Childhood cancer

To coincide with Childhood Cancer Awareness Month, we are highlighting a range of reviews that have been undertaken at CRD that focus on ameliorating the effects of the aggressive therapies used to treat childhood cancers.

Febrile neutropenia is a common and potentially life-threatening complication of treatment for childhood cancer. Work at CRD has highlighted the uncertainties around the value of biomarkers in the prediction of adverse outcomes from episodes of febrile neutropenia (Phillips 2012) and around the predictive accuracy of risk stratification clinical decision rules upon which targeted treatment decisions are based (Phillips 2010; Phillips 2012).  Further work has focussed on the safety and efficacy of fluoroquinolones (Sung 2012) and has examined the effectiveness of outpatient versus inpatient management and oral versus parenteral antibiotics in children with low-risk febrile neutropenia (Manji 2012).

As with adults, chemotherapy to treat cancer in children and young people can produce nausea and vomiting. This can be extremely unpleasant and continues to be a problem despite better antiemetic drugs. A Cochrane review (Phillips 2010) assessing the effectiveness of antiemetics found that no firm conclusions can be made about which drugs are best. From the limited evidence available, 5-HT3 antagonists appear more effective than older antiemetic agents, even when those agents are combined with a steroid. Adding dexamethasone to the 5-HT3 antagonist of choice doubles the chance of complete control of acute vomiting.

The CRD Databases provide access to other critically appraised systematic reviews and economic evaluations relevant to childhood cancer. To search for these click here.

Individually tailored therapy for febrile neutropenia

  1. Phillips RS, Lehrnbecher T, Alexander S, Sung L. Updated systematic review and meta-analysis of the performance of risk prediction rules in children and young people with febrile neutropenia. PLoS ONE 2012; 7(5):e38300
  2. Phillips RS, Wade R, Lehrnbecher T, Stewart LA, Sutton AJ. Systematic review and meta-analysis of the value of initial biomarkers in predicting adverse outcome in febrile neutropenic episodes in children and young people with cancer. BMC Medicine 2012; 10:6
  3. Phillips B, Wade R, Stewart LA, Sutton AJ. Systematic review and meta-analysis of the discriminatory performance of risk prediction rules in febrile neutropaenic episodes in children and young people. European Journal of Cancer 2010; 46(16): 2950-2964

Outpatient and oral antibiotic management of low risk febrile neutropenia.

  1. Sung L, Manji A, Beyene J, Dupuis LL, Alexander S, Phillips R, Lehrnbecher T. Fluoroquinolones in children with fever and neutropenia: a systematic review of prospective trials. Pediatric Infectious Disease Journal 2012; 31(5): 431-435
  2. Manji A, Beyene J, Dupuis LL, Phillips R, Lehrnbecher T, Sung L. Outpatient and oral antibiotic management of low-risk febrile neutropenia are effective in children: a systematic review of prospective trials. Supportive Care in Cancer 2012; 20(6): 1135-1145

Preventing chemotherapy induced nausea and vomiting

  1. Phillips RS, Gopaul S, Gibson F, Houghton E, Craig JV, Light K, Pizer B. Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood. Cochrane Database of Systematic Reviews: Reviews 2010; Issue 9
  2. Manji A, Beyene J, Dupuis LL, Phillips R, Lehrnbecher T, Sung L. Outpatient and oral antibiotic management of low-risk febrile neutropenia are effective in children: a systematic review of prospective trials. Supportive Care in Cancer 2012; 20(6): 1135-1145

Preventing chemotherapy induced nausea and vomiting

  1. Phillips RS, Gopaul S, Gibson F, Houghton E, Craig JV, Light K, Pizer B. Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood. Cochrane Database of Systematic Reviews: Reviews 2010; Issue 9

Page last updated: 29 May, 2013