Department of Paediatrics, College of Medicine, Blantyre, Malawi.
Academy Outreach and Department of Solid Tumours, Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands.
Pediatr Blood Cancer. 2020 Jul;67(7):e28322. doi: 10.1002/pbc.28322. Epub 2020 May 11.
The WHO Global Initiative for Childhood Cancer aims to increase survival to at least 60% for all children with cancer globally, with initial focus on six common curable cancer types. Frequent causes of treatment failure in low income countries (LICs) are treatment abandonment and death during treatment. Here, we report on the outcome at the end of treatment of patients with newly diagnosed common and curable cancer types, admitted in the Queen Elizabeth Central Hospital, Blantyre, Malawi.
Outcome at end of treatment was documented and analyzed retrospectively for all children with a working diagnosis of a common and curable cancer type (ALL, Hodgkin disease, Wilms tumor, retinoblastoma, and Burkitt lymphoma) admitted over a 2-year period. Patients with a misdiagnosis were excluded. Outcomes were categorized as alive without evidence of disease, treatment abandonment, death during treatment, or persistent disease.
We included 264 patients. Seven patients with a misdiagnosis were excluded. At the end of treatment, 53% (139 of 264) of patients were alive without evidence of disease, 19% (49 of 264) had abandoned treatment, 23% (61 of 264) had died during treatment, and 6% (15 of 264) had persistent disease.
Survival of children with common and curable cancers is (significantly) below 50%. Almost half (42%) of the patients either abandoned treatment or died during treatment. Strategies to enable parents to complete treatment of their child and improved supportive care are needed. Such interventions may need to be given priority to improve the currently poor survival.
世界卫生组织全球儿童癌症倡议旨在使全球所有癌症患儿的生存率至少提高到 60%，最初重点关注六种常见可治愈癌症类型。在低收入国家（LICs），治疗失败的常见原因是治疗中断和治疗期间死亡。在这里，我们报告了在马拉维布兰太尔伊丽莎白女王中央医院新诊断出的常见和可治愈癌症类型的患者在治疗结束时的结果。
对所有患有常见和可治愈癌症类型（ALL、霍奇金病、肾母细胞瘤、视网膜母细胞瘤和伯基特淋巴瘤）的患儿的治疗结束时的结果进行了回顾性记录和分析。排除了误诊的患者。结果分为无疾病证据的存活、治疗中断、治疗期间死亡或持续疾病。
我们纳入了 264 名患者。排除了 7 名误诊患者。在治疗结束时，53%（264 名患者中的 139 名）无疾病证据存活，19%（264 名患者中的 49 名）治疗中断，23%（264 名患者中的 61 名）治疗期间死亡，6%（264 名患者中的 15 名）持续存在疾病。
患有常见和可治愈癌症的儿童的生存率（显著）低于 50%。近一半（42%）的患者要么放弃治疗，要么在治疗期间死亡。需要制定使父母能够完成其子女治疗的策略，并改善支持性护理。这些干预措施可能需要优先考虑，以提高目前的生存率。
