basis of their nonverbal Intelligence Quotient (IQ scores obtained on the Wechsler Intelligence Scale for Children test, the study children were divided into three groups: (i average-nonverbal intelligence group (IQ 90-109, (ii bright normal-nonverbal intelligence group (IQ 110-119, and (iii superior-nonverbal intelligence group (IQ 120-129. A battery of 13 Cognition Function tests (CFTs devised by Jnana Prabodhini′s Institute of Psychology, Pune based on Guilford′s Structure of Intellect Model was administered individually on each child in the four areas of information viz. figural, symbolic, semantic and behavioral. STATISTICAL ANALYSIS USED: The mean CFTs scores obtained in the four areas of information were calculated for each of the three groups and compared using one-way analysis of variance test. A P value < 0.05 was to be considered statistically significant. RESULTS: There were no statistically significant differences between their mean CFTs scores in any of the four areas of information. CONCLUSIONS: Cognition abilities are similar in children with SpLD having average, bright-normal and superior nonverbal intelligence.

  17. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schuengel Carlo

    2011-07-01

    Full Text Available Abstract Background Coping with a chronic illness (CI challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the intervention program may enhance the use of learned coping strategies in daily life, especially on the long-term. The primary aim of the present study is to examine the effectiveness of a cognitive behavioral based group intervention (called 'Op Koers' 1 for children with CI and of a parallel intervention for their parents. A secondary objective is to investigate why and for whom this intervention works, in order to understand the underlying mechanisms of the intervention effect. Methods/design This study is a multicentre randomized controlled trial. Participants are children (8 to 18 years of age with a chronic illness, and their parents, recruited from seven participating hospitals in the Netherlands. Participants are randomly allocated to two intervention groups (the child intervention group and the child intervention combined with a parent program and a wait-list control group. Primary outcomes are child psychosocial functioning, wellbeing and child disease related coping skills. Secondary outcomes are child quality of life, child general coping skills, child self-perception, parental stress, quality of parent-child interaction, and parental perceived vulnerability. Outcomes are evaluated at baseline, after 6 weeks of treatment, and at a 6 and 12-month follow-up period. The analyses will be performed on the basis of an intention-to-treat population. Discussion This study evaluates the effectiveness of a group intervention improving psychosocial functioning in children with CI and their parents. If proven effective, the intervention will be implemented in clinical practice. Strengths and limitations of the study design are discussed

  18. School Counselors' Experiences with a Summer Group Curriculum for High-Potential Children from Low-Income Families: A Qualitative Study

    Science.gov (United States)

    Peterson, Jean Sunde

    2013-01-01

    School counselors facilitated group guidance for children from low-income families and assisted in classrooms with a full economic range during a summer academic program for young gifted children in order to increase knowledge about giftedness. This qualitative study explored how the counselors experienced being immersed with gifted children. The…

  19. The Joint Effects of Risk Status, Gender, Early Literacy and Cognitive Skills on the Presence of Dyslexia among a Group of High-Risk Chinese Children

    Science.gov (United States)

    Wong, Simpson W. L.; McBride-Chang, Catherine; Lam, Catherine; Chan, Becky; Lam, Fanny W. F.; Doo, Sylvia

    2012-01-01

    This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by…

  20. Acute Respiratory Infections among Under-Five Age Group Children at Urban Slums of Gulbarga City: A Longitudinal Study

    Science.gov (United States)

    Pattankar, Jayashree; Puttahonnappa, Suresh Kuralayanapalya

    2016-01-01

    Introduction Among all illness, Acute Respiratory Infections (ARI) account for 30-60% of paediatric outpatient attendance and 20-30% of hospital admissions. Aim To study the morbidity pattern of ARI among under-five-age group children and to assess the determinants. Materials and Methods A longitudinal cohort study was conducted for a one year period, comprising a cumulative sample of 400 children from 3 urban slums of Gulbarga city. History of nasal discharge, cough, fever, sore throat, breathing difficulty, any discharge from ear alone or in combination, was used in the recognition of an ARI episode. Respiratory rate >60/minute (50(2-11 months) and >40(1-5 years) in a child with cough, cold or fever singly or in combination was considered the criteria for recognition of pneumonia. Results Out of the 400 surveyed, ARI was detected among 109 children giving an incidence of 27.25%. Among these, Upper Respiratory Tract Infection (URTI) was found among 19.25% and Lower Respiratory Tract Infection (LRTI) among 8%. ARI was observed among 38.04% of infants, 37.84% of 2-3-year-old children, 36.87% of boys, 40.43% of children born to illiterate father’s, 35.77% of SES class IV & 40.79% of SES class V, and 41.89% of children with family history of respiratory illness. All these data were found to be statistically significant. High rates of ARI were also observed among 41.36% of children living in households with firewood fuel usage, 35.04% of children with pets in the household, 34.82% of children with delayed milestones, 53.85% of children with grade IV and 66.67% of children with grade V malnutrition. More episodes occurred during winter months of the year (Oct – Jan). During the follow-up phase of study done on a cohort of 112 children for a period of one year, an attack rate of 3.27 episodes/child/year was observed. Conclusion Community education programs should focus on addressing specific issues viz. identification of respiratory illness, simple case management

  1. Empathy in Children with Autism and Conduct Disorder: Group-Specific Profiles and Developmental Aspects

    Science.gov (United States)

    Schwenck, Christina; Mergenthaler, Julia; Keller, Katharina; Zech, Julie; Salehi, Sarah; Taurines, Regina; Romanos, Marcel; Schecklmann, Martin; Schneider, Wolfgang; Warnke, Andreas; Freitag, Christine M.

    2012-01-01

    Background: A deficit in empathy is discussed to underlie difficulties in social interaction of children with autism spectrum disorder (ASD) and conduct disorder (CD). To date, no study has compared children with ASD and different subtypes of CD to describe disorder-specific empathy profiles in clinical samples. Furthermore, little is known about…

  2. Spirometry in an unselected group of 6-year-old children

    DEFF Research Database (Denmark)

    Kjaer, Henrik Fomsgaard; Eller, Esben; Bindslev-Jensen, Carsten;

    2008-01-01

    % of children, respectively. Linear regression analyses for 242 children included in the reference population demonstrated height to be the main predictor of all spirometric indices except FEV1/FVC. FEV1, FEV75, and FVC correlated reasonably to anthropometric data in contrast to flow parameters. Gender...

  3. Education of Deaf Children in Israel: A Case of Marginalizing a Minority Group

    Science.gov (United States)

    Gor Ziv, Haggith

    2015-01-01

    All children have the right to education that meets their needs and aims to enable them full integration in their society. Education should guarantee all children an equal chance to actively participate in society regardless of race, gender, ethnicity or disability (Convention on the Rights of the Child, 1989). Yet sophisticated mechanisms within…

  4. Consumption of fruits and vegetables in a group of valencian children of school age.

    Directory of Open Access Journals (Sweden)

    Alba Tamarit,

    2012-12-01

    Full Text Available Introduction: In the last 25 years there has beena great change in the food habits in Spain.Objectives: To calculate and assess the consumption of fruits and vegetables in school children. To identify the type of desserts eaten and analyze the influence children have on the purchase of fruit andvegetables made by parents.Materials and methods: A survey was carried out on parents of primary school children. A total of 155 questionnaires were handed into the school, obtaining a sample of 116 completed questionnaires. Results: Only 5.17% eat 3 or more portions of fruit per day. Regarding vegetables, 30.17% consume 1 or 2 portions. 18.97% have fruit as a dessert. 25% of the parents purchase fruit most days as a result of the children request and 12.93% purchase vegetables.Discussion: Children do not consume enough fruit and vegetables. Children have an influence on fruit and vegetable purchases. Conclusions: The majority of the studied children do not follow the dietary recommendations regarding consumption of fruit and vegetables. Consumption of fruit for dessert is low. Children have a bigger influence on fruit purchases than in vegetables purchases.

  5. Gender and theory of mind in preschoolers' group effort: evidence for timing differences behind children's earliest social loafing.

    Science.gov (United States)

    Thompson, R Bruce; Thornton, Bill

    2014-01-01

    This study explored mental state reasoning within the context of group effort and possible differences in development between boys and girls. Preschool children (59 girls, 47 boys) were assessed for theory of mind (ToM) ability using classic false belief tests. Children participated in group effort conditions that alternated from one condition, where individual effort was transparent and obvious, to one where individual effort remained anonymous. The aim was to investigate if emergent mental state reasoning, after controlling for age, was associated with the well-known phenomenon of reduced effort in group tasks ("social loafing"). Girls had slightly higher ToM scores and social loafing than boys. Hierarchical regression, controlling for age, indicated that understanding of others' false beliefs uniquely predicted social loafing and interacted weakly with gender status. PMID:25280164

  6. Development and pilot of a group skills-and-support intervention for mothers of children with feeding problems.

    Science.gov (United States)

    Jones, C J; Bryant-Waugh, R

    2012-04-01

    Child feeding problems are often associated with parental factors which may influence and maintain difficulties. This paper reports the development, pilot and preliminary evaluation of a group intervention for mothers of children with feeding problems. Themes for the group were derived from a survey of parents and professionals. Three pilot interventions were conducted in order to make an assessment of the feasibility, acceptability and potential for achieving change in levels of maternal mood, parenting stress and concerns related to feeding. While single case analysis revealed little change in standardised measures of mood and parenting stress, participants valued the social and emotional support offered by the group and reported improvements in concerns and maladaptive behaviours related to feeding. An intervention which provides support and a sense of a shared experience appears to have beneficial effects for mothers of children with feeding problems and therefore, may offer a constructive means of supporting this population. PMID:22245132

  7. Assessment of environmental and genetic factors in the etiology of childhood cancers: the Childrens Cancer Group epidemiology program.

    Science.gov (United States)

    Robison, L L; Buckley, J D; Bunin, G

    1995-01-01

    The occurrence of cancer during childhood represents one of the leading causes of death within the pediatric and adolescent age group. It is estimated that approximately 8000 children will be diagnosed annually with cancer in the United States. Epidemiologic research addressing the etiology of childhood cancer has been limited because of the difficulties in identifying a sufficiently large study population. Moreover, the use of retrospectively ascertained childhood cancer cases in epidemiologic investigations has restricted the incorporation of biological and clinical parameters. The Childrens Cancer Group has developed an active program in epidemiologic research, with over a decade of experience demonstrating the feasibility and strengths of conducting analytic epidemiologic studies within a cooperative clinical trials network. The availability of detailed clinical and biologic data on cases diagnosed within the cooperative group facilitates the transfer of state-of-the-art technology to epidemiologic research. PMID:8549456

  8. Therapists in Oncology Settings

    Science.gov (United States)

    Hendrick, Susan S.

    2013-01-01

    This article describes the author's experiences of working with cancer patients/survivors both individually and in support groups for many years, across several settings. It also documents current best-practice guidelines for the psychosocial treatment of cancer patients/survivors and their families. The author's view of the important qualities…

  9. Randomized phase III study comparing best supportive care to biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: Radiation therapy oncology group (RTOG) 97-13

    International Nuclear Information System (INIS)

    Purpose: To determine if Biafine compared to Best Supportive Care (BSC) is effective in minimizing or preventing radiation-induced dermatitis in women undergoing breast irradiation. Methods and Materials: Patients were randomized between Biafine (n = 83) vs. BSC (n = 89). The institutions identified preference for BSC at the time of randomization. A no-treatment arm was allowed (16% received no treatment). Patients were instructed to apply randomized product three times a day, but not within 4 h of their daily RT session. Application began following their first radiation treatment and continued 2 weeks postradiation. Skin dermatitis was scored weekly utilizing the RTOG and ONS (Oncology Nursing Society) skin toxicity scales, a weekly patient satisfaction and quality-of-life questionnaire. Results: Using the RTOG toxicity scale there was no overall difference for maximum dermatitis during RT between Biafine and BSC (p = 0.77). There was no difference in maximum toxicity by arm or breast size. There was an interaction between breast size and toxicity, with large-breasted women exhibiting more toxicity. Large-breasted women receiving Biafine were more likely to have no toxicity 6 weeks post RT. Conclusion: There was no overall difference between BSC and Biafine in the prevention, time to, or duration of radiation-induced dermatitis.

  10. Sensitivity to reinforcement and family factors as predictors of psychological health problems in different age groups of children and teenagers

    Directory of Open Access Journals (Sweden)

    V. Kuznetsova

    2013-04-01

    Full Text Available The follow-up study was designed to assess and to compare the effects of sensitivity to reward, sensitivity to punishment and family environment on internalizing and externalizing problems in a community sample of 477 children and adolescents aged 3-18 (50% female. The level of problem behavior at Time 1 in all age groups was the best predictor of corresponding type of problem level at Time 2; the residual variance in problem behavior was also predicted by sensitivity to reinforcement. Family factors contributed for change in externalizing problems and hyperactivity in preschool and middle childhood children; living in the urban environment was significant factor for peer problem. The study showed that individual differences interact with the family factors in the process of development, and family environment could strengthen or mitigate the influence of biological factors on children and adolescents’ adjustment.

  11. CLINICAL PROFILE OF CHILDREN IN THE AGE GROUP 6 MONTHS TO 60 MONTHS WITH LOWER RESPIRATORY TRACT INFECTION

    Directory of Open Access Journals (Sweden)

    Bharath Kumar

    2015-05-01

    Full Text Available CONTEXT : Infections of the respiratory tract are perhaps the most common human ailments. Acute Respiratory Infections (ARI has quite a high morbidity and mortality in children in developing countries 1 ARI is responsible for about 30 - 50 percent of visits to health facilities and for about 20 - 40 percent of hospital admissions. Pneumonia is a leading cause of mortality in children worldwide. Because mortality due to pneumonia in developing countries is attributable mainly to bacterial etiology , IM NCI strategy recommends the use of antibiotics when a child presented with tachypnea as defined previously . AIMS : To re - define or refine tachypnea as a specific indicator of bacterial pneumonia. To identify other clinical predictors for identifying bacteri al pneumonia. DESIGNS : The study was designed to be done in two phases . In the first phase it is to be carried out as a descriptive study of children presenting with fever and respiratory distress in the OPD to identify the specific markers for bacterial p neumonia. In the second phase presenting clinical features in children with radiological pneumonia will be analysed to validate the findings from Phase I. MATERIALS AND METHODS : This was a hospital based study and was conducted in Sri Manakula V inayagar Me dical College and Hospital , Puducherry . The study included 100 Children in the age group 6 months to 5 years presenting in the out patients department with fever and respiratory distress Children attending the out - patient department on a fixed day of the w eek (Monday and who come under this study population during the study period were admitted and recruited in the study and informed verbal consent for participation was taken from the parents. Their clinical profiles were recorded as in phase I. All childr en coming under this study population were given antibiotics and supportive treatment. The cases were monitored for any worsening or improvement every 6 th hourly on day 1 and

  12. The importance of oral hygiene on children of Romany ethnic group with the focus on preventive measures resulting in the reduction of oral cavity diseases frequency.

    OpenAIRE

    Hanusová, Markéta

    2015-01-01

    The main objective of this diploma thesis is to describe an awareness and level of oral hygiene of children of Romany ethnic group and subsequently optimize the care of oral cavity leading to the reduction in frequency of hanging apparatus illnesses. The other target of this thesis is a preparation of educational program that would motivate children to correct and regular dental hygiene. The thesis deals with history and characteristic of Romany ethnic group, issues of Romany children and low...

  13. Prediction tools in surgical oncology.

    Science.gov (United States)

    Isariyawongse, Brandon K; Kattan, Michael W

    2012-07-01

    Artificial neural networks, prediction tables, and clinical nomograms allow physicians to transmit an immense amount of prognostic information in a format that exhibits comprehensibility and brevity. Current models demonstrate the feasibility to accurately predict many oncologic outcomes, including pathologic stage, recurrence-free survival, and response to adjuvant therapy. Although emphasis should be placed on the independent validation of existing prediction tools, there is a paucity of models in the literature that focus on quality of life outcomes. The unification of tools that predict oncologic and quality of life outcomes into a comparative effectiveness table will furnish patients with cancer with the information they need to make a highly informed and individualized treatment decision. PMID:22583992

  14. Raman Spectroscopy for Clinical Oncology

    Directory of Open Access Journals (Sweden)

    Michael B. Fenn

    2011-01-01

    Full Text Available Cancer is one of the leading causes of death throughout the world. Advancements in early and improved diagnosis could help prevent a significant number of these deaths. Raman spectroscopy is a vibrational spectroscopic technique which has received considerable attention recently with regards to applications in clinical oncology. Raman spectroscopy has the potential not only to improve diagnosis of cancer but also to advance the treatment of cancer. A number of studies have investigated Raman spectroscopy for its potential to improve diagnosis and treatment of a wide variety of cancers. In this paper the most recent advances in dispersive Raman spectroscopy, which have demonstrated promising leads to real world application for clinical oncology are reviewed. The application of Raman spectroscopy to breast, brain, skin, cervical, gastrointestinal, oral, and lung cancers is reviewed as well as a special focus on the data analysis techniques, which have been employed in the studies.

  15. Nuclear medical oncology; Nuklearmedizinische Onkologie

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Bernd J.; Buck, Andreas K.; Schwaiger, Markus (eds.) [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik

    2007-07-01

    Modern nuclear oncology is based on molecular imaging techniques and radiotherapy. The book is aimed to integrate efficiently nuclear medical diagnostics and therapy into oncologic patient management. The book covers the following topics: Chapter 1: basics: instrumentation (SPECT, PET, PET/CT), digital image processing, radiopharmaceuticals, radiation protection, nuclear medical dosimetry, radiotherapy planning. Chapter 2: diagnostics: PET and PET/CT, skeleton metastases diagnostics, lymphoma diagnostics in case of mammary carcinomas and malign melanoma, MIBG (metaiodobenzylguanidin) diagnostics. Chapter 3: therapy: Radiotherapy of thyroid carcinomas, radioimmunotherapy of malign melanomas and in haematology, MIBG therapy, radiotherapy of neuroendocrine tumors, radiotherapy of skeleton metastases, intercavitary and locoregional therapy, 32{sup 3}2 phosphor therapy of polycythaemia vera.

  16. Adenoid and tonsil surgeries in children: How relevant is pre-operative blood grouping and cross-matching?

    Directory of Open Access Journals (Sweden)

    Lucky Onotai

    2013-01-01

    Full Text Available Background: As a part of pre-operative evaluation, several otolaryngologists group and cross-match blood routinely for children undergoing adenoid and tonsil surgeries. This practice has generated several debates either in support or against this practice. The aim of this study is to critically evaluate the incidence of post-tonsillectomy (with or without adenoidectomy bleeding and blood transfusions in otherwise healthy children with adenoid/tonsil pathologies conducted in the University of Port Harcourt Teaching Hospital (UPTH. Patients and Methods: A descriptive retrospective study of children who underwent adenoid and tonsil surgeries in the Department of Ear, Nose and Throat (ENT surgery of UPTH from January 2003 to December 2012. Children with family history of bleeding disorders and derangement of clotting profile as well as different co-morbidity like sickle cell disease were excluded from this study. The patients′ data were retrieved from the registers of ENT out-patient clinics, theatre registers and patients case notes. Demographic data, indications for surgery, preoperative investigations, complications and management outcomes were recorded and analyzed. Results: Out of 145 children that had adenoid and tonsil surgeries; only 100 met the criteria for this study. The study subjects included 65 males and 35 females (male: female ratio 1.9:1 belonging to 0-16 years age group (mean age: 3.46 ± 2.82 years. The age group of 3-5 years had the highest (n = 40, 40% number of surgeries. Adenotonsillectomy was the commonest (n = 85, 85% surgery performed on patients who had obstructive sleep apnea (OSA. The commonest (n = 6, 6% complication was haemorrhage, and only few (n = 3, 3% patients had blood transfusion. However, mortality was recorded in some (n = 3, 3% patients. Conclusion: This study confirms that the incidence of post adenoidectomy/tonsillectomy bleeding in otherwise healthy children is low and rarely requires blood transfusion

  17. PET/TAC in Oncology

    International Nuclear Information System (INIS)

    From this presentation of PET-TAC in oncology the following advantages on the conventional PET are obtained: 1. More short study and stadium in one session. 2. It adds the information of both techniques. 3. Better localization of leisure: affected organ, stadium change (neck, mediastinum, abdomen). 4. Reduction of false positive (muscle, brown fat, atelectasis, pneumonias, intestine, urinary vials, etc.). 5. Reduction of negative false. 6. Reduction of not conclusive. 7. More understandable for other specialists. 8. Biopsies guide. 9. Planning radiotherapy

  18. Comparative Effectiveness Research in Oncology

    OpenAIRE

    Lyman, Gary H.

    2013-01-01

    Randomized controlled trials represent the gold standard for comparative effective research, but additional methods are available when randomized controlled trials are lacking or inconclusive. Comparative effective research requires oversight of study design and analysis, but if appropriately conducted, offers an opportunity to identify the most effective and safe approach to patient care. Oncologists and oncology societies are uniquely positioned to provide the expertise to steer the appropr...

  19. Serum Zinc Level in Children with Febrile Convulsion and its Comparison with that of Control Group

    OpenAIRE

    Nahid Vahid Harandi; Mahshid Talebi-Taher; Fahimeh Ehsanipour; Keivan Kani

    2009-01-01

    Objective:Febrile convulsion is the most common disorder in childhood with good prognosis. There are different hypotheses about neurotransmitters and trace element (such as zinc) changes in cerebrospinal fluid and serum, which can have a role in pathogenesis of febrile convulsion. The aim of the present prospective analytical case-control study was to determine whether there was any changes in serum zinc level in children with febrile convulsion during seizure.Methods: Ninety-two children age...

  20. Using group role-playing games with gifted children and adolescents: A psychosocial intervention model

    OpenAIRE

    Rosselet J. G.; Stauffer S. D.

    2013-01-01

    Gifted children develop asynchronously, often advanced for their age cognitively, but at or between their chronological and mental ages socially and emotionally (Robinson, 2008). In order to help gifted children and adolescents develop and practice social and emotional self-regulation skills, we investigated the use of an Adlerian play therapy approach during pen-and-paper role-playing games. Additionally, we used Goffman's (1961, 1974) social role identification and distance to encourage par...