Libro blanco de las ACES Pediátricas 2024
Hematología y Oncología Pediátricas. Anexos ❚ 321 European Training Programme in Paediatric Haematology and Oncology _________________________________________________________________________________________ SIOP Europe – March 2020 Management of clinical tumor‐related problems, i.e., hypertension, spinal cord compression Laboratory findings: urinary catecholamines, neurone specific enolase, ferritin and lactate dehydrogenase Treatment and prognosis according to age, stage, histology and molecular‐genetic aspects (such as MYCN amplification) Role of MIBG scintigraphy for assessment of response Immunotherapy (anti‐GD2 therapy, retinoic acid) Late effects and long‐term follow‐up BONE TUMORS Genetic (i.e., Rothmund‐Thompson Syndrome/RECQL4, Li‐Fraumeni/TP53, retinoblastoma/RB) and non‐genetic predisposing factors (e.g., previous irradiation) and screening strategies in affected individuals. Differential diagnosis of a suspected bone tumor, according to anatomic site (e.g., metaphyseal, diaphyseal or epiphyseal), patient’s age and radiological aspects (e.g., Codman’s triangle). Admission to a tumor orthopaedic centre for biopsy and histopathological as well as genomic aspects of osteosarcomas (e.g., high‐grade vs. low‐ grade, genomic instability) and Ewing Tumors (EWS1‐FLI1 fusion gene, MIC‐99, epigenetics) Frequency and site of primary metastases (i.e., lung metastases, skip metastases) and staging investigations. Systemic therapy: Role of neoadjuvant chemotherapy to facilitate surgery and assess tumor response to treatment (good and poor response criteria). How to choose adjuvant chemotherapy. Local therapeutic approaches: Ablative (amputation and rotation plasties) vs. limbs salvage surgery (allo‐, autografts or prostheses) and the role of radiotherapy (photon‐, proton‐ or heavy ion therapy). Classification of resection margins and importance of completeness of surgical resection. Liquid biopsies in bone sarcomas Late effects and long‐term follow‐up after bone sarcoma therapy: Principles of rehabilitative and preventive care. Management of relapsed disease SOFT TISSUE SARCOMA Diagnostic procedures, histological and biological subtypes of RMS, prognosis and inherent treatment stratification based on histology/molecular diagnosis, IRS‐stage, size, site, and nodal stage. Importance of adequate local therapy, often including radiotherapy. Basic chemotherapy schedule for low, standard and high and very high‐risk RMS
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