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1.
Pediatr Blood Cancer ; 65(5): e26945, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29350457

RESUMO

BACKGROUND: The Collaborative Wilms Tumour (WT) Africa Project has implemented an adapted WT treatment guideline in sub-Saharan Africa as a multi-centre prospective clinical trial. A retrospective, baseline evaluation of end-of-treatment outcome was performed for a 2-year period prior to the introduction of this guideline. The collaborative project aims to reduce both treatment abandonment and death during treatment to less than 10% for improving survival. PROCEDURE: All participating centres obtained local Institutional Research Board (IRB) approval and implemented the adapted WT treatment guideline. End-of-treatment outcome was documented for 2 years. It was divided into alive without evidence of disease, treatment abandonment, death during treatment and persistent disease. The outcome of children enroled in the first 2 years of the prospective clinical trial has been compared to the outcome before the start of the project. RESULTS: One hundred twenty-two patients were included in the baseline evaluation (2011-2012) and 133 in the first 2 years of the collaborative clinical trial (2014-2015). The percentage of patients alive without evidence of disease at the end of treatment increased from 52% (63/122) to 68% (90/133; P = 0.01). Treatment abandonment decreased from 23% (28/122) to 13% (17/133; P = 0.03). Death during treatment decreased from 21% (26/122) to 13% (17/133; P = 0.07). CONCLUSION: This collaboration, using relatively simple and low-cost interventions, led to a significant decrease in treatment abandonment and increase in survival without evidence of disease at the end of treatment.


Assuntos
Neoplasias Renais/mortalidade , Tumor de Wilms/mortalidade , África , Pré-Escolar , Terapia Combinada , Seguimentos , Humanos , Lactente , Recém-Nascido , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Estudos Prospectivos , Taxa de Sobrevida , Resultado do Tratamento , Tumor de Wilms/patologia , Tumor de Wilms/terapia
2.
Oncol Nurs Forum ; 43(4): 525-8, 2016 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-27314196

RESUMO

Children and adolescents represent a small, but critically important, number of patients with cancer worldwide (14.1 million newly diagnosed adults versus 160,000 children annually). The life years saved when a child is cured of cancer are about 71 compared to 15 years for an adult in most high-income countries (HICs). In HICs, about 80% of children survive cancer. Unfortunately, in low- and middle-income countries (LMICs), the survival rates are generally 50% or less. In these resource-limited settings, only 15%-37% of children and adolescents have access to cancer treatment, and most are diagnosed with advanced-stage disease, making cure impossible.


Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Neoplasias/diagnóstico , Neoplasias/terapia , Pobreza/estatística & dados numéricos , Taxa de Sobrevida , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino
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