Cancer in Childhood by John R. Evans M.D., D.Phil. (Oxon.), F.A.C.P., F.R.C.P.(C)

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By John R. Evans M.D., D.Phil. (Oxon.), F.A.C.P., F.R.C.P.(C) (auth.), John O. Godden M.D., C.M., M.Sc.(Med.), F.R.C.P.(C), M.A.(Educ. Th.) (eds.)

Viewed as contributions to carrying on with clinical schooling, many medical conferences disappoint simply because, even if application committees plan with care, compile very good school and disclose them to their friends, to different physicians and to accommodate employees. the influence is evanescent. conferences burn up a lot specialist time and public cash to stimulate the fairly few who attend. for this reason the dictum "Hold a symposium and succeed in a couple of hundred; flow a lawsuits and achieve the realm. " regardless of this dictum, many organizers of medical conferences shrink back from the e-book of complaints. insisting that academics won't take part in the event that they need to arrange publishable manuscripts and, in the event that they do conform to organize them, will hold up for months or, in certain cases, won't come via in any respect. although, this is a question of association and resolution: e. g . . a few software chairmen make the money of charges and honoraria contingent upon receipt of a publishable manuscript. Cox and his colleagues in Australia went one greater: they prepared the 1st overseas melanoma convention in Sydney in November 1972 and released a two-volume lawsuits ("Melanoma and pores and skin melanoma" and 'The Nature of Leukemia") prior to the conferences all started. As Dr. Cox notes, "This preprinting of the complete papers freed every one speaker from the need of recounting huge amounts of knowledge in order that each one paper will be opened extra swiftly and provocatively after which defended in dialogue" (Report of the foreign melanoma convention, Med J an inventory, I: 12-33, June 24, 1972).

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EVANS, A. , KING, L. , PICKETT, L. , SUTOW, W. W. and WOLFF, J. : The National Wilms' Tumor Study: A Progress Report. Cancer. (In press) 53 APPENDIX I National Wilms' Tumor Study Committee Members Name Institution Specialty Beckwith, J. Bruce Bishop, Harry C. Breslow, Norman *D'Angio, Giulio J. **Evans, Audrey E. Goodwin, Willard E. King, Lowell R. Pickett, Lawrence K. Sinks, Lucius F. Sutow, Wataru W. Wolff, JamesA. Children's Orthopedic Hospital, Seattle Children's Hospital of Philadelphia University of Washington Seattle Memorial Hospital, New York Children's Hospital of Philadelphia University of California at Los Angeles St.

After 1957, the whole abdomen was radiated in almost all children over the age of two years and in those under two who had extension beyond the capsule, spill of the tumor or infiltration of lymph nodes. At that time it was thought that all patients over two years of age had a worse prognosis. In girls, the pelvis was shielded to protect the ovaries unless the tumor had ruptured so, in them. approximately three-fourths of the abdomen was radiated. The tumor dose was 2500 rads in four weeks. When the whole abdomen was radiated, the normal kidney was shielded in the posterior t1eld and received approximately one-half the tumor dose.

LOWELL R. , LAWRENCE K. , LUCIUS F. , WATARU W. D. and JAMES A. ** Wilms' tumor was virtually incurable before pediatric surgeons, notably Ladd 1, perfected their surgical techniques. Steady improvements thereafter added radiation therapy2 and chemotherapy. The routine postoperative use of actinomycin-D, as reported by Farber 3 , produced a two-year survival rate of 81 % in patients managed from the outset by an experienced team using combination therapy. Wolff and his colleagues4 demonstrated the value of cyclic actinomycin-D given over a prolonged period after operation, and others S ,6 showed that vincristine sulfate was effective in the management of these children.

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