Hamid Syed Ahmer, Zia Nida, Maqsood Sidra, Rafiq Naila, Fatima Mushkbar, Syed Yumna, Tabori Uri, Bartels Ute, Hawkins Cynthia, Huang Annie, Ramsawami Vijay, Mushtaq Naureen, Bouffet Eric
Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan.
Indus Hospital Research Centre, Indus Hospital & Health Network, Karachi, Pakistan.
Pediatr Blood Cancer. 2022 Nov;69(11):e29887. doi: 10.1002/pbc.29887. Epub 2022 Jul 20.
Brain tumors are the most common solid neoplasms and the second most common malignancy in the pediatric age group. Due to the complexity of their management, pediatric central nervous system (CNS) tumors are not a priority in low- and middle-income countries (LMICs).
In an attempt to improve the survival rate and overall care, we introduced a dedicated pediatric neuro-oncology service in our institute and evaluated its impact by dividing the pre- and post-era into two cohorts and comparing them: 1998-2013 (16 years: cohort A) and 2014-2019 (6 years: cohort B, after the start of dedicated neuro-oncology services).
We observed that after the implementation of a proper neuro-oncology service, the proportion of patients treated with curative intent increased, and survival improved in cohort B. The patient volume also increased from 15.5 per year in cohort A to 44.8 per year in cohort B. The percentage of children given radiation therapy also increased significantly, while the proportion of children treated with chemotherapy remained stable.
A dedicated multidisciplinary team trained and knowledgeable in the specialty of pediatric neuro-oncology can enhance and improve outcomes, and supportive care and help can provide good quality of life to children and their families with brain neoplasms.
脑肿瘤是最常见的实体肿瘤，在儿童年龄组中是第二常见的恶性肿瘤。由于其治疗的复杂性，儿童中枢神经系统（CNS）肿瘤在低收入和中等收入国家（LMICs）并非优先事项。
为提高生存率和整体护理水平，我们在本机构引入了专门的儿童神经肿瘤学服务，并通过将前时代和后时代分为两个队列并进行比较来评估其影响：1998 - 2013年（16年：队列A）和2014 - 2019年（6年：队列B，在专门的神经肿瘤学服务开始后）。
我们观察到，在实施适当的神经肿瘤学服务后，B队列中接受根治性治疗的患者比例增加，生存率提高。患者数量也从A队列的每年15.5例增加到B队列的每年44.8例。接受放射治疗的儿童百分比也显著增加，而接受化疗的儿童比例保持稳定。
一个在儿童神经肿瘤学专业方面受过培训且知识渊博的专门多学科团队可以改善治疗结果，提供支持性护理，帮助患有脑肿瘤的儿童及其家庭获得良好的生活质量。
