Challenges and Opportunities in Pediatric Oncology [antikvár]

Preface: Understanding the Challenges and Opportunities of Pediatric Oncology in Our Small World FREDERICK F. HOLMES Department of Medicine University of Kansas Medical Center 39th and Rainbow Boulevard Kansas City, Kansas 66160 This volume contains papers from physicians, scientists, and surgeons who attended the fifth annual Winnie the POOH Conference on pediatric malignancies held in Budapest, Hungary, in October of 1996. With funding from the U.S. Agency for International Development (USAID) and sponsorship of the University of Kansas Medical Center, there were 150 attendees from 23 countries, more than half from the nations of Central and Eastern Europe, still adjusting after decades of domination by the former Soviet Union. Cancer is the second leading cause of death for children in the Western world. Rates of remission, survival, and cure of childhood malignancy may well represent the best measurements of the sophistication and efficiency of medical services provided to children in particular societies. The conference attempted to close the gaps between basic and cHnical sciences in pediatric oncology and between countries with the most advanced treatment modalities and those striving to join them. All aspects of childhood mahgnancy, from basic research to clinical trials to supportive care were addressed and are presented in the papers of this volume. The multidisci-plinary approach to treating the child with cancer was central to the presentations, with concentration on basic and clinical science information useful to the day-to-day practices of those who care for children with cancer. Opening the conference. His Excellency, Árpád Göncz, President of Hungary, reminded those present that its children are the most important resource any nation has in planning for its future. The reader of this volume will find consideration of molecular genetics and cellular events such as apoptosis, with particular focus on bone marrow and stem cell transplantation in childhood leukemia. Direct clinical application of basic science knowledge to chemotherapy is considered in detail as well as the importance of biological markers in guiding and directing therapy. Pediatric central nervous system tumors are considered in detail, from the immunobiology of gliomas generally to the specifics of surgical approaches to uncommon tumors and, of course, the remarkable advances of recent years in the multidisciph-nary management of tumors such as medulloblastomas. In respect to quality of life for long-term survival for children cured of brain tumors, careful attention to the specifics of initial management has proved to be of the greatest importance. In this regard, considering all pediatric malignancies, the conference carefully and thoroughly addressed the consequences of treatment, cure, and long survival. Supportive care, treatment toxicity, quality assurance, and the psychosocial aspects of pediatric cancer are presented in papers in this volume as well. Finally, the great