Pediatric Oncology Open Access Articles
Pediatric cancers are rare, representing only 1% of all new cancers diagnosed in the United States (Ward 2014); however, they are the second leading cause of death after accidents in children age 1 to 14 years (Siegel 2017). In 2017, an estimated 10,270 children (birth to 14 years) were diagnosed with
cancer (excluding benign/borderline malignant
brain tumors) and 1,190 died of the disease in the United States (Siegel 2017).
Cancer occurs more commonly in
adolescents and young adults age 15–39 years than in younger children. Cancers occurring in adults are classified by the anatomical site of the primary tumor. Similarly, cancers in children and younger
adolescents are classified by site but also according to histology. The six most common childhood cancers by International Classification of Childhood Cancers groups are listed in Table 1-1.
Cancer affects children throughout the world, and there are many international
cancer research groups. Unless otherwise indicated, the focus of this chapter will be limited to U.S.-based research groups. Pediatric
Oncology Research and Cooperative Groups The effort to treat childhood cancers began with individual researchers at individual institutions. Early investigators were Sidney Farber at Children’s Hospital Boston and Joseph H. Burchenal at Memorial Hospital Sloan-Kettering Institute, who both studied
leukemia in the 1940s. As the most common type of pediatric cancer,
leukemia naturally became a focus of early pediatric
cancer research. At that time, children diagnosed with
leukemia died within weeks of diagnosis. In 1947, Farber achieved the first partial remission of pediatric
leukemia in a 4-year-old girl using the drug aminopterin (an analog of methotrexate). In a landmark scientific paper, Farber documented 10 cases of remission, although these were temporary
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