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Texas Children's Hospital HandbookTexas Children's Hospital Handbook

Section 3. Pediatrics > 

Chapter 23. Oncology

Topics Discussed: antiemetic agent; antineoplastic agents; antineoplastic combined chemotherapy protocols; bone marrow harvest; bone marrow transplantation; bone neoplasms; central nervous system tumor; chemotherapy regimen; chemotherapy sickness; childhood cancer; complications of bone marrow transplant; craniopharyngioma; craniopharyngioma, childhood; drug reactions; ewing's sarcoma; fever; histiocytosis; histiocytosis, langerhans-cell; hodgkin's lymphoma, childhood; leukemia, lymphocytic, acute, childhood; leukocytosis, marked; lymphohistiocytosis, hemophagocytic; lymphoma, non-hodgkin's, childhood; malignant bone neoplasm; medical oncology; mucositis following chemotherapy; myeloblastic leukemia, pediatric acute; nausea; neoplasms, connective tissue; nephroblastoma; neuroblastoma; neuroectodermal tumors, primitive, peripheral; neutropenia; neutropenia, febrile ; oncologic emergency; osteosarcoma, childhood; pediatric oncology; spinal cord compression; spinal cord neoplasms; spinal neoplasms; stem cell transplantation, juvenile; toxicity due to chemotherapy; tumor lysis syndrome; wilms' tumor, pediatric.
Excerpt:"National Wilms Tumor Staging system (NWTS): Based on intraoperative evaluation before the administration of chemotherapy. Used in North America.
  • Stage 1: Completely resectable tumor with no extension beyond the renal capsule; no previous capsule rupture or biopsy
  • Stage 2: Tumor beyond the capsule (Gerota's fascia) with complete resection without residual tumor at the time of surgery
  • Stage 3: Residual unilateral tumor after surgery without extraabdominal extension; includes tumor spillage during surgery or on previous biopsy
  • Stage 4: Hematogenous tumor spread beyond the abdomen or pelvis (to the lung, bone, brain, or lymph nodes)
  • Stage 5: Bilateral renal involvement; each side is staged separately to guide management

Société Internationale d'Oncologie Pédiatrique (SIOP): Intraoperative staging after chemotherapy to reduce the size of the tumor; used in Europe
  • Often the first and only sign of serious infection. It should be evaluated immediately.
  • Definition
    • Fever: Single temperature 38.3°C (101°F) or a temperature 38.0°C (100.4°F) on two occasions 1 h apart. (Note: The temperature should not be taken rectally for..."
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