Division of Pediatric Oncology, Department of Oncology, Aga Khan University, Karachi, Pakistan.
Indus Children Cancer Hospital, Karachi, Pakistan.
Pediatr Blood Cancer. 2022 Sep;69(9):e29726. doi: 10.1002/pbc.29726. Epub 2022 Apr 28.
Low- and middle-income countries sustain the majority of pediatric cancer burden, with significantly poorer survival rates compared to high-income countries. Collaboration between institutions in low- and middle-income countries and high-income countries is one of the ways to improve cancer outcomes.
Patient characteristics and effects of a pediatric neuro-oncology twinning program between the Hospital for Sick Children in Toronto, Canada and several hospitals in Karachi, Pakistan over 7 years are described in this article.
A total of 460 patients were included in the study. The most common primary central nervous system tumors were low-grade gliomas (26.7%), followed by medulloblastomas (18%), high-grade gliomas (15%), ependymomas (11%), and craniopharyngiomas (11.7%). Changes to the proposed management plans were made in consultation with expert physicians from the Hospital for Sick Children in Toronto, Canada. On average, 24% of the discussed cases required a change in the original management plan over the course of the twinning program. However, a decreasing trend in change in management plans was observed, from 36% during the first 3.5 years to 16% in the last 3 years. This program also led to the launch of a national pediatric neuro-oncology telemedicine program in Pakistan.
Multidisciplinary and collaborative efforts by experts from across the world have aided in the correct diagnosis and treatment of children with brain tumors and helped establish local treatment protocols. This experience may be a model for other low- and middle-income countries that are planning on creating similar programs.
中低收入国家承担了大部分儿科癌症负担，与高收入国家相比，其生存率明显较低。中低收入国家和高收入国家的机构之间的合作是改善癌症结果的方法之一。
本文描述了加拿大多伦多 SickKids 医院与巴基斯坦卡拉奇的几家医院之间开展的儿科神经肿瘤双胞胎项目在 7 年内的患者特征和效果。
共有 460 名患者纳入本研究。最常见的原发性中枢神经系统肿瘤是低级别胶质瘤（26.7%），其次是髓母细胞瘤（18%）、高级别胶质瘤（15%）、室管膜瘤（11%）和颅咽管瘤（11.7%）。与来自加拿大 SickKids 医院的专家医生协商后对提出的管理计划进行了更改。平均而言，在双胞胎项目期间，24%的讨论病例需要更改原始管理计划。然而，管理计划变更的趋势呈下降趋势，从前 3.5 年的 36%降至最后 3 年的 16%。该项目还促成了巴基斯坦全国儿科神经肿瘤远程医疗项目的启动。
来自世界各地的专家的多学科和协作努力有助于正确诊断和治疗脑肿瘤患儿，并帮助建立了当地的治疗方案。这种经验可能是其他计划创建类似项目的中低收入国家的典范。
