Presentation Description: This presentation offered a visual review of the remarkable surgical options available in skilled hands to preserve and restore the best possible function of the genitor-urinary tract after local control of sarcomas of this anatomical site.
Speaker:
Antoine E. Khoury, MD, FRCSC, FAAPProfessor
Department of Urology, University of California Irvine and Chief of Pediatric Urology Children’s Hospital of Orange County
University of California, Irvine
Pediatric Urologist
Children’s Hospital of Orange County and University of California, Irvine Medical Center, Orange County, CA
Presentation Description: High Dose Methotrexate (HDMTX) is an integral part of osteosarcoma therapy whose main toxicities include myelosuppression, mucositis, nephrotoxicity, and hepatitis. In order to deliver HDMTX therapy safely, patients require urinary alkalinization, hydration, monitoring of renal function, therapeutic drug monitoring, and leucovorin rescue. Due to the required supportive care needs, HDMTX has historically been given as an inpatient. In some centers however, HDMTX is being given safely as an outpatient in order to reduce health care costs, improve patient quality of life and to deliver timely therapy with limited inpatient chemotherapy beds available.
At the time of this presentation, a pilot study was being undertaken at SickKids to: 1. determine the safety and feasibility of delivering HDMTX in an outpatient setting, 2. determine if there is an economic benefit in delivering HDMTX as an outpatient compared to as an inpatient, 3. describe the outpatient MTX experience from the patient’s and parent’s perspective.
This aim of this presentation was to outline the processes and procedures that were necessary to set up ambulatory HDMTX. This project was truly a multidisciplinary undertaking, and would not have been possible without the knowledge and expertise of multiple health care providers. This presentationl reviewed how the outpatient program was set up within the Ontario Health Care context, as well as highlight lessons learned along the way.
Speakers: Eleanor Hendershot, RN(EC), MN, BScN
Nurse Practitioner, Paediatric AfterCare Program
The Hospital for Sick Children, Toronto
Princess Margaret Cancer Centre, Toronto
Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, Toronto
Sandra Ross, BA, RN
Clinical Support Nurse, Outpatient Day Hospital
Division of Hematology/Oncology
The Hospital for Sick Children, Toronto
The 2010 POGO Multi-Disciplinary Symposium on Childhood Cancer – Pediatric Sarcomas: Biology to Impact – explored advances in biology, diagnosis and therapy of rhabdomyosarcoma and osteosarcoma in particular, and examined the impacts of sarcomas and their treatment on the daily lives of the patient and family both during and after treatment. The related domains of rehabilitation, developmental aspects including sexuality, and cultural and developmental impacts on decision making were also targeted. This material is relevant to all professional disciplines that manage these patients.
NOTE: The content of each presentation below captures the unedited information and opinions presented by the speakers. Please note that the information contained in the presentations was current at the time it was presented – there may be further information in subsequent literature. Listed speaker credentials were current at the time of presentation.
Presentation Description: Osteosarcoma was initially considered to be a chemo-resistant tumor. In the early 1970s high dose Methotrexate and amputation administered alone or in combination with other agents yielded a cure rate of 40-65 percent. This result was challenged. In this presentation, the saga of the controversy and the final acceptance of the regimen is described.
Speaker:
Norman Jaffe, MD, Dip Paed, DSc
Professor Emeritus
The University of Texas MD Anderson Cancer Centre, Houston, TX
Presentation Description: A small portion of stem cells in a given tissue give rise to all of the cells that make up that tissue, and help regenerate and maintain the tissue over its lifespan. Cells with these characteristics have been identified in a variety of tumor types and are called tumor initiating cells (TIC). A subpopulation of cells with TIC characteristics have been identified in a number of sarcomas, along with some novel characteristics within this TIC population. Some of these characteristics can be exploited using novel chemotherapeutic approaches. At the time of the presentation, these approaches were being tested in mouse models of sarcomas.
Speaker:
Benjamin Alman, MD, FRCSC
Head, Division of Orthopaedic Surgery
Senior Scientist, Program in Developmental & Stem Cell Biology
The Hospital for Sick Children, Toronto, ON
