Childhood NHL in Switzerland: Incidence and Survival of 120 Study and 42 Non‐Study Patients

Abstract

Based on the Swiss Pediatric Oncology Group (SPOG) cancer registry data during 1981-1991, a high average incidence of 8 new NHL per million children younger than 15 years per year was found. Of 162 children with NHL registered in 1976-1991, 120 were study patients, i.e., officially registered and treated according to SPOG or Pediatric Oncology Group (POG) protocols, while 42 were non-study patients, i.e., patients not officially enrolled on protocols. Overall, 91 of 120 (76%) study patients remained alive. Seventy-nine study patients were treated according to older SPOG protocols, and 53 (67%) of these survived, while 38 of 41 (93%) study patients treated according to newer POG protocols remained alive (P = 0.0068). Only 22 (52%) of the 42 non-study patients survived (P = 0.0001). There was no improvement if the survival of non-study patients before and since 1986 was compared. Population-based treatment results in Switzerland were similar to those in the United Kingdom. They provided an important base for the development of future treatment strategies.

Identical chemotherapy schedules given on and off trial protocol in small cell lung cancer response and survival results

“…The finding is in contrast with reports suggesting that on study treatment is an independent prognostic factor, correlated with better survival (Davis et al, 1985;Schea et al, 1995;Quoix et al, 1986;Wagner et al, 1995). However, in these studies the treatment regimens on and off trial protocol were different.…”

“…The finding of statistically significant higher survivals among trial participants than in trial control patients was highlighted in childhood leukaemia (Stiller and Draper, 1989). Subsequently a beneficial survival effect for participants has been noted in myeloma, nephroblastoma, non Hodgkin lymphoma and sarcoma trial patients (Karjalainen and Palva, 1989;Lennox et al, 1979;Wagner et al, 1995;Antman et al, 1985).…”

Implementation of Electronic Checklists in an Oncology Medical Record: Initial Clinical Experience

“…This approach in clinical trials provides greater uniformity and quality of treatment compared with treatment of the general patient population and is known to enhance outcomes. [10][11][12][13] In the book, "Checklist Manifesto," Gawande 14 describes how faulty memory and distraction can lead to errors in achieving complex tasks for all-or-none processes: preparing an airplane for takeoff, or evaluating a sick person in the emergency room. Checklists provide protection against such failures by providing process verification and instilling discipline to improve performance.…”

Standards for Pediatric Cancer Centers

“…Experienced investigators and allied health professionals recognize the importance of a national clinical trials network in developing more successful treatment strategies. 4 The importance of comprehensive, multidisciplinary treatment in improving patient outcome in a cost-effective manner has been well documented for children with acute lymphoblastic leukemia, 5 non-Hodgkin' s lymphoma, 6,7 brain tumors, 8 rhabdomyosarcoma, 6,8 Wilms tumor, 9 and Ewing sarcoma. 6 Almost 80% of these children can be treated successfully if modern diagnostic and therapeutic approaches are initiated expeditiously.…”

“…[5][6][7][8][9] After diagnosis has been established and the treatment plan has been determined by the pediatric cancer center, certain aspects of care that are not investigational may be continued in the office of a primary care pediatrician for selected children when mandated by distance from the cancer center or other individual specific circumstances. In some circumstances, communication via telemedicine may be beneficial.…”