Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience

Elhassan, Moawia Mohammed Ali; Osman, H.; Parkes, Jeannette

doi:10.1007/s00381-017-3414-1

Cited by 10 publications

(15 citation statements)

References 28 publications

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“…For meta‐analyses, all studies reporting ARs were assembled and narrowed to one study per institution, leaving the same 38 studies representing 2497 children in 14 countries. We found only one report of AR from a low‐income country (Sudan) . When reports were pooled by country, ARs ranged from < 5% in several countries (Brazil, Iran, Jordan, El Salvador, Venezuela, and Egypt) to 42% in Pakistan (Table ).…”

Section: Overall Resultsmentioning

confidence: 94%

“…No studies attempted to formally analyze predictors of treatment abandonment in CNS tumors. However, authors of 12 studies reported possible causes of abandonment (Table ), based on their personal experience with patients, patient records, and knowledge of patients’ backgrounds . Only one (Chinese) study conducted a questionnaire with caregivers to identify reasons for abandonment .…”

Section: Overall Resultsmentioning

confidence: 99%

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The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

Seah

Zhang

Halbert

et al. 2019

Pediatric Blood & Cancer

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Background Outcomes of pediatric central nervous system (CNS) tumors in low‐ to middle‐income countries (LMIC) are poorer than their high‐income counterparts. Abandonment of therapy is increasingly recognized as a key contributor to this disparity, but has been poorly quantified. We performed a meta‐analysis to determine the magnitude of abandonment in pediatric CNS tumors in LMIC, and risk factors and interventions aimed at reducing this. Patients and methods We searched seven databases for pediatric CNS tumor cohorts followed up from diagnosis and treated in LMIC. All languages were included. Two reviewers independently selected articles and extracted data on abandonment rates (ARs) and predictors. The authors were contacted for additional information. Results Of 50 660 publications, 643 in five languages met criteria for full review; 131 met analysis inclusion criteria. ARs were not reported in the majority, and a small number were available from the authors. Available ARs ranged from 0% to 59%, from 38 studies (2497 children in 14 countries), and these were quantitatively analyzed. Lower‐middle‐income countries had higher ARs than upper‐middle‐income countries (27%, 95% confidence interval [CI] 20%–36% vs 9%, 95% CI 6%–14%, P < 0.0001), with significant heterogeneity within each (LMIC I2 = 78%, P < 0.00001, UMIC I2 = 85%, P < 0.00001). Common predictors for abandonment included distance to treatment centers, financial hardship, and prognostic misconceptions. Conclusion In LMICs, ARs are highest in lower‐MICs. However, the paucity of published data limits further evaluation. Given the increasing burden of pediatric CNS tumors in LMIC, addressing deficits in abandonment reporting is critical. Consistent reporting is needed for developing interventions to improve outcomes.

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Section: Overall Resultsmentioning

confidence: 94%

Section: Overall Resultsmentioning

confidence: 99%

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

Seah

Zhang

Halbert

et al. 2019

Pediatric Blood & Cancer

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“…The incidence of CNS tumours is reduced in LMICs, which may reflect ethnic variation or limited neurosurgical resources or attenuated availability of advanced imaging equipment, such as CT and MRI scanners. 8,19 In the current study, the steep increase in the relative frequency of CNS tumours reported in the second and third periods (2006-2010 and 2011-2015) compared to the first period (1999)(2000)(2001)(2002)(2003)(2004)(2005) is likely because of the introduction of CT scan, MRI and neurosurgical services in central Sudan. …”

Section: Discussionmentioning

confidence: 94%

“…17 In Sudan, the main sources of data on childhood cancers are found in hospital-based case series. 12,13,18,19 Among all patients admitted to the NCI for treatment during the study period, children with cancers constituted 7.5%. This finding is similar to those of a previous study in Sudan, in which childhood cancers constituted approximately 7% of all cancer cases registered in the state of Khartoum from 2009 to 2010.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological review of childhood cancers in central Sudan

et al. 2018

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Background: Epidemiological studies of paediatric cancer incidence in Sudan are rare.Objectives: The aim of this study was to provide baseline information about the epidemiology of childhood cancers in patients treated at the National Cancer Institute (NCI) in Wad Medani, Sudan.Methods: We performed a retrospective health facility–based study of cancer incidence and patient characteristics of children who were treated at the NCI from January 1999 to December 2015. The changing patterns of cancers incidence during the study period were also recorded.Results: Of 15 387 new patients with cancer who were registered at the NCI during the study period, 1159 (7.5%) were children (younger than 15 years). The mean age of the paediatric patients was 7 years, with standard deviation of 5. Most of the patients (36%) were 10 to 15 years old, 33% were 0 to 4 years old and 31% were 5 to 10 years old. Among the study population, 60% were males and 40% were females. Approximately 76% of children lived in rural areas in Sudan. Leukaemias (29%) and lymphomas (26%) comprised 55% of all paediatric cancers. Central nervous system (CNS) tumours constituted 6% of all paediatric tumours, whereas non-CNS embryonal tumours (i.e. nephroblastoma, neuroblastoma, hepatoblastoma and retinoblastoma) accounted for 20%. The average number of cases per year increased from 42 in 1999–2005 to 75 in 2006–2010 and 106 in 2011–2015.Conclusion: The number of patients seeking treatment for childhood cancers has increased every year in central Sudan. Leukaemias and lymphomas constitute more than half of these cancers. A population-based cancer registry is needed to determine the true incidence of childhood cancers in Sudan.

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“…In addition, the number and type of cases diagnosed and referred will reflect local conditions in the primary health care system of a given country. 29 For example, in many LIC and L-MIC, the diagnosis of brain tumors is delayed due to lack of imaging, although this is slowly improving over time. 30 In general terms, patients can be divided into patients with a long life expectancy requiring potentially curative radiotherapy, and patients who require palliative radiotherapy for symptom control.…”

Section: Pediatric Cancers Commonly Referred For Radiotherapy In Lmicmentioning

confidence: 99%

Recommendations for the treatment of children with radiotherapy in low‐ and middle‐income countries (LMIC): A position paper from the Pediatric Radiation Oncology Society (PROS‐LMIC) and Pediatric Oncology in Developing Countries (PODC) working groups of the International Society of Pediatric Oncology (SIOP)

Parkes

Hess

Burger

et al. 2017

Pediatric Blood & Cancer

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Pediatric radiotherapy is a critical part of pediatric oncology protocols and the quality of the radiotherapy may determine the future quality of life for long-term survivors. Multidisciplinary team decision making provides the basis for high-quality care. However, delivery of highquality radiotherapy is dependent on resources. This article provides guidelines for delivery of good quality radiation therapy in resource-limited countries based on rational procurement and maintenance planning, protocol development, three-dimensional planning, quality assurance, and adequate staff numbers and training. K E Y W O R D Sadapted treatment regimen, low and middle income countries, LMIC, Pediatric radiotherapy, PODC, PROS

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Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience

Abstract: Overall, this study draws attention to the situation of paediatric brain tumours in Sudan. Late presentation, misdiagnosis and limited diagnostic and treatment resources are challenges that may contribute to poor outcome in these patients.

Cited by 10 publications

References 28 publications

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

Epidemiological review of childhood cancers in central Sudan

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