• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3515-3519
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• 2016

Background: In Thailand, a national treatment protocol for childhood leukemia and lymphoma (LL) was implemented in 2006. Access to treatment has also improved with the National Health Security system. Since these innovations, survival of childhood LL has not been fully described. Materials and Methods: Trends and survival of children under 15 with childhood cancers diagnosed between 1993 and 2012 were investigated using the hospital-based data from the Khon Kaen Cancer Registry, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Childhood cancers were classified into 12 diagnostic groups, according to the ICCC based on the histology of the cancer. Survival rates were described by period, depending on the treatment protocol. For leukemias and lymphomas, survival was assessed for 3 periods (1993-99, 2000-5, 2006-12) while for solid tumors it was for 2 periods (before and after 2000). The impacts of sex, age, use of the national protocol, and catchment area on leukemia and lymphoma were evaluated. Overall survival was calculated using the Kaplan-Meier method while the Cox proportional hazard model was used for multivariate analysis. Trends were calculated using the R program. Results: A total of 2,343 childhood cancer cases were included. Survival for acute lymphoblastic leukemia (ALL) from 1993-9, 2000-5, and 2006-12 improved significantly (43.7%, 64.6%, and 69.9%). This was to a lesser extent true for acute non-lymphoblastic leukemia (ANLL) (28.1%, 42.0%, and 42.2%). Survival of non-Hodgkin lymphoma (NHL) also improved significantly (44%, 65.5%, and 86.8%) but not for Hodgkin disease (HD) (30.1%, 66.1%, and 70.6%). According to multivariate analysis, significant risk factors associated with poor survival in the ALL group were age under 1 and over 10 years, while not using the national protocol had hazard ratios (HR) of 1.6, 1.3, and 2.3 respectively. In NHL, only non-use of national protocols was a risk factor (HR 3.9). In ANLL and HD, none of the factors influenced survival. Survival of solid tumors (liver tumors, retinoblastomas) were significantly increased compared to after and before 2000 while survival for CNS tumors, neuroblastoma and bone tumors was not changed. Conclusions: The survival of childhood cancer in Thailand has markedly improved. Since implementation of national protocols, this is particularly the case for ALL and NHL. These results may be generalizable for the whole country.

• 대한소아치과학회지
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• 제50권4호
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• pp.421-433
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• 2023

This study was to examine the developmental dental abnormalities in childhood cancer survivors. Risk factors were assessed for 125 children with radiographic data through a retrospective analysis of medical records and panoramic images. 68.0% of childhood cancer survivors exhibited at least one dental abnormality. The types of abnormalities varied depending on the age at cancer diagnosis and treatment intensity, ranging from microdontia (43.2%), to abnormal root development (39.2%) and tooth agenesis (33.6%). Logistic regression analysis demonstrated that a young age at diagnosis (under 3 years), the use of heavy metal agents, a history of hematopoietic stem cell transplantation (HSCT), and combination treatment of chemotherapy, radiation therapy, and HSCT were associated with a significantly higher risk for overall dental abnormalities. The increased risk ratios were 6.00, 3.06, 3.22, and 7.87, respectively (p < 0.05). The results of this study will predict dental abnormality in permanent dentition according to the diagnosis age and treatment method of childhood cancer.

• Child Health Nursing Research
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• 제12권3호
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• pp.304-313
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• 2006

Purpose: This study was done to describe psychosocial adjustment of adolescents who have survived childhood acute lymphocytic leukemia (ALL). Method: Out of a total of 16 adolescents ($11{\sim}20$ years old) registered at the Pediatric Oncology Clinic at one university affiliated hospital, 13 adolescents agreed to participate in this study. The data were collected through in-depth interviews using a semi-structured questionnaire. The contents of the interviews were analyzed using the inductive content analysis method. Result: Three main categories were identified 'personal characteristics', 'coping patterns', and 'interpersonal relationship'. Personal characteristics included self-praise, self-confidence, altruism, being worrisome, and being difficult. Coping patterns included positive thinking, activeness, and avoidance. Interpersonal relationship included appreciation, intimacy, burdened by over protectiveness, and feelings of regret and equality as peers. Conclusion: The results indicate that adolescents who have survived childhood cancer have both positive and negative experiences. It is suggested that care providers identify and support the strengths of the adolescents in order to help them to adjust more positively after the experience of childhood cancer.

• Radiation Oncology Journal
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• 제13권3호
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• pp.267-275
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• 1995

방사선치료와 항암화학요법 등 암의 치료법이 점차 발전해감에 따라 치료후 장기간 생존하는 환자들이 많아지고 특히 소아암 치료후 장기 생존자가 증가하면서 여러가지 치료로 인한 합병증 및 문제점들이 발생하고 있다. 그중 중요한 하나가 이차암의 발생인데 본과에서 이차 악성 고형 종양 발생 환자 2예를 경험하였기에 보고하고자 한다. 한 예는 우측 슬와부에 발생한 rhab-domyosarcoma group II로 수술후 방사선치료 및 항암화학요법을 시행받았는데 3년7개월 후 방사선치료부위에서 osteosarcoma가 발생하였고 또 다른 한 예는 우측 하복부에 소장 악성 림프종이 발생하여 방사선치료 및 항암화학요법을 시행받았고 18년후에 방사선치료부위에 leimyosarcoma가 발생하였다. 문헌 고찰을 통해 소아암 치료후 이차암 발생의 위험 요인들을 고찰하였고 이차암에 대한 인식 및 세밀한 추적 조사가 필요함을 확인하였다.

• 정신신체의학
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• 제11권2호
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• pp.159-169
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• 2003

연구목적: 본 연구의 목적은 소아암 환아 부모와 일반 부모 사이의 스트레스와 삶의 질을 비교하는 데 있다. 방 법: 스트레스 인자지각는 전반적인 스트레스평가 척도(global assessment of recent stress)를, 스트레스 반응(정신병리)은 간이정신진단척도(Symptom checklist-90-revised)를 이용하였다. 대응전략은 대응척도를 이용하였으며, 삶의 질은 스미스클라인비참 삶의 질 척도를 이용하였다. 결 과: 소아암 환아 부모군은 대인관계, 관계의 변화, 질병 및 상해, 경제적 문제, 비일상적인 사건 등과 관련한 스트레스인자 지각점수가 대조군보다 각각 유의하게 더 높았다. 대응전략에서는 소아암 환아 부모군이 대조군보다 자기 통제, 긍정적 재평가 점수가 각각 유의하게 더 높았다. 정신병리에서는 소아암 환아 부모군이 대조군보다 불안, 우울, 신체화, 공격성 점수가 각각 유의하게 더 높았다. 삶의 질 척도 점수는 소아암 환아 부모군이 대조군보다 유의하게 더 낮았다. 급성 백혈병 환아 부모 사이의 비교에서 대응전략에서는 ANLL 환아 부모가 ALL 환아 부모보다 거리감두기, 책임수용 점수가 각각 유의하게 더 높았다. 정신병리에서 ANLL 환아부모가 ALL 환아 부모보다 우울 점수가 유의하게 더 높았다. 결 론: 소아암 환아 부모들이 높은 스트레스 지각과 낮은 삶의 질을 보고하고 있으므로 이에 대한 스트레스 관리프로그램 등 정신사회적 개입이 필요하다.

• Journal of Ginseng Research
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• 제48권1호
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• pp.68-76
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• 2024

Background: Although the survival outcomes of childhood cancer patients have improved, childhood cancer survivors suffer from various degrees of immune dysfunction or delayed immune reconstitution. This study aimed to investigate the effect of Korean Red Ginseng (KRG) on T cell recovery in childhood cancer patients who underwent autologous hematopoietic stem cell transplantation (ASCT) from the perspective of inflammatory and senescent phenotypes. Methods: This was a single-arm exploratory trial. The KRG group (n = 15) received KRG powder from month 1 to month 12 post-ASCT. We compared the results of the KRG group with those of the control group (n = 23). The proportions of T cell populations, senescent phenotypes, and cytokine production profiles were analyzed at 1, 3, 6, and 12 months post-ASCT using peripheral blood samples. Results: All patients in the KRG group completed the treatment without any safety issues and showed a comparable T cell repopulation pattern to that in the control group. In particular, KRG administration influenced the repopulation of CD4⁺ T cells via T cell expansion and differentiation into effector memory cell re-expressing CD45RA (EMRA) cells. Although the KRG group showed an increase in the number of CD4⁺ EMRA cells, the expression of senescent and exhausted markers in these cells decreased, and the capacity for senescence-related cytokine production in the senescent CD28^- subset was ameliorated. Conclusions: These findings suggest that KRG promotes the repopulation of CD4⁺ EMRA T cells and regulates phenotypical and functional senescent changes after ASCT in pediatric patients with cancer.

• Child Health Nursing Research
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• 제8권1호
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• pp.44-54
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• 2002

The main purpose of this methodological study was to develop an assessment tool and intervention protocol for child and family with childhood cancer at early diagnosis stage. The assessment tool and intervention protocol was developed by extensive literature review and consultation with experts. Review of nine domestic and sixty-six international journal articles were done to identify stress, interventions, coping strategies and adjustment of children with cancer and their family. Results were as follows; First, assessment at the early diagnosis stage need to include information on patient, family, and patient/family attitude toward diagnosis and treatment. Second, intervention protocol for children with cancer includes control physical symptoms, manage the side effects of chemotherapy and diagnostic or therapeutic procedures, control emotional responses, provide support and information, assist decision-making and adjust to environment. Third, intervention protocol for family includes controlling emotional responses, provision of informations, inducing family support to patient, improving family cohesion, supporting siblings and supporting spiritual growth. In conclusion, the early diagnosis stage in cancer treatment is important for child and family since this stage greatly affects the overall adjustment of child and family to live with cancer. Therefore, pediatric nurses need to be sensitive to the need of patient/family and systematically manage their needs at this stage.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2347-2350
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• 2015

Childhood acute lymphoblastic leukemia (ALL) is one of the most common hematologic malignancies, accounting for one fourth of all childhood cancer cases. Exposure to environmental factors around the time of conception or pregnancy can increase the risk of ALL in the offspring.This study aimed to evaluted the role of prenatal and postnatal exposure to high voltage power lines on the incidence of childhood ALL.This cross-sectional case control study was carried out on 22 cases and 100 controls who were born and lived in low socioeconomic families in Isfahan and hospitalized for therapeutic purposes in different hospitals from 2013-2014.With regard to the underlying risk factors, familial history and parental factors were noted but in this age, socioeonomic and zonal matched case control study, prenatal and childhood exposure to high voltage power lines was considered as the most important environmental risk factors of ALL (p=0.006, OR=3.651, CI 95%, 1.692-7.878). As the population was of low socioeconomic background, use of mobiles, computers and microwave was negligible. Moreover prenatal and postnatal exposure to indoor electrically charged objects was not determined to be a significant environmental factor. Thus, pre and post natal exposure to high voltage power lines and living in pollutant regions as well as familial influence could be described as risk factors of ALL for the first time in a low socioeconomic status Iranian population.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7613-7618
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• 2015

Childhood acute lymphoblastic leukemia (ALL) is one of the most common hematologic malignancies which accounts for one fourth of all childhood cancer cases. Exposure to environmental factors around the time of conception or pregnancy can increase the risk of ALL in the offspring. This study aimed to evaluate the influence of prenatal and postnatal exposure to high voltage power lines on the incidence of childhood ALL. It also examines the role of various factors such as environmental factors and alpha-amylase as a marker in the development of leukemia.This cross-sectional case control study was carried out on 22 cases and 100 controls who born and lived in low socioeconomic families in Tehran and were hospitalized for therapeutic purposes in different hospitals ofrom 2013-2014. With regard to the underlying risk factors; familial history and parental factors were detected as risk factors of ALL but in this age, socioeonomic and zonal matched case control study, prenatal and childhood exposure to high voltage power lines was considered as the most important environmental risk factor (p=0.006, OR=3.651, CI 95% 1.692-7.878). As the population study was from low socioeconomic state, use of mobiles, computers and microwaves was negligible. Moreover prenatal and postnatal exposure to all indoor electrically charged objects were not detected as significant environmental factors in the present study. This work defined the risk of environmental especially continuous pre and postnatal exposure to high voltage power lines and living in pollutant regions through the parents or children as well as the previously described risk factors of ALL for the first time in low socioeconomic status Iranian population.

• Advances in pediatric surgery
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• 제14권2호
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• pp.189-195
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• 2008

Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.