SIOP PODC: Clinical guidelines for the management of children with Wilms tumour in a low income setting

Israëls, Trijn; Moreira, C.; Scanlan, Trish; Molyneux, Liz; Kampondeni, Sam; Hesseling, Peter; Heij, Hugo A.; Borgstein, Eric; Vujanić, Gordan; Pritchard‐Jones, Kathy; Hadley, Larry

doi:10.1002/pbc.24321

Cited by 96 publications

(102 citation statements)

References 34 publications

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“…Medical delays, including those caused by neutropenia and fever/infection, were the most common and expected in oncologic populations. 18 More stringent use of dose reductions in underweight and malnourished patients, as recommended by SIOP Pediatric Oncology in Developing Countries Committee, 15,23 and ongoing education are essential. Medical delays caused by infections could also be addressed through developing capacity to perform blood cultures and broadening antibiotic options.…”

Section: Discussionmentioning

confidence: 99%

Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Shyirambere

Elmore

et al. 2016

JGO

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PurposeSuccess in treating nephroblastoma in high-income countries has been transferred to some resource-constrained settings; multicenter studies report disease-free survival of greater than 70%. However, few reports present care models with rural-based components, care tasks shifted to internists and pediatricians, and data collection structured for monitoring and evaluation. Here, we report clinical outcomes and protocol compliance for patients with nephroblastoma evaluated at Butaro Cancer Center of Excellence in Rwanda.Patients and MethodsThis retrospective study reports the care of 53 patients evaluated between July 1, 2012, and June 30, 2014. Patients receiving less than half of their chemotherapy at Butaro Cancer Center of Excellence were excluded.ResultsOf the 53 patients included, 9.4% had stage I, 13.2% had stage II, 24.5% had stage III, 26.4% had stage IV, and 5.7% had stage V disease; the remaining 20.8% had unknown stage disease from inadequate work-up or unavailable surgical report. The incidence of neutropenia increased with treatment progression, and the greatest proportion of delays occurred during the surgical referral phase. At the end of the study period, 32.1% of patients (n = 17) remained alive after treatment; 24.5% (n = 13) remained alive while continuing treatment, including one patient with recurrent disease; 30.2% (n = 16) died; and 13.2% (n = 7) were lost to follow-up.ConclusionOur findings confirm that nephroblastoma can be effectively treated in resource-constrained settings. Using an approach in which chemotherapy is delivered at a rural-based center by nononcologists and data are used for routine evaluation, care can be delivered in safe, novel ways. Protocol modifications to mitigate chemotherapy toxicities and strong communication between the multidisciplinary team members will likely minimize delays and further improve outcomes in similar settings.

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Section: Discussionmentioning

confidence: 99%

Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Shyirambere

Elmore

et al. 2016

JGO

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“…[20][21][22][23][24][25] These adapted regimens are intended for children with common and curable cancers.…”

Section: Interventions To Address Challenges In Lmicsmentioning

confidence: 99%

Treating Children With Cancer Worldwide—Challenges and Interventions

et al. 2015

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“…Using the graduated intensity philosophy first proposed for the treatment of acute lymphoblastic leukemia, [39] the Adapted Treatment Regimens WG has produced pragmatic guidelines for the management of individual childhood cancers depending on the supportive care facilities available. [19][20][21][22][23][24][25] These guidelines were developed by physicians from LMIC and HIC. Several others including those on the management of children with Hodgkin lymphoma, osteosarcoma, acute myeloid leukemia, and an algorithm for nutritional assessment and intervention are in advanced stages of development.…”

Section: Development Of Adapted Treatment Guidelinesmentioning

confidence: 99%

Improving Care for Children With Cancer in Low- and Middle-Income Countries-A SIOP PODC Initiative

Arora

Challinor

Howard

et al. 2015

Pediatr Blood Cancer

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The Paediatric Oncology in Developing Countries (PODC) committee of International Society of Paediatric Oncology (SIOP) has 10 working groups that provide a forum for individuals to engage, network, and implement improvements in the care of children with cancer in low-and middle-income countries. The development of adapted guidelines (medulloblastoma, retinoblastoma, Wilms tumor, neuroblastoma, retinoblastoma, Burkitt lymphoma, supportive care), advocacy and awareness (on hospital detention and essential drugs), education and training, and global mapping (nutritional practice, abandonment rates, and twinning collaborations) have been the initial areas of focus, and the impact of some of these activities is evident, for example, in the SIOP Africa PODC Collaborative Wilms tumor project.

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SIOP PODC: Clinical guidelines for the management of children with Wilms tumour in a low income setting

Cited by 96 publications

References 34 publications

Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Treating Children With Cancer Worldwide—Challenges and Interventions

Improving Care for Children With Cancer in Low- and Middle-Income Countries-A SIOP PODC Initiative

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