, ,

10-20 100 000

,
.


:
1-4 3
5-14 2
 5

19942004.

16,3%:
9,8 11,4 100000

Over the past 20 years, there has been some
increase in the incidence of children
diagnosed with all forms of invasive cancer,
from 11.5 cases per 100,000 children in 1975
to 14.8 per 100,000 children in 2004.


In developed countries, around 1 in 200 (0.5

per cent) of all cancers occur in children aged
under 15 years. The incidence rate is typically
in the range 11-15 per 100 000 children per
year,1 equivalent to a risk of around 1 in 500
during the first 15 years of life.
Nevertheless, in Great Britain, cancer
accounts for around 20 per cent of all deaths
in children aged 1 to 14 years.


About one-third of childhood cancers are
leukemias.



.


The most common solid tumors are

brain tumors (e.g., gliomas and
medulloblastomas), with other solid
tumors (e.g., neuroblastomas, Wilms
tumors, and sarcomas such as
rhabdomyosarcoma and osteosarcoma)
being less common
 90%
,

.


, ,
.
: PNET ( );
; ; ;
; ; ;
;

.
: ; (
); ; ;
.
.
: ,
, ,
.







()



()
.
, ,

,
1 .

.

, ,
, ,


.
( .. ., 2001)

Over the past 20 years death rates declined
dramatically and 5-year survival rates
increased for most childhood cancers. For
example, the 5-year survival rates for all
childhood cancers combined increased from
58.1 percent in 197577 to 79.6 percent in
19962003. This improvement in survival rates
is due to significant advances in treatment,
resulting in a cure or long-term remission for a
substantial proportion of children with cancer.

,
, ,
.
.
,



.

.

Eventually, more than 1 in 1,000 adults

of all ages will be survivors of childhood
cancer
1 1000

.



:


( )

. , 2010 .


(),
, - 0,72
100 000 (0-14 ) [ .
., 2005].
:

10-15%.

5- , 5-7%



1 2
DAL-HD
2-6 ,
()
, ,
, , 2 ()+
0/2/4 +


36-46 20-35
,


1-6 (. )


1 2

6,7 ( 3,8 (
0,5 32 ) 0,25 13 )

, 255 121

3 213 (83%) 71 (59%)

4 166 (65%) 53 (44%)



 (
)
 ,

 2
1

1 2

32/255 4/121


P<0,05
% 12,5% 3,3%



1 2

- -

P=0,02 26 69% 30 37%

9 33% 31 16%

35 94,3% 28 67,9%
=0,007
 ,
12


9 28 ,
13




1 2

49 49(100%) 47 46 (97,9%)

37 7(18,9%) 45 3 (6,7%)

1 ,
2, (=0,08)


 :
, ,
,

1 2

30 826,7 % 41 13 31,6%

2151,2% 1945,2%
WPW 12,4% 12.4%
614,6 % 6 14,3%

28 1967,9% 38 11 28,9 %

P=0,02
=0,07 28 20 71,0% 36 29 - 80,6%

26 415,4 % 35 5-14,3 %
 :


.
1 ( ).
.

.

,
()
 :

,
1 2



35 1131,4 % 38 1026,3%

47 1225,5% 43 716,3%


P=0,03 50 15-30% 43 24,7%
46 24,3% 43 24,7%

40 615,0% 42 614,3%

30 3-10,0% 30 3-10,0%
33 39,1% 40 25,0%

25 28,0% 36 38,3%
 (),
()

10 9 ,

1
,
( )

3 ,
.






-

1 .. 13 IIA 1 10 25 , 30
\\
2. .\\ 5 IIIA 1 15 44

3. .\\ 10 IIA 2 7 30

4. 3 IIIB 2 5 30
\\
5. \\ 11 IIBE 1 14
- 36 ,
- 45

6. 14 II 1 12
\\ - 33,5 ,
40
 ()







- -



7. \\ 5 IIIB 1 5 40
.
8. 2 IIIB 2 C 5 25
\\.

9. \\ 14 IIB 2 6 30, 2
35

10. . 7 IVB 1 16 40
\\
11. 3 IIA 1 17 36
\\
12. 13 IB 1 29 41
\\ T2NxM1
 ()

13. 13 IVB 1 3,5 35-45

\\

14. 8 IIIA 1 11 35-52

\\

15. . 6 IIIB 1 3 35-52

\\





, DAL-
HD90,

.


- ,
,
10 , ,
, .

. ,
,
.






.
.
, ,

.
 !