الفهرس 
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Abstract
One hundred and thirty three consecutive eases of children • with malignant tumours other than Thumb’ seen in the Radio-therapy Unit of Alexandria Faculty of Medicine, from January 1969 to June 1979 were analysed . The relative frequencies of cases per year showed progressive increase in number in the
last five years. The three commonest types in rank order were lymphoma (61%), neuroblastoma (17%) and soft tissue sarcoma (11%)
The youngest age reported was 6 months (a case of neuro-blastoma); males were found to be more commonly affected than females with a sex ratio of 1.6:1 .
The clinical presentations of these cases varied according to the type of the tumour, its site of origin and stage. The most common presentations were abdominal masses (45%), enlarged lymph nodes, aortic, iliac and inguinal (23%), abdominal pain (19%), loss of weight (19%) and fever (15%) ,
In oases of lymphoma with abdominal involvement, Non Hodgkin Is lymphomas were found to be more common than Hodgkin’s disease
(43 cases with Non Hodgkin’s lymphoma and 38 oases with Hodgkin’s
disease) and lymphocytic lymphoma constituted 72% of the Non Hodgkin’s lymphoma. Most of Oases seen in the Radiotherapy Department presented with late stages (e.g. 82% of lymphoma oases were stages III & IV, while 72.7% of patients of neuro-blastoma were stage IV and 47% had general dissemination in soft tissue sarcoma). Surgery played an important role; all cases of lymphoma were subjected to biopsy (81. cases), 43 cases were submitted to exploratory laparotomy for pathological staging and treatment planning (20 Non Hodgkin’s lyzaphotet and 13 Hodgkin’s disease). Excision of mass was done in 20 cases
of Non Hodgkin’s lymphoma presenting with intestinal involvement. Excision of the suprarenal mass was done in 18 cases of neuro-blastoma. Only biopsy could be done in most of the cases with soft tissue sarcoma and partial excision was performed in 5
oases only end in teratoma excision of the ovarian and testicular masses was done in 5 cases only
The most frequent method of treatment in this series was irradiation (72%), this was given either alone or in combination with chemotherapy. Patients with Hodgkin’s disease stage (subdiaphragmatio) received inverted Y technique, while those with Non Hodgkin’s lymphoma received whole abdominal irradiation; Patients with stages and III-B received total nodal.
irradiation followed by chemotherapy, but 7 with Non Hodgkin’s lymphoma with intestinal involvement received chemotherapy alone and gave good results. Those with stage IV received chemotherapy and palliative irradiation. The treatment of other types of the tumours varied according to their stages.
Lymphoma and soft tissue sarcoma showed the best survival followed by teratoma and neuroblastoma respectively. The earlier the stage, the better the prognosis, at the same time in lymphoma patients, those presenting with constitutional symptoms showed relatively lower survival than those without. Of the 8 children with Hodgkin’s disease surviving 5 years and 7 had favourable histology: lymphocytic predominance and nodular sclerosis.
Lt the same time, of the 9 cases with Non Hodgkin’s lymphoma, surviving the same period, 8 patients were of the lymphocytic type. Patients with neuroblastoitta showed poor results . This can be related to late stages of the disease amen in most of the children. Only 14% survived fox 2 years. The younger the age the better the prognosis, 2 Yeaxs dropped from 33% in patients with 0 to 2 years to 0% in those over 6 years . Prognosis in soft tissue sarcoma was relatively better .
These who survived for four years had rhabdomyosercoma receiving
radiotherapy after resection. In teratocareinoma only two
Patients with testicular and paratistioular tumours survived three years after surgery followed by irradiation to regional lymph nodes