According to the current follow-up, EFS with MAP plus MC is not statistically superior to EFS with MAP alone in patients with high-grade, resectable OSTs of the extremities. Cancer 2017;123:1003-10. © 2016 American Cancer Society.

ASR of NB in Argentina is lower than in developed countries, with considerable regional variation. SRs are also lower than in developed countries.

In Argentina, ASR of osteosarcoma is similar to that in high-income countries, but survival is lower in all regions. Future work will focus on identification and reduction of causes of preventable treatment failure.

Racotumomab vaccination has a favorable toxicity profile up to a dose of 0.4 mg, and most patients elicited an immune response. Its activity as immunotherapy for neuroectodermal malignancies will be tested in further clinical trials.

PurposeThe use of traditional complementary/alternative medicine (TCAM) among children with cancer has been well documented. South America has a rich history of traditional healers and medicinal resources; however, little is known about the use of TCAM among children with cancer. We sought to investigate patterns, beliefs, and determinants of TCAM use among South American children with cancer.MethodsA cross-sectional survey was administered to 199 children treated for cancer at institutions located in Buenos Aires, Argentina, and Montevideo, Uruguay. Participants were queried about the type of TCAM and strength of beliefs associated with its use. Logistic regression analysis was used to estimate the odds ratios with 95% CIs.ResultsWe found that the use of TCAM was common in both Argentina (47%) and Uruguay (76%). Variations in the forms of TCAM used were observed between the countries; however, both countries used TCAM primarily for supportive care. Mother’s education, wealth index, and TCAM belief system were significant predictors of TCAM.ConclusionTo our knowledge, this study is the first to report on the use of TCAM in pediatric oncology in South America. The study identifies several predictors of TCAM use, which may serve as target variables for educational and research initiatives. The finding that most families use TCAM for supportive care suggests that future efforts could evaluate the role of TCAM to enhance existing supportive care regimens, particularly in settings where access to conventional medications are limited.

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BACKGROUND: Children with cancer in high-income and low-income countries often use traditional complementary/alternative medicine (TCAM). With efforts by the World Health Organization and international twinning programs improving access to conventional care for patients with childhood cancer, understanding the global use of TCAM is important because reliance on TCAM may affect time to presentation, adherence, and abandonment of care. In the current study, the authors describe the process and validation of an international survey documenting the use of TCAM among children with cancer. METHODS: The survey was designed to collect information on TCAM use and associated factors through both open-ended and close-ended questions. During the period between June 2012 and December 2013, the survey was administered to 300 children and adolescents (or their parents) who were undergoing treatment for cancer at a collaborating institution located in Mexico, Uruguay, and Nicaragua. RESULTS: For the majority of constructs, the survey demonstrated strong test-retest reliability as evidenced by an intraclass correlation of at least 0.79 in each of the participating countries. The survey demonstrated good internal consistency and reliability across countries (a range from. 77 to. 85 for the belief scale; and an a range from. 60 to. 86 for the cause scale) and convergent validity between TCAM beliefs and behavior constructs (adjusted correlation range, 0.35-0.60). CONCLUSIONS: The results of the current study demonstrate the successful development of a cross-cultural survey that produced results that were reliable and valid. These findings will aid investigators in providing guidelines concerning TCAM, support the development of education and research priorities, and identify variables associated with TCAM that are region-specific. Cancer 2015;121:1492-8. V C 2014 American Cancer Society.KEYWORDS: pediatric oncology, complementary/alternative medicine, supportive care, survey design, twinning programs. INTRODUCTIONThe differential mortality outcomes in childhood and adolescent cancer between developed and developing countries have become increasingly apparent. Greater than 80% of children with cancer reside in developing countries, in which survival rates are estimated to be approximately 35%, which is in stark contrast to the overall survival rate of 70% observed for children residing in developed countries.1,2 Although improved access to drugs, political stability, and the availability of locally trained health care providers have been crucial in expanding the delivery of Western care, the role of traditional complementary/alternative medicine (TCAM) in regions with diverse medical systems is less understood. Understanding the application and role of TCAM in other pediatric conditions, including human immunodeficiency virus/acquired immunodeficiency syndrome and severe malaria, has helped to bridge the gap in communication among traditional healers and conventional health care providers and improve access to medical care in child...

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