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Dana-Farber/Brigham and Women’s Cancer Center
Massachusetts General Hospital Cancer Center
Boston, Massachusetts
800.320.0022
www.dfbwcc.org
www.massgeneral.org/cancer

Pediatric Oncology Services

Introduction

Pediatric oncology services are provided through a collaborative program between Dana-Farber Cancer Institute and Children's Hospital Boston. This more than 60-year old partnership, known as Dana-Farber/Children's Hospital Cancer Care, offers the combined strengths of one of the nation's leading cancer research and treatment institutions and one of the premier pediatric medical centers to provide state-of-the-art care for children, adolescents and young adults with cancer. Outpatient care is provided at Dana-Farber's Jimmy Fund Clinic, while inpatient care and certain outpatient procedures occur at Children's. These two neighboring institutions function as one to provide continuity of care for children with cancer.

The pediatric oncologists at Dana-Farber and Children's have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

General Information

Leadership

Clinical and Research Information

Research Efforts

Major research initiatives are underway in the following areas:

· Anti-angiogenesis in the treatment of pediatric brain tumors

· Medulloblastoma

· Ependymoma

· Brain stem tumors or gliomas

· Brain tumors - recurrent or progressive

· Leukemia - Precursor B Cell

· Low-grade pediatric brain tumors, including astrocytoma

· Hodgkin disease and Non-Hodgkin lymphoma

· Osteosarcoma

· Rhabdomyosarcoma

· Renal tumors

· Solid tumors

· Ewings

· Retinoblastoma

· Neuroblastoma

· Stem cell transplantation: autologous transplant for brain tumors and neuroblastoma, including the use of MIBG, management of post-transplant pulmonary complications, the role of double umbilical cord blood transplant and reduced-intensity transplants for aplastic anemia.

· Immunology

· Cancer Genetics

· Gene therapy

· Progeria

· Quality of Life Outcomes

Special Expertise

Acute Lymphoblastic Leukemia

Treatment programs for acute lymphoblastic leukemia cover newly diagnosed and relapsed patients. Dana-Farber Cancer Institute leads a cooperative group in the investigation of newly diagnosed acute lymphoblastic leukemia and is the recipient of a program project grant from the National Cancer Institute for these endeavors. The Acute Lymphoblastic Leukemia program has numerous publications and is considered a model for the world.

Bone Marrow/Stem Cell Transplantation

The Stem Cell Transplantation program at Dana-Farber and Children's is one of the oldest and largest programs in the nation. It remains a pioneer in areas such as the treatment of high-risk solid tumors, infant transplantation, and other specialized protocols. Types of conditions treated include:

· Leukemias: acute lymphocytic leukemia, acute myelogenous leukemia, chronic myeloid leukemia

· lymphomas

· primary immunodeficiencies, including severe combined immunodeficiency syndrome

· inherited blood disorders, such as sickle cell disease, and

· solid tumors, including neuroblastoma, brain tumors and Wilms' tumor, among others.

The 13-bed transplant unit combines state-of-the-art filtration and infection control with comfort for patients and parents. In 2008, the unit added a lead-lined room used for neuroblastoma MIBG treatments. Patients have their own television and computers, with easy access to the hallway area, nurse's station, and playroom. All patient rooms are equipped with a bed and closet so one parent can always stay with their child.

Bone Tumors-Ewing's Sarcoma and Osteosarcoma

An accomplished multidisciplinary team, consisting of an orthopedic surgeon, two pediatric oncologists, and a radiotherapist, provides comprehensive care for patients with bone tumors. Each member of this team also leads efforts with the Children's Oncology Group.

Brain Tumor /Neuro-Oncology Program

Dana-Farber and Children's Brain Tumor program is the largest in the region. World-class neurosurgical staff use the latest technologies, including operating with microscopes, the latest MRI techniques, and new focal radiotherapy procedures. Children's also offers the Intraoperative MRI, which is used to optimize tumor resection. Stereotactic radiotherapy used to treat small tumors more precisely. After treatment, Dana-Farber's Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic provides specialized care for patients dealing with long-term effects caused by treatments, including the Back to School program.

Germ Cell Tumors

A multidisciplinary team of oncologists, pediatric surgeons and pediatric gynecologists provides treatment of germ cell tumors. Treatment protocols are generally those used by the Children's Oncology Group.

Graft-vs.-Host Disease

Research expertise in immunology and the effects of immuno-suppression drugs are applied to bone marrow and stem cell transplant reactions. Patients are seen in a multidisciplinary clinic focused on chronic GVHD and on late effects and follow-up.

Late Effects

Dana-Farber Cancer Institute operates an extensive quality of life/late effects clinic for young cancer survivors called The David P. Perini, Jr. Quality of Life Clinic. This multidisciplinary clinic offers the expertise of pediatric oncologists, radiation oncologists, endocrinologists, cardiologists, dentists, psychologists, advanced practice nurses, and many other experts to evaluate and provide aid for patients who have previously received treatment for childhood cancers. Research efforts include the long-term side effects of many drugs including anthracyclines and cyclophosphamide. Recently the team also published two Transition to Survivorship notebooks, which offer patients and families post-treatment guidelines.

Lymphoma-Hodgkin's and non-Hodgkin's Lymphoma

A multidisciplinary team supervises the care of all patients with Hodgkin's disease and non-Hodgkin's lymphoma. This team consists of pediatric oncologists, radiation oncologists, and surgeons, all nationally prominent in the care of patients with lymphomas.

Non-Bone Solid Tumors-Rhabdomyosarcoma, Neuroblastoma, and Wilms' Tumor

A multidisciplinary team is dedicated to the care of patients with non-bone solid tumors. The team consists of a pediatric oncologist, a dedicated oncologic surgeon, and a radiation oncologist.

Psychosocial Services

Psychologists, social workers, and resource specialists offer a wide range of supportive services to help patients and families manage the emotional and practical challenges raised by a cancer diagnosis and its treatment. Psychosocial experts work closely with the child's medical teams, as well as with other staff members involved in caring for the child and family. Services are available on a short or long-term basis throughout the child's treatment, including: individual and family therapy, play therapy, behavioral interventions and strategies to manage anxiety, pain, or stress, support groups, consultation with schools, information about insurance and other financial matters, and psycho-education.

Radiation Oncology

This program offers state-of-the-art technologies, some available at only a few medical centers in the nation. These include a unique two-headed linear accelerator for total body irradiation given prior to transplantation. a radiation simulator, which allows radiation treatment to be carefully mapped out in advance for optimum treatment with minimum exposure, and a unique two-headed linear accelerator for total body irradiation given prior to transplantation. If needed, pediatric anesthesiologists provide procedural sedation. The team may also prescribe proton beam therapy, when necessary.

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