By Arthur J. Olch

content material: assessment of adolescence melanoma : prevalence, survival, and overdue results --
demanding situations of treating kids with radiation treatment --
Leukemia --
Tumors of the important anxious procedure --
Hodgkin lymphoma --
Neuroblastoma --
Wilms' tumor --
Soft-tissue tumors : (rhabdomyosarcoma and different soft-tissue sarcomas) --
Bone sarcomas (osteosarcoma and Ewing's sarcoma) --

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Extra resources for Pediatric radiotherapy : planning and treatment

Sample text

Osteosarcoma is the most frequent second cancer occurring within 20 years of treatment of a solid primary cancer in childhood (Olsen et al. 1993). Patients with retinoblastoma (RB), Ewing’s sarcoma, and Hodgkin lymphoma (HL) suffer the highest risk for developing a SM, particularly secondary sarcomas (Strong et al. 1979; Kuttesch et al. 1996; Abramson and Frank 1998; Henderson et al. 2007). Cumulative risk of secondary bone cancer after Ewing’s sarcoma was 22% at 20 years with a RR of 694 and a RR of 106 after HL in a study by the Late Effects Study Group (LESG), and in others, 5% to 7% at 20 years with relative risk also in the hundreds (Hawkins et al.

1 Bone and Soft-­Tissue Sarcomas 31 32 Pediatric Radiotherapy Planning and Treatment studies that risk of second bone cancer increased substantially with increased exposure to radiation. Both Hawkins et al. (1996) and the LESG reported virtually no increased risk of secondary sarcoma with radiation doses less than about 10 Gy, and Diallo et al. (2009) found a higher median dose of 26 Gy for secondary sarcomas compared to 15 Gy for all other SM. Retinoblastoma (RB) patients in particular are at a very high risk for developing a SM, most of which are bone or soft-­tissue sarcomas.

Radiation-­induced changes occur instantly when x-­rays or other ionizing radiation ejects electrons from orbital paths around the atoms’ nucleus as it passes through tissue. We are all continuously exposed to low levels of ionizing radiation from cosmic rays and terrestrial sources, such as the emissions from radioactive uranium and potassium in the soil, concrete, and our own bodies. The biological effects of ionizing radiation result largely from DNA damage, caused directly by ionizations within the DNA (about 30% of the time) or indirectly from the action of highly reactive hydroxyl radicals formed by ionization of intranuclear water molecules (70% of the time).

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