The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa

Abstract

Purpose The aim of the World Health Organization-International Paediatric Oncology Society is to improve childhood cancer survival in low- and middle-income countries to 60% by 2030. This can be achieved using standardised evidence-based national treatment protocols for common childhood cancers. The aim of the study was to describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol as part of the treatment harmonisation process of the South African Children’s Cancer Study Group. Methods The Consolidated Framework for Implementation Research was used to identify factors that could influence the implementation of the national NB protocol as a health care intervention. The evaluation was done according to five interactive domains for implementation: intervention characteristics, inner setting, outer setting, individual or team characteristics and the implementation process. Results The protocol was developed over 26 months by 26 physicians involved in childhood cancer management. The process included an organisational phase, a resource identification phase, a development phase and a research ethics approval phase. Challenges included nationalised inertia, variable research ethical approval procedures with delays and uncoordinated clinical trial implementation. Conclusion The implementation of the national NB protocol demonstrated the complexity of the implementation of a national childhood cancer treatment protocol. However, standardised paediatric cancer treatment protocols based on local expertise and resources in limited settings are feasible. Supplementary Information The online version contains supplementary material available at 10.1007/s10552-021-01424-2.

A Retrospective Analysis of the Therapeutic Outcomes of 117 Neuroblastoma Patients Treated at a Single Pediatric Oncology Center in China

“… 9 Patients who have traditionally depended heavily on conventional treatment strategies, such as surgery, high-dose chemotherapy, and radiation therapy, are beginning to embrace protocols employing advanced therapeutic strategies. 10 , 11 In certain underdeveloped countries, the survival rates of NB patients with low (LR) to intermediate-risk (IR) disease may be comparable to those in the developed countries. However, the survival rate of patients with high-risk (HR) NB in developing countries ranges from 20% to less than 50%, which is much lower than newly released statistics from the Europe and North America, which indicate a survival rate of 60% or more.…”