The changing face of paediatric oncology

Childhood malignancies differ from those encountered in adult life not only in tumour type but also in their response to treatment. There have been major advances in the use of combined modality and combination chemotherapy regimens over recent years. High-dose therapy with bone marrow and peripheral stem cell transplantation procedures are being increasingly incorporated into specialized treatment regimens, particularly in the management of 'high-risk' and relapsed patients who were previously incurable. Overall, cure rates for children with cancer now exceed 60%. Despite this, the progress in the treatment of some tumour groups remains poor. This paper summarizes recent advances but also highlights some of the problem areas that still exist or are expected to be encountered in the near future.