SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings

Abstract

Effective treatment of children with low grade glioma (LGG) requires a functioning multidisciplinary team with adequate neurosurgical, neuroradiological, pathological, radiotherapy and chemotherapy facilities and personnel. In addition, the treating centre should have the capacity to manage a variety of LGG and treatment-associated complications. These requirements have made it difficult for many centers in low and middle-income countries (LMIC) to offer effective treatment and follow up. This article provides management recommendations for children withLGG according to the level of facilities available.

The COVID‐19 pandemic: A rapid global response for children with cancer from SIOP, COG, SIOP‐E, SIOP‐PODC, IPSO, PROS, CCI, and St Jude Global

“…TA B L E 1 Summary of contents of supplements: A global response to pandemic COVID-19 Supplement I and Supporting Information Tables S1-S6 Disease-specific guidance for (1) acute lymphoblastic leukemia, (2) Burkitt lymphoma, (3) Hodgkin lymphoma, (4) retinoblastoma, (5) Wilms tumor, and (6) low-grade glioma. Information Tables S7-S9 Specialty and service-specific guidance; (7) radiotherapy; (8) Our guidance is set out in this paper and two accompanying supplements whose detailed contents are described in Table 1.…”

“…Among the different LGG protocols, monthly carboplatin and TPCV are the most suitable in this context. 8,42,43…”

“…However, some temporary changes could be considered in order to reduce hospital visits (Supplement I; Supporting Information Table S6). Among the different LGG protocols, monthly carboplatin and TPCV are the most suitable in this context 8,42,43 . For newly diagnosed patients, situations are closely related to the resources available.…”

“…The WHO Global Initiative for Childhood Cancer (GICC), launched in 2018, has set an ambitious goal of improving survival rates for the 90% of the world's children who live in low‐ and middle‐income countries (LIMC) to 60% by 2030 1,2 . The GICC has identified six common index cancers—acute lymphoblastic leukemia (ALL), Burkitt lymphoma (BL), Hodgkin lymphoma (HL), retinoblastoma, Wilms tumor, and low‐grade gliomas (LGGs)—all have a very good prognosis in high‐income countries (HICs) and can be treated with curative intent in low‐ and middle‐income countries (LMICs), using established standards of care or resource‐adapted treatment regimens such as those previously published by the SIOP‐PODC (Pediatric Oncology in Developing Countries) group 3,4‐8 . Here our specific focus is on these index cancers as they account for the majority of cancers seen in HIC and LMICs, and the core principles for care and treatment of these cancers are generalizable across most other cancers seen in childhood.…”

A systematic review of ongoing clinical trials in optic pathway gliomas

“…We did not identify any trials run from a low- or middle-income country (LMIC) despite reports that up to 80% of all paediatric cancer patients occur in these countries. Potential reasons for the lack of clinical trials in LMIC include a lack of specialised centres, equipment and staff, and a lower priority of cancer for healthcare planning strategies [ 19 – 21 ]. There were a small number of trials looking at non-pharmacological diagnostics, therapeutics and assessment social functioning relating to OPG.…”