Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Ward, Richard A.; Jones, Hannah M.; Witt, Davis; Boop, Frederick A.; Bouffet, Éric; Rodríguez‐Galindo, Carlos; Qaddoumi, Ibrahim; Moreira, Daniel C.

doi:10.1200/go.22.00199

Cited by 11 publications

(8 citation statements)

References 41 publications

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“…[ 8 ] There are many factors to explain this, such as very late diagnosis, the inability to perform innovative radiation therapy techniques until 2018 and the fact that between 2001 and 2010 the chemotherapy regimens were not as effective as the more recent ones. However, the survival rates recorded in our study are similar to those reported by other middle-income countries [ 12 ].…”

Section: Discussionsupporting

confidence: 91%

Therapeutic results in children with brain tumors – a single center experience over 18 years

Cosnarovici,

Piciu

2023

Medicine and Pharmacy Reports

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Background and aims. Tumors of the central nervous system represent the main cause of death by cancer in children. The diagnosis and molecular classification of these neoplasms have seen great improvement in the past years, due to ongoing genomic advances. In general, the treatment consists of surgery, radiation therapy and chemotherapy. However, the currently available pharmacological treatment options have limited effectiveness due to the particular characteristics of the blood-brain barrier. Methods. We decided to study the therapeutic results in children treated for brain tumors in the Cluj-Napoca “Prof. dr. Ion Chiricuta” Oncology Institute, between 2001 and 2018, in order to provide a more accurate understanding of the disease and the available therapeutic options in our center. Results. Out of the 207 cases included in this study, we recorded 98 deaths (47.3%). This is significantly less than the 5-year survival rate recorded in the US between 2012 and 2018 (74.9%). There are many factors that could explain the low survival rate, such as a very late diagnosis, the inability to implement innovative radiation therapy techniques until 2018, and the fact that between 2001 and 2010 the chemotherapy regimens in our center were not as effective as the more recent ones. Conclusions. The therapeutic results recorded in this study are similar to those in other middle-income countries, however, the available treatment options for pediatric brain tumors are not as effective as those currently in use for other pediatric and adult malignancies.

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Section: Discussionsupporting

confidence: 91%

Therapeutic results in children with brain tumors – a single center experience over 18 years

Cosnarovici,

Piciu

2023

Medicine and Pharmacy Reports

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“…Finally, although the survey sought to capture capacity, further granularity in neuro-oncologic patient-level outcomes was not captured as these are harder to consistently collect. 16 These data would shed important light on care gaps for children with CNS tumors and underscore the need for comprehensive pediatric cancer registries.…”

Section: Discussionmentioning

confidence: 95%

Pediatric Neurosurgical Capacity for the Care of Children With CNS Tumors Worldwide: A Cross-Sectional Assessment

Roach

Qaddoumi

Baticulon

et al. 2023

JCO Global Oncology

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PURPOSE Efforts to address inequities in the treatment of pediatric CNS tumors and the burden of childhood cancer globally have prompted the designation of low-grade glioma as one of six index cancers for the World Health Organization Global Initiative for Childhood Cancer. Understanding the importance of neurosurgical interventions and evaluating pediatric neurosurgical capacity may identify critical interventions to improve outcomes for children with low-grade glioma and other CNS tumors. METHODS An online, cross-sectional survey assessing pediatric neurosurgical practice and capacity was distributed to members of the International Society of Pediatric Neurosurgery. The survey included 36 items covering domains including patient volume, available infrastructure, scope of practice, case distribution, and multidisciplinary care. RESULTS Responses from 196 individuals from 61 countries, spanning all WHO regions, were included. Ninety-six (49.0%) were from high-income countries, 57 (29.1%) were from upper-middle–income countries, 42 (21.4%) were from lower-middle–income countries (LMICs), and 1 was (0.5%) from a low-income country. Most respondents had a catchment population of ≥ 1 million and indicated the availability of basic neurosurgical resources such as a dedicated neurosurgical operating theater and surgical microscope. The presence of a neurosurgical intensive care unit, inpatient rehabilitation services, and infection monitoring showed similar availability across country groups. Quantitative scoring of 13 infrastructure and service items established that fewer resources were available in low-income countries/LMICs and upper-middle–income countries compared with high-income countries. The volume of pediatric CNS tumor cases and case distribution did not vary according to World Bank country groups. CONCLUSION This study provides a comprehensive evaluation of pediatric neurosurgical capacity across the globe, establishing variability of resources on the basis of the country income level. Our findings suggest that pediatric neurosurgeons in LMICs may benefit from key neurosurgical instrumentation and increased support for multidisciplinary brain tumor programs and childhood cancer research efforts.

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“…In this series, the most frequent presenting sign was decreased visual acuity and the visual outcomes of 10 patients was included, with improvement in a subset of patients. Data on functional outcomes of pediatric LGG in LMICs are exceedingly sparse ( 19 ). Functional outcomes be investigated more in depth in LMICs as this is a key parameter of outcomes for this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Low-grade glioma (LGG) is one of the six index cancers selected by the GICC to demonstrate the impact of increasing access to quality care for children with cancer ( 18 ). Importantly, there are few studies describing the outcomes of the treatment of children with OPG in LMICs ( 19 ). The aim of this study was to determine the clinical course and outcomes of children with OPG at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca in Mexico.…”

Section: Introductionmentioning

confidence: 99%

Challenges in treating children with optic pathway gliomas: an 18-year experience from a middle-income country

Ramírez-Melo,

Moreira,

Orozco-Alvarado

et al. 2024

Front. Oncol.

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IntroductionPatients with optic pathway gliomas (OPG) have good survival rates although their long-term quality of life can be affected by the tumor or treatment-related morbidity. This retrospective study sought to describe the clinical presentation and outcomes of children with OPG at a tertiary center in Mexico.MethodsConsecutive patients <18 years-of-age with newly diagnosed OPG between January 2002 and December 2020 at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca in Guadalajara, Mexico were included.ResultsThirty patients were identified with a median age of six years. The most frequent clinical manifestations were loss of visual acuity (40%) and headaches (23%). Neurofibromatosis-1 was found in 23.3% of the patients. Surgery, either biopsy or resection, was done in 20 of 30 patients. Two patients died shortly after initial surgery. The 5-year event-free survival (EFS) was 79.3% ± 10.8% and the 5-year overall survival was 89.5% ± 6.9%. Lower EFS was associated with age less than 3 years, intracranial hypertension at presentation, and diencephalic syndrome. Patients who received surgery as first-line treatment had a 3.1 times greater risk of achieving a performance score of less than 90 points at 6 months after diagnosis (p=0.006). Of 10 patients with vision testing, 5 had improvement in visual acuity, 4 had no changes, and one patient showed worsening.ConclusionOur data suggests that favorable outcomes can be achieved with OPG in low- and middle-income countries, although a high rate of surgical complications was described leading to a lower overall survival. These data can be used prospectively to optimize treatment at this institute and other middle-income countries through a comprehensive, multidisciplinary approach.

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Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Cited by 11 publications

References 41 publications

Therapeutic results in children with brain tumors – a single center experience over 18 years

Therapeutic results in children with brain tumors – a single center experience over 18 years

Pediatric Neurosurgical Capacity for the Care of Children With CNS Tumors Worldwide: A Cross-Sectional Assessment

Challenges in treating children with optic pathway gliomas: an 18-year experience from a middle-income country

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