Treatment abandonment and refusal among children with central nervous system tumors in Jordan.
Pediatr Blood Cancer
; 68(8): e29054, 2021 08.
Article
in En
| MEDLINE
| ID: mdl-34022111
ABSTRACT
BACKGROUND:
Treatment abandonment and refusal are reported to contribute significantly to poor survival of children with cancer in low- and middle-income countries. We aimed to assess this phenomenon among children diagnosed with central nervous system (CNS) tumors in Jordan.METHODS:
We retrospectively reviewed the medical charts of children <18 years diagnosed with CNS tumors (2010-2020). Patients who abandoned or refused part of treatment were reviewed for their clinical characteristics, social circumstances, and possible reasons. We excluded patients referred for second opinion, radiotherapy only, or who traveled abroad for treatment.RESULTS:
Four hundred seventy-three Jordanian children were identified; 12 families (2.5%) abandoned treatment, and 15 refused part of therapy (3%). Most patients were females (67%) and most had good or moderate performance status (89%). Most families (93%) lived within 2 hours from King Hussein Cancer Center. Most parents were university graduates (71%) and all fathers were employed, while 71% of mothers were housewives. The most common reasons to abandon or refuse therapy were treatment intensity in view of poor tumor outcome or bad quality of life, conflicting recommendations from other health care providers, "personal beliefs" against chemotherapy, and preference to use alternative medicine.CONCLUSIONS:
Treatment abandonment and refusal in Jordanian children with CNS tumors is low. Universal cancer insurance, high level of education in the country, centralized cancer care in one institution, and the twinning program likely contributed to our low incidence. Improving knowledge on CNS tumors and better community rehabilitation and supportive services may help further decrease the abandonment and treatment refusal rate.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Treatment Refusal
/
Patient Compliance
/
Central Nervous System Neoplasms
Type of study:
Guideline
/
Observational_studies
/
Prognostic_studies
Country/Region as subject:
Asia
Language:
En
Journal:
Pediatr Blood Cancer
Year:
2021
Type:
Article
Affiliation country:
Jordan