Krailo M D, Bernstein L, Sullivan-Halley J, Hammond G D
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles.
Cancer. 1993 May 15;71(10 Suppl):3325-30. doi: 10.1002/1097-0142(19930515)71:10+<3325::aid-cncr2820711731>3.0.co;2-k.
To assess the proportion of children diagnosed with cancer who are enrolled on studies conducted by the two national pediatric cooperative groups, population-based cancer incidence data for Los Angeles county children younger than age 20 for the years 1980 through 1987 were linked with patient records of children registered with the Childrens Cancer Group (CCG) or the Pediatric Oncology Group (POG). For patients not enrolled on a protocol, demographic and disease characteristics were compared with summary eligibility requirements for CCG protocols that were open for enrollment during 1980-1987. The proportion of patients enrolled on studies conducted by the cooperative groups varied with tumor type and age at diagnosis. When patients younger than the age of 10 were diagnosed at an institution affiliated with one of the groups, the majority of those evaluated by our review as eligible for a study were enrolled on a protocol. The proportion of young patients entered on study among those whose diagnosis was not made at a cooperative group institution was generally smaller. Seventy-three percent of all potentially eligible patients with acute leukemia diagnosed between 1980-1987 were entered on a pediatric group protocol. Approximately 50% of all potentially eligible patients with brain tumors were entered on protocol. In contrast to this, less than 50% of patients older than the age of 14 and likely to be eligible for a study were entered on a pediatric group protocol, regardless of the tumor type. Indeed, bone tumors constituted the category of patients most likely to be enrolled, with 39% of all potentially eligible patients entered on a study in the period examined. If the patient's diagnosis was made at a cooperative group institution, the individual was more likely to be entered on a protocol than if the diagnosis was made at a center outside the cooperative group network. It was not possible to determine the precise reason for this trend from the data available. Some explanations include policies at cooperative group institutions regarding admission of patients older than age 14 and the availability of protocols from cooperative groups primarily focused on the treatment of cancers of adults.
为评估被诊断患有癌症的儿童中参加两个全国性儿科合作组所开展研究的比例，将1980年至1987年洛杉矶县20岁以下儿童的基于人群的癌症发病率数据与儿童癌症组（CCG）或儿科肿瘤组（POG）登记的儿童患者记录相链接。对于未参加方案的患者，将其人口统计学和疾病特征与1980 - 1987年期间开放入组的CCG方案的总结性入选标准进行比较。参加合作组所开展研究的患者比例随肿瘤类型和诊断时的年龄而变化。当10岁以下的患者在与其中一个组相关的机构被诊断时，经我们审查评估为符合研究条件的大多数患者参加了方案。在非合作组机构诊断的患者中参加研究的年轻患者比例通常较小。1980 - 1987年期间所有潜在符合条件的急性白血病患者中有73%参加了儿科组方案。所有潜在符合条件的脑肿瘤患者中约50%参加了方案。与此形成对比的是，无论肿瘤类型如何，14岁以上且可能符合研究条件的患者中参加儿科组方案的不到50%。实际上，骨肿瘤患者是最有可能被纳入研究的类别，在所研究期间所有潜在符合条件的患者中有39%参加了研究。如果患者的诊断是在合作组机构做出的，那么该个体比在合作组网络之外的中心做出诊断的个体更有可能参加方案。根据现有数据无法确定这一趋势的确切原因。一些解释包括合作组机构关于14岁以上患者入院的政策以及合作组主要侧重于成人癌症治疗的方案的可用性。
