4 research outputs found
Reducing pain in children with cancer: Methodology for the development of a clinical practice guideline
Abstract
Although pain is one of the most prevalent and bothersome symptoms children with cancer
experience, evidence-based guidance regarding assessment and management is lacking. With
44 international, multidisciplinary healthcare professionals and nine patient representatives, we
aimed to develop a clinical practice guideline (following GRADE methodology), addressing assessment and pharmacological, psychological, and physical management of tumor-, treatment-, and procedure-related pain in children with cancer. In this paper, we present our thorough methodology for this development, including the challenges we faced and how we approached these. This
lays the foundation for our clinical practice guideline, for which there is a high clinical demand
Radiotherapy in advanced-stage Hodgkin's lymphoma.
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Clinico-biologic profile of Langerhans cell histiocytosis: A single institutional study
Context: Langerhans cell histiocytosis (LCH) is a rare atypical
cellular disorder characterized by clonal proliferation of Langerhans
cells leading to myriad clinical presentations and highly variable
outcomes. There is a paucity of Indian studies on this subject. Aim: To
present the experience of management of LCH at a single institution.
Settings and Design: This is a retrospective observational study of
patients with LCH who presented at the Tata Memorial Hospital between
January 1987 and December 2002. Materials and Methods: Fifty-two
patients with LCH were treated in the study period. Due to the long
observation period and variability in diagnostic and therapeutic
protocols, the patients were risk-stratified based on present criteria.
The disease pattern, management approaches and treatment outcomes of
patients were recorded. Statistical Analysis Used: Statistical
analyses were done using Student\u2032s \u2032t\u2032 test, test for
proportion and survival estimates based on the Kaplan-Meier method.
Results: The median age at presentation was 3 years and more than 48%
of the patients had Group I disease. Skeleton, skin and lymphoreticular
system were the commonly involved organs. Majority (80%) required some
form of therapy. The projected overall survival is 63% at 10 years and
mean survival is 118 months. Seventeen percent of surviving patients
developed long-term sequelae. Conclusions: The clinico-biologic
profile of LCH patients in India is largely similar to international
patterns except a higher incidence of lymphoreticular involvement.
Majority of the patients respond favorably to therapy and have a good
outcome, except a subset of Group I patients who warrant enrolment in
clinical trials with innovative therapeutic strategies to improve
outcome