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《乌干达病例研究:描绘低资源环境下儿童成神经管细胞瘤诊疗挑战和差异的髓母细胞瘤病例系列》

A Case Series of Children With Medulloblastoma Depicting the Disparities in Care and the Challenges in the Detection and Treatment of Pediatric Central Nervous System Tumors in Low-Resource Settings: A Case Study of Uganda.

机构信息

Department of Pediatrics and Child Health, Pediatric Hematology/Oncology, Mulago National Referral Hospital, Kampala, Uganda.

Department of Neurosurgery, CURE Children's Hospital of Uganda, Mbale, Uganda.

出版信息

Pediatr Neurol. 2024 Dec;161:67-72. doi: 10.1016/j.pediatrneurol.2024.08.006. Epub 2024 Aug 23.

Abstract

BACKGROUND

Primary central nervous system tumors are the second most common cancer among children in high-income countries (HICs). These tumors are also the leading cause of cancer-related deaths in children in this setting. Studies from HICs report gliomas as the most common pediatric cancer. However, there is paucity of data from low- and middle-income countries as not many publications have been made in this field.

METHODS

The objective was to describe the disparities in detection, treatment, and survival of children with central nervous system tumors in low-income countries (LICs) when compared with HICs, using a case series. A retrospective chart review of three children treated for medulloblastoma in Uganda was done. In addition, a review of the literature about management of pediatric central nervous system tumors in both LICs and HICs was conducted.

RESULTS

There are no quantifiable results for this case series.

CONCLUSION

There are notable differences in the quality of care for children with pediatric central nervous system tumors in LICs when compared with HICs. In Uganda, the challenges in management of these children include few multidisciplinary specialists, long distance from the neurosurgery centers, and difficulties in making a correct pathologic diagnosis, among others.

摘要

背景

原发性中枢神经系统肿瘤是高收入国家(HICs)儿童中第二常见的癌症。这些肿瘤也是该环境下儿童癌症相关死亡的主要原因。来自 HICs 的研究报告称,神经胶质瘤是最常见的儿科癌症。然而,来自中低收入国家的数据很少,因为在这一领域没有发表多少出版物。

方法

本研究的目的是使用病例系列描述低收入国家(LICs)与 HICs 相比,儿童中枢神经系统肿瘤的检测、治疗和生存差异。对在乌干达接受髓母细胞瘤治疗的三名儿童进行了回顾性图表审查。此外,还对 LICs 和 HICs 中儿科中枢神经系统肿瘤管理的文献进行了综述。

结果

本病例系列没有可量化的结果。

结论

与 HICs 相比,LICs 儿童的儿科中枢神经系统肿瘤的护理质量存在显著差异。在乌干达,管理这些儿童的挑战包括:多学科专家较少、距离神经外科中心较远、以及难以做出正确的病理诊断等。

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