Pediatric age cutoff

[Impressions]

Advertisement - Members don't see this ad

Can anyone tell me what is the age cut-off to qualify a patient as a peds case? 18 years or less?? Thanks!

 

[Impressions]

It is defined within the Radiation Oncology Program Information Form(PIF) as a patient being less than 18 years of age.

 

[radonc]

for many paediatric malignancies, the age cutoff is variable. for some tumours, if you got it, you are eligible for trials (ewings, rhabdo). It is known that the majority of tumours occur in the known age range, but there are always outliers. and for the most part, you treat peds tumours based on histology & location. ie the treatment for an 18yo ewings pt may be the same as that of a 30yo ewings pt with the same stage/grade/location/etc. the exception occurs in younger patients (<3yo), where treatment may be affected by young age.

In COG ARST0531 (Randomized Study of Vincristine, Dactinomycin and Cyclophosphamide (VAC) versus VAC Alternating with Vincristine and Irinotecan (VI) for Patients with Intermediate-Risk Rhabdomyosarcoma (RMS))

it says:
3.2.1 Age
Age < 50 years at the time of enrollment.

 

[Impressions]

for many paediatric malignancies, the age cutoff is variable. for some tumours, if you got it, you are eligible for trials (ewings, rhabdo). .....
In COG ARST0531 (Randomized Study of Vincristine, Dactinomycin and Cyclophosphamide (VAC) versus VAC Alternating with Vincristine and Irinotecan (VI) for Patients with Intermediate-Risk Rhabdomyosarcoma (RMS))

it says:
3.2.1 Age
Age < 50 years at the time of enrollment.

So you're telling me if I have a 25-yo patient with RMS getting treated using the COG protocol, I can count him/her as a peds case? Seriously, would that fly???

 

[stephew]

it really depends upon why youre asking the quesiton. Eligibility to a protocol? treatment at a peds clinic? Maybe adults with pediatric tumors are treated "parallel to protocol" though not technically eligible due to age.

 

[radonc]

So you're telling me if I have a 25-yo patient with RMS getting treated using the COG protocol, I can count him/her as a peds case? Seriously, would that fly???

yes it would and does. i have worked at 2 major peds hospitals where they routinely see pts in their 20's (but not much older than that) with peds tumors. depending on the trial, it may have a acutoff of 10, 18, 21, 25, or even 50 (like above). its variable, depending on the histology, site, treatment, etc, etc.

 

[alvin]

According to the ACGME rules for radiation oncology- it is less than 18. This definition is clearly stated in the program information form (ACGME). This is the document that is evaluated during a residency program site visit. So if you are concerned about what is the "cut off" to count toward the 12 case minimum for the resident log, that is how the ACGME sees it. Nine of the 12 cases must be solid tumors.

 

[radonc]

alvin, i was unable to find an age cutoff in the acgme requirements.

i did, however, find the statement below:
http://www.acgme.org/acWebsite/RRC_430/430_faq.asp#num18

# How many pediatric patients must be treated to satisfy minimum requirements?

The RRC reviews diversity as well as number. In general, however, residents should simulate a minimum of 12 children (of whom at least 9 have solid tumors) during their residency to satisfy minimum standards. Programs may satisfy pediatric requirements through outside rotations. To do so, the program director must submit the following information at the time of the site visit:

1. Provide a signed letter of agreement with the outside (participating) institution;

2. Provide an annual summary of the total number of pediatric patients simulated at the outside institution, and an accounting of all radiation oncology residents who are assigned to rotations at this institution.


Programs may supplement their residents’ pediatric experience with long-term follow-up clinics and with pediatric oncology rotations. These experiences may be valuable but cannot substitute for the basic requirement to participate in the planning and treatment of children.

 

[alvin]

Go back to the ACGME site, go to residency review committee(RRC) on the drop down on th left, then radiation oncology, and you will find a variety of possible downloadable documents. Download PIF(new application). Look on page 2 of the PIF and you will find the definition.

 

[radonc]

thanks, i guess i need to amend one or two of logged patients!