Introduction

Cancer is the fourth leading cause of death in the pediatric population with boys having a higher death rate than girls (1). Even though only 2% of the total number of cancers occurs in children it accounts for 10% of all childhood deaths in the USA and is second only to accidents (1, 2).

The most common cancers in the pediatric population are leukemia, lymphomas, and central nervous system tumors (3). Together these cancers account for 63% of all cases presenting each year. Other common cancers that present in childhood are neuroblastoma, Wilms’ tumor, and rhabdomyosarcoma (3). These tumors most commonly occur in younger children while osteosarcoma, Ewing’s sarcoma, and Hodgkin’s disease tend to present in children older than 10 years of age (3).

The treatment of children with cancer is in the great majority performed in pediatric cancer treatment centers that are members of the Children’s Oncology Group, the single pediatric cooperative clinical trials group that resulted from the recent unification of four pediatric cooperative groups, the Children’s Cancer Group, the Pediatric Oncology Group, the National Wilms Tumor Study Group, and the Intergroup Rhabdomyosarcoma Study Group (2). This guarantees access to state-of-the-art treatment protocols and diagnostic investigations.