PAEDIATRIC ONCOLOGY: EVOLUTION OF DIAGNOSIS AND TREATMENT

Key words: Paediatric oncology, Diagnosis, Treatment

The objective of treatment for more than 70% of children with cancer outlines the successful routes built up by paediatric oncologists over the latest 40 years. In addition to the evolution of diagnostic routes reported in our former article, the second backbone of this successful story stands for the development of multicenter (national, international), cooperative, non-profit clinical trials. The therapeutic approach is based on limited surgery, radiotherapy and, principally, on chemotherapy protocols, part of controlled clinical studies as consequence of the progressive use of new drugs, new drug schedules and doses. However, about 25% of children still die without additional efficacious therapeutic options and the treatment may often represent cause of early toxic events and even of long term sequelae. The progress of our understanding of the molecular bases of the neoplastic transformation has opened the possibility to interfere directly with genes and their altered products inside the tumour cell. Of course, the “dream“ to rely upon more specific substances selectively directed towards known “targets” evokes the advantages of a personalized and more specific medicine in favour of the reduction of early and long term toxicity, which does represent an important objective to pursue also with the presently available therapies.