الفهرس 
Pediatric Malignancies
Wilms TumorOnly 14 pages are availabe for public view
 |  | from | 170 |  |  |
| | | from | 170 | | |
Abstract
Children with cancer are at high risk of feeding problems, both from the tumor itself and from the treatment administered. Malnutrition is a common problem in cancer patients, which originates from loss of appetite, nausea and gustatory disturbances. These feeding difficulties are anorexia, cachexia, nausea, vomiting, mucositis, diarrhea, constipation, changed taste and smell.
The aim of the study was to determine the prevalence of feeding difficulties that occur in pediatric patients having malignancies as a result of chemotherapy and/or radiotherapy. This study was carried out during the period from June 2008 to June 2009 and included 150 patients with hematological and solid tumors recruited from cases referred to the pediatric Hematology and Oncology unit, Children’s Hospital, Ain Shams University.
Patients were subjected to clinical examination and laboratory assessment. Statistical analysis was done to evaluate the different studied parameters .
Our study revealed that acute leukemia was the most common type of childhood malignancy representing(58%), followed by neuroblastoma , lymphoma , Wilms tumor , germ cell tumor, Langerhan cell histiocytosis , teratoma and rhabdomyosarcoma in a percentage of 16%, 12%, 4%, 3.33%, 3.33%, 2%, 1.33% respectively. All the patients received chemotherapy and 44 patients received radiotherapy in addition to chemotherapy.
In the current study; the prevalence rate of acute vomiting was 51.33%, delayed vomiting was 26%, while anticipatory vomiting was 12%.
In our study; the percentage of patients who experienced
both mild and moderate nausea and vomiting were the same and constituted 30.6%, while severe vomiting was 10.6% and 28% had no vomiting
Regarding patient’s expectations as a predictor of nausea and vomiting after chemotherapy, we found significant correlation between expectations of nausea and subsequent prevalence of nausea and vomiting but there no statistical correlation between anticipatory vomiting and severity of vomiting
With respect to correlation between anticipatory vomiting and the emetic potentiality of the chemotherapeutic drugs, it was not statistically significant
In the current study, no statistical significance was found between age of patients and both expected and delayed vomiting
Though 66.6%of patients who had anticipatory vomiting were females, it was not statistically significant. This implicates that gender difference is not a risk factor in the occurrence of anticipatory vomiting
In the current study we observed that 40% of the enrolled patient suffered from mucositis, ranging from grade 1 to 3 according to WHO definition in 32% of the patients, most of them were those suffering from hematological malignancies.
Methotrexate, cyclophosphamide, cytarabine, arac, carboplatin, cisplatin were the most chemotherapeutic agents frequently associated with mucositis
In our study there was no statistical correlation between mucositis and marked weight and no statistical correlation between mucositis and BMI
Exposure to radiotherapy was associated with high prevalence of mucositis grading 1-2 according to WHO classification
In the current study, prevalence of candidal and herpes simplex virus infection on top of mucositis was recorded; where 10% and 12% patients had oral candidiasis and HSV infection respectively. Additionally we found 30 patients with absolute neutrophil count <500/mm3 ( severe neutropenia).
The effect of malignancy on body weight changes revealed that 42.6% of patients had anorexia and 12% had cachexia, also we found that incidence of weight gain was 10%
28% of the enrolled patients had attacks of diarrhea while 11.33% experienced constipation mostly due to vicristine and/or opioids.
In coclusion, this study revealed that pediatric cancer patients are subjected to chemotherapy and/ or radiotherapy which are very powerful methods of treating malignancies which cause many side effects resulting in feeding problems in those patients