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Question 1
Is methylphenidate a useful treatment for cancer-related fatigue in children?
  1. Victoria Sharp,
  2. Fiona Finlay,
  3. Diluki Kevitiyagala
  1. Community Child Health, Sirona Care and Health, Bath & North East Somerset NHS Trust, Bath, UK
  1. Correspondence to Dr Victoria Sharp, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Cosham PO6 3LY, UK. vickyjsharp{at}yahoo.co.uk

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Scenario

A 9-year-old boy with a brain tumour attends my outpatient clinic for review. His current most disabling symptom is fatigue. His parents have done a Google search and found that methylphenidate can be used to treat fatigue in adults. They ask my opinion as to whether this would be an option for their son. What should I advise?

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Table 1

Our studies therefore include one Cochrane review and two individual random control trials

Structured clinical question

In children with a brain tumour (subject), is methylphenidate (intervention) useful for treating fatigue (outcome)?

Search strategy and outcome

Primary sources

MEDLINE was searched from 1950 to February 2011 and EMBASE from 1980 to 31 March 2011 via the OVID interface. The advanced search mode was used. A keyword search was performed using ‘methylphenidate’ ‘cancer’ and ‘fatigue*’ as individual groups. The searches were then combined using the AND function. The results were subsequently restricted using the limits: ‘all children 0–18 yrs’ in MEDLINE and ‘child <unspecified>’ in EMBASE.

Secondary sources

The Cochrane library was searched using the terms ‘methylphenidate’, ‘fatigue’, ‘cancer’ AND ‘child’. The search of EMBASE yielded no papers.

Outcome

The search of MEDLINE revealed one paper which was read in full and shown to be for patients aged 18–70 years. The search of the Cochrane Library revealed no papers. Therefore, no relevant paediatric papers were found.

Commentary

There were no papers found exploring the use of methylphenidate to treat fatigue in children with cancer. It was therefore decided to expand the search to include adult papers.

A second search …

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