Lemerle J, Barsaoui S, Harif M, Hireche K, Ladjadj Y, Moreira C, Andoh J, Doumbé P, Togo B, Kam L, Rafaramino F, Patte C, Tournade M F, Raphaël M, Boccon-Gibod L, Mallon B, Raquin M A, Msefer Alaoui F
GFAOP, Institut Gustave Roussy, Villejuif, France.
Med Trop (Mars). 2007 Oct;67(5):497-504.
The childhood cancer survival rate is currently 75% in industrialized countries. Rates in developing countries are much lower. The Franco-African Childhood Cancer Group (French acronym, GFAOP) was founded in 2000 with aim of reducing this unfavorable situation in Africa. The GFAOP has developed two forms of action. The main form consists of organizing two- to twelve-month training sessions for physicians and nurses in France and Morocco. The other form involves assessing the feasibility of modern treatment protocols for various cancers in Africa. The first feasibility trials were carried out on nephroblastoma and Burkitt's lymphoma in 12 pilot units in North Africa, West Africa, and Madagascar. In the first study from 2001 to 2005 we treated 306 cases of Burkitt's lymphoma using French LMB protocols adapted to the African setting and achieved a survival rate of 61%. A second study started in 2005 using Endoxan alone achieved a highly satisfactory survival rate of 73% for neuroblastoma in all stages except bilateral. Altogether from 2001 to 2007 more than 1000 cases of nephroblastoma and Burkitt's lymphoma were treated in African hospitals by African doctors and nurses. No patients were transferred to Europe. The GFAOP supplied drugs when necessary and took care of most travel expenses. African and French doctors worked together on protocol design, trial management, and data analysis. These promising results show that the latest therapeutic techniques can be used to treat childhood cancer in Africa by adapting the protocol to conditions in developing countries. Sanofi-Aventis Laboratories in association with the International Union against Cancer has launched a major campaign to improve Pediatric Oncology in developing countries. Projects in four GFAOP units are being financed through this campaign. In 2006 the GFAOP began assessment of two new treatment protocols, i.e., one for acute lymphoblastic leukemia and the other for Hodgkin's disease. Two other projects are being planned, i.e., one for treatment of retinoblastoma and the other for treatment of some types of brain tumors.
目前,工业化国家儿童癌症的生存率为75%。发展中国家的生存率则低得多。法非儿童癌症组织(法语首字母缩写为GFAOP)成立于2000年,旨在减少非洲的这种不利状况。GFAOP开展了两种形式的行动。主要形式包括在法国和摩洛哥为医生和护士组织为期两到十二个月的培训课程。另一种形式是评估非洲各种癌症现代治疗方案的可行性。首次可行性试验于2001年在北非、西非和马达加斯加的12个试点单位针对肾母细胞瘤和伯基特淋巴瘤进行。在2001年至2005年的第一项研究中,我们使用适应非洲情况的法国LMB方案治疗了306例伯基特淋巴瘤病例,生存率达到61%。第二项研究于2005年开始,仅使用环磷酰胺,除双侧神经母细胞瘤外,各阶段神经母细胞瘤的生存率达到了非常令人满意的73%。从2001年到2007年,非洲医院的非洲医生和护士共治疗了1000多例肾母细胞瘤和伯基特淋巴瘤病例。没有患者被转移到欧洲。GFAOP在必要时提供药物,并承担了大部分差旅费。非洲和法国医生共同进行方案设计、试验管理和数据分析。这些令人鼓舞的结果表明,通过使方案适应发展中国家的情况,最新的治疗技术可用于治疗非洲的儿童癌症。赛诺菲-安万特实验室与国际抗癌联盟联合发起了一项重大运动,以改善发展中国家的儿科肿瘤学。通过这项运动,GFAOP的四个单位的项目获得了资助。2006年,GFAOP开始评估两项新的治疗方案,即一项用于急性淋巴细胞白血病,另一项用于霍奇金病。另外两个项目也在计划之中,即一个用于治疗视网膜母细胞瘤,另一个用于治疗某些类型的脑肿瘤。