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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

156
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
156
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

177
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
177
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

215
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
215
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

206
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
206
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

218
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
218
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

5.8K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Pediatric Cancer.

Sujith Baliga1, Torunn I Yock2

  • 1Department of Radiation Oncology, Massachusetts General Hospital/Harvard Medical School, Francis H. Burr Proton Therapy Center, 30 Fruit Street, Boston, MA 02114, USA.

Hematology/Oncology Clinics of North America
|November 20, 2019
PubMed
Summary

Intensified chemotherapy reduces radiotherapy volume in pediatric brain tumors like medulloblastoma. Proton beam therapy offers promise for reducing toxicities in pediatric CNS and non-CNS tumors.

Keywords:
Pediatric cancerProton beam therapySurvivorship

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Area of Science:

  • Pediatric Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Chemotherapy intensification has enabled reduced radiotherapy (RT) volumes in pediatric brain tumors.
  • Current trends favor delaying RT with chemotherapy for low-grade gliomas, using smaller margins when RT is administered.
  • Intensive chemotherapy is standard for extracranial tumors, balancing systemic disease treatment and local control.

Purpose of the Study:

  • To review the evolving role of radiotherapy in pediatric oncology.
  • To highlight the potential benefits of proton beam therapy in managing pediatric tumors.

Main Methods:

  • Literature review of current treatment strategies for pediatric brain and extracranial tumors.
  • Analysis of trends in radiotherapy application and chemotherapy use.
  • Evaluation of proton beam therapy's role in pediatric oncology.

Main Results:

  • Reduced radiotherapy volumes and involved-field approaches are increasingly utilized for pediatric brain tumors, especially medulloblastoma.
  • Delayed radiotherapy with chemotherapy is common for low-grade gliomas, with smaller margins when RT is employed.
  • Proton beam therapy demonstrates potential for mitigating acute and long-term toxicities in pediatric CNS and non-CNS tumors.

Conclusions:

  • Modern chemotherapy regimens allow for more conservative radiotherapy approaches in pediatric oncology.
  • Proton beam therapy presents a promising advancement for improving treatment outcomes and reducing side effects in pediatric cancer patients.