الفهرس 
IntroductiionOnly 14 pages are availabe for public view
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Abstract
Childhood cancer is relatively uncommon. The average annual incidence rate for all cancers is 14.9 cases per 100,000 persons for children and adolescents. The problem of cancer in childhood is multifaceted, thus it is best managed with multidisciplinary care. Surgery is a critical component in the multimodal therapy of childhood cancer. Surgeons are required to take decisions regarding biopsies, accurate staging and successful resection of tumors. Chemotherapy is another pivotal modality in the total management plan of childhood cancer. Since the introduction of chemotherapy for the treatment of childhood leukemia more than 50 years ago, the prognosis of childhood cancer has improved dramatically. Radiation therapy is a another highly effective treatment modality for many pediatric malignancies. The treatment of children with radiotherapy poses special challenges for the radiation oncologist which include; psychosocial issues, technical issues, and biologic issues such as the radiosensitivity of growing normal tissues and late treatment effects in this population of patients who often have a high chance of cure. Recently, new advances have been introduced into radiation therapy; namely, three dimensional conformal radiotherapy (3D-CRT), intensity modulated radiation therapy (IMRT) and proton beam therapy (PBRT). However; while IMRT for adults is widely used as a standard of care, for several reasons IMRT is used with great caution in the pediatric population. Overall, management of pediatric tumors is a problematic issue. Both the physician and the child are faced with short term and long term problems which can either be secondary to the tumor itself or to the treatment used. The childhood cancer survivorship study has released guidelines for adequate detection and management of these problems.