{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:39:23Z","timestamp":1787729963141,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,24]],"date-time":"2024-11-24T00:00:00Z","timestamp":1732406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children with end\u2010stage solid tumors would benefit from established nonsurgical options for palliative site\u2010directed local control with the intent of improving quality of life (QOL) and extending survival. We investigated the practice and tolerability of palliative ablation strategies in patients with pediatric solid tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children and young adults with solid tumors ineligible for surgical site\u2010directed control were treated with palliative ablative strategies between 2010 and 2020 at five institutions participating in the Pediatric Surgical Oncology Research Collaborative. Demographic, histologic, and clinical data were retrospectively evaluated, and assessment of patient reasons for choosing ablative strategies was qualitatively assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 69 patients underwent 89 ablative procedures for 132 lesions. More than 10 histologies were represented, the most common of which were Ewing sarcoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a015 patients), osteosarcoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a013 patients), and rhabdomyosarcoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a09 patients). Ablation techniques included cryoablation (<jats:italic>n<\/jats:italic>\u00a0=\u00a09 procedures\/16 lesions), radiofrequency ablation (RFA) (<jats:italic>n<\/jats:italic>\u00a0=\u00a04 procedures\/5 lesions), microwave ablation (MWA) (<jats:italic>n<\/jats:italic>\u00a0=\u00a05 procedures\/12 lesions), and stereotactic body radiotherapy (SBRT) (<jats:italic>n<\/jats:italic>\u00a0=\u00a068 procedures\/99 lesions). Grade 3 or higher adverse events (AEs) included pain requiring IV medication in cryoablation (three out of 12 procedures), RFA (one out of four procedures), and MWA (two out of five procedures), bleeding in MWA (two out of five procedures), and skin burns requiring surgical intervention in SBRT (one out of 68 procedures). Patients were generally hospitalized after percutaneous ablation (19 out of 21 cryoablation, RFA, and MWA procedures) but the hospital stay was short (mean\/SD 1\u00a0\u00b1\u00a04 days). Only four patients who were already hospitalized experienced hospitalization extension due to undergoing an ablative procedure. The primary reason for pursuing ablative measures could be broadly categorized into four groups: treatment of unresectable disease either due to surgical inaccessibility or metastasis (<jats:italic>n<\/jats:italic>\u00a0=\u00a031), symptom relief, either pain or mass effect (<jats:italic>n<\/jats:italic>\u00a0=\u00a025), specific patient QOL concerns unrelated to pain or life prolongation (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), and physiologic instability for otherwise resectable disease (<jats:italic>n<\/jats:italic>\u00a0=\u00a04). All patients undergoing treatment for symptom relief received SBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this cohort of patients undergoing palliative treatment of incurable or unresectable pediatric solid tumors, ablation strategies were well tolerated. Further research is needed to determine patient reported outcomes after ablation strategies are pursued and patient and family satisfaction with the choice for ablative strategies. An understanding of institutional availability and ability to employ these strategies would also be informative.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31453","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T05:07:02Z","timestamp":1732511222000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Use of Palliative Site\u2010Directed Ablation in Pediatric Oncology: A Retrospective Study From the Pediatric Surgical Oncology Research Collaborative"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7409-9873","authenticated-orcid":false,"given":"Lindsay J.","family":"Talbot","sequence":"first","affiliation":[{"name":"Department of Surgery St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Schechter","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj Sarvode","family":"Mothi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mecklin","family":"Ragan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6547-1220","authenticated-orcid":false,"given":"Jennifer H.","family":"Aldrink","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Brungardt","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshni","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3323-6509","authenticated-orcid":false,"given":"Timothy B.","family":"Lautz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Ann &amp; 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