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Badar Q.,Aga Khan University | Ali N.,Aga Khan University | Abbasi N.,Aga Khan University | Ashraf S.,Children Cancer Hospital | And 2 more authors.
Journal of the Pakistan Medical Association

Ewing's sarcoma is the second most common primary tumour of bone in childhood. Less frequently it occurs in soft tissues. Ewing's sarcoma/primitive neuroectodermal tumour (ES/PNET) is an extra ordinarily rare primary tumour in the kidney. Only very few cases of primary renal Ewing's sarcoma have been reported in the literature to date. We present a case of primary right renal Ewing's sarcoma in a 13 year old girl who was diagnosed as a case of stage IV ES/PNET of kidney with metastases to lung and liver. Right nephrectomy was done followed by adjuvant radiotherapy and chemotherapy with complete response to local and distant area. Source

Shad A.,Georgetown University | Ashraf M.S.,Children Cancer Hospital | Hafeez H.,Shaukat Khanum Memorial Cancer Hospital and Research Center
Journal of Pediatric Hematology/Oncology

Palliative care services are poorly developed in most resource-poor countries. With the increase in the number of cancer cases being diagnosed in these countries, most of whom present in advanced stages, an urgent need for palliative care is emerging. Pakistan is an example of a resource-poor country where palliative care services are in the initial phase of development. Copyright © 2011 by Lippincott Williams & Wilkins. Source

Attalla E.M.,Cairo University | Eldesoky I.,Children Cancer Hospital | Eldebawy E.,Cairo University
Chinese-German Journal of Clinical Oncology

Objective: The aim of the work was to compare the dosimetric results that were obtained by using two treatment planning systems (TPS) Siemens KonRad version 2.2.23, Elekta XiO version 4.4 to perform a simultaneous integrated boost (SIB) for head and neck and central nervous system (CNS) cases in paediatric patients. Methods: The CT scan data for five paediatric patients, with head and neck and CNS tumors, were transferred into both of the TPSs. Clinical step-and-shoot intensity-modulated radiotherapy (IMRT) treatment plans were designed using 6 MV photon beam for delivery on a Siemens Oncor Accelerator with multileaf collimator MLC (82 leaf). Plans were optimized to achieve the same clinical objectives using the same beam energy, number and direction of beams. The analysis was based on isodose distributions, the dose volume histogram (DVH) for planning target volume (PTV) and the relevant organs at risk (OARs) as well as volume receiving 2 Gy and 5 Gy, also total number of segments, MU/segment, and the number of MU/cGy had been investigated. Treatment delivery time and conformation number were two other parameters in this study. Results: The segmentation using KonRad was more efficient, resulting in fewer segments (reduction between 13.2% and 48.3%), fewer MUs (reduction between 10.7% and 33%) and that reflected on treatment delivery times to be shorter by up to 8 min or 46%. In most of the cases KonRad had the highest volume receiving in excess of 2 and 5 Gy, and XiO showed the lowest. Also KonRad achieved slightly better conformality (0.76 ± 0.054) than XiO (0.73 ± 0.05) while XiO presented a higher modulation factor value (3.3 MU/cGy) than KonRad (2.4 MU/cGy). Conclusion: The KonRad treatment planning system was found to be superior to the XiO treatment planning system. This is true for the possible increase of radiation-induced secondary malignancies as well as for the local control. © 2013 Springer-Verlag Berlin Heidelberg. Source

Ashraf M.S.,Children Cancer Hospital
Journal of Pediatric Hematology/Oncology

Pediatric oncology in Pakistan has developed over last decade with substantial increase in the facility for treatment and number of expertise. Though large numbers of children still do not reach treatment center more children have now access to quality cancer treatment. There has been gradual improvement in Pediatric oncology nursing and allied services. Pediatric Palliative care in Pakistan is in initial phase of development. Pediatric Oncology services are largely supported by philanthropists. Children Cancer Hospital a project of Children Cancer Foundation Pakistan Trust is not only providing quality treatment to every child regardless of paying ability but also playing a pivotal role in capacity building and creating awareness about childhood cancer in Pakistan. Copyright © 2012 by Lippincott Williams & Wilkins. Source

Palliative care is uprising in developing countries. The Children Cancer Hospital Egypt 57357 palliative care service put the main concepts in pediatric palliation in consideration while facing the challenges and needs for these children and their families. The palliative care program developed will be connected to other centers in Egypt as well as further branches of the hospital in other Egyptian cities. Copyright © 2011 by Lippincott Williams & Wilkins. Source

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