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Background Neuroblastoma is the third most common malignancy in children with a very heterogeneous feature. In this study, the epidemiological and clinical characteristics of children with neuroblastoma treated in a referral oncology hospital in Shiraz, Southern Iran, were investigated. Material and method In this historical cohort study, the medical files of 36 children under 18 years old with neuroblastoma were reviewed, who were admitted to Amir Oncology Hospital in Shiraz, Iran from 2006 to 2013. Overall survival and event free survival (EFS) curves were demonstrated by Kaplan Meier methods. Also the effects of demographic and clinical characteristics of the patients on survival were evaluated by Cox regression model. Results The median age of diagnosis was 30 months (age range: from 4 to144 months), with M/F ratio of 63.9%. Over 70% of the patients had stage 4 of neuroblastoma at their initial presentations. Adrenal gland comprised 72.2% of the primary tumor site. The most common presenting symptoms were gastrointestinal and constitutional symptoms. The mean overall survival and EFS were 30.75 and 20.56 months, respectively. Among the different variables analyzed, only liver metastasis had an adverse effect on EFS (p=0.025 Hazard ratios 2.83, CI: 1.14-7.02). Conclusion This study revealed that the majority of children suffering from neuroblastoma in our center are high stage with disseminated disease at the time of detection. It also warns us about an urgent necessity for holding a re-educational program for general practitioners and pediatricians to review the warning signs of common pediatric cancers such as neuroblastoma.

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Abstract
Background:

Children suffering from cancer frequently use complementary and alternative medicine (CAM). Most of people do not disclose using CAM to their physicians as they fear to be blamed or prohibited using them. Some of these products may interfere with the conventional remedies. The aim of this study was to investigate the frequency and characteristics of CAM use in pediatric oncology patients in 2 referral centers in south of Iran.
Materials and Methods:

In this cross-sectional study, all pediatric cancer patients (from 5 months to 18 years old) registered at two referral center (n=135) were investigated from January to July 2015 in Shiraz, southern Iran. Interview with their parents and completing the specific check list were done. Data were analyzed by SPSS v. 21 using Chi-square and Student t- test.
Results:

From 150 families approached, 135 (90%) completed the questionnaires. Overall, 114 (84.4%) children ever used a kind of CAM product while 92.6% sought faith healing. Concurrently, 81.1% of the CAM admitted users applied them with their conventional treatments. The most common used CAM products were Zinc (43.7%) and multivitamins (31.9%). None of the evaluated variables significantly influenced CAM use in the patients. Most of the patients (77%) introduced their physicians as the source of knowledge about CAM which was the most trusted source as well. About half of the patients (50.9%) did not inform their physicians to use these products.
Conclusion:

Oncologists should be aware of highly prevalent use of CAM among their patients. They should discuss with the families about the possible interactions of these products may have with chemotherapy drugs. A filled diary at regular intervals may help the physicians to monitor CAM use in their oncology patients.