Cytotoxic therapy for paediatric malignancy continues to be associated
with significant mortality and morbidity. However, survival figures c
ontinue to improve despite increasingly toxic treatment protocols. Agg
ressive supportive care, more than any other modality, has produced a
dramatic reduction in mortality during the past 30 years, and includes
the appropriate management of infection, provision of adequate nutrit
ion, and proper use of blood and blood products. The paediatric surgeo
n plays an integral role in the multidisciplinary team of cancer manag
ement and together with other team specialists is responsible for the
planning of surgical intervention and also ensuring the safe passage o
f immunologically impaired patients through the additional stress of s
urgery. This paper details essential aspects of supportive care as com
monly practiced in paediatric patients undergoing therapy and surgery.
(C) 1993 Wiley-Liss, Inc.