Abstract
A multi-institutional collaborative pediatric bone tumor program for improving access to specialized care
Journal of clinical oncology, Vol.33(15_suppl), pp.e21020-e21020
05/20/2015
DOI: 10.1200/jco.2015.33.15_suppl.e21020
Abstract
Abstract only
Background: Osteosarcoma and Ewing sarcoma are the most common malignant bone tumors in pediatrics. Average 5-year survival rates of 60-70% are achieved with current multimodality therapy. Local control modalities aiming at preserving function greatly influence quality of life of long term survivors. In developing countries, the limited availability of multidisciplinary care, expertise in specialized surgeries, and in pediatric radiation therapy, forms barriers to achieving optimal outcomes. Methods: We established a multi-institutional Collaborative Pediatric Bone Tumor Program, where children newly diagnosed with bone tumors have access to specialized local control at a tertiary Children’s Cancer Center. Central review of pathology, staging and treatment planning was performed in a multidisciplinary tumor board setting. Patients received chemotherapy locally on a unified treatment plan; local control was done at the Children’s Cancer Center at no cost to families through a program development initiative led by St Jude Children’s Research Hospital (SJCRH). Challenging cases were discussed with SJCRH team via teleconference. Results: Over 2.5 years, 30 patients were enrolled. Nationalities were Lebanese (15), Iraqi (8), and Syrian (7). Seventeen patients (57%) had Ewing sarcoma, 13 (43%) had osteosarcoma. Nineteen (63%) had localized disease. Protocol adherence was > 90%. Local control included 3 expandable and 6 standard prostheses, 3 fibular allografts, 7 simple resections and 3 amputations. Eleven patients received radiation therapy, and in 5 it was the sole mode of local control. At a median follow up of 16 months (range 5-29), 20 patients (67%) are in CR, 7 (23%) had disease progression or relapse, 2 (7%) were lost to follow-up in CR, and 1 (3%) died of toxicity. Conclusions: A collaborative bone tumor program in Lebanon resulted in timely local control and protocol adherence at 8 collaborating centers. Overall survival and functional outcome were comparable to those of international published series. Facilitating access to specialized multidisciplinary care, resolution of financial barriers, and close coordination, all contributed to the success of the program.
Details
- Title: Subtitle
- A multi-institutional collaborative pediatric bone tumor program for improving access to specialized care
- Creators
- Raya Hamad Saab - American University of BeirutMiguel Abboud - American University of BeirutSamar Muwakkit - American University of BeirutPeter Noun - Lebanese Hospital Geitaoui-University Medical CenterGladys Gemayel - Beirut General Hospital, Beirut, LebanonElie Bechara - Lebanese Hospital Geitaoui-University Medical CenterHassan Khalifeh - Zahraa Hospital, Beirut, LebanonRoula Farah - University Medical Center Rizk HospitalNabil Kabbara - Centre Hospitalier Du Nord, Zgharta, LebanonTarek El Khoury - Damascus HospitalRachid Haidar - American University of Beirut Medical CenterSaid Saghieh - American University of Beirut Medical CenterToufic Eid - American University of Beirut Medical CenterSamir Akel - American University of Beirut Medical CenterNabil Khoury - American University of BeirutMatthew J. Krasin - St. Jude Children's Research HospitalSima Jeha - St. Jude Children's Research HospitalHassan Mohamed El Solh - American University of Beirut Medical Center
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.33(15_suppl), pp.e21020-e21020
- DOI
- 10.1200/jco.2015.33.15_suppl.e21020
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 05/20/2015
- Academic Unit
- Radiology
- Record Identifier
- 9984700447302771
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