Welcome to SIOP 2022 Interactive Programme
The Congress will officially run on CET time zone (Central European Time, Barcelona)
- Michael J. Sullivan (Australia)
- Muhammad Saghir Khan (Pakistan)
ADDRESSING THE GAP IN RESEARCH METHODOLOGIES EDUCATION IN PEDIATRIC ONCOLOGY IN THE EASTERN MEDITERRANEAN REGION
- Raya Saab (Lebanon)
Abstract
Background and Aims
Formal training in research methodologies is limited in LMICs. The Pediatric Oncology East & Mediterranean Group (POEM) and St. Jude Global developed a workshop focused on capacity building in research skills. We describe its structure, implementation, and early results.
Methods
Leveraging virtual capabilities, lectures and small group ‘breakout’ exercise sessions were conducted for 3 hours per day on 2 consecutive days over 2 weeks, at 15:00-18:00 GMT to accommodate time zones. Topics included research design, data registries, healthcare statistics, research ethics, and scientific writing. Each applicant submitted a research study abstract. Breakout groups selected one abstract each for further development, which they subsequently presented in a groupwide session. Feedback was captured through an online survey.
Results
Attendance included 29 registrants from 12 countries and 6 disciplines (17 physicians, 6 research staff, 2 nurses, 4 other). Final output presentations included a retrospective, a prospective observational, a prospective interventional, and a registry study proposal. After the workshop, participants were invited to further develop their original abstracts and 3 received additional mentoring. The post-workshop survey was filled by 100% of attendees, with a score of “excellent” or “very good” given by 84% on overall quality, 87% on platform suitability, and 72% on course length. Course objectives were deemed met by 79-94% of participants, by specific session. At least 25% of the material was new for 93%, and more than 50% was new for 51%. All attendees felt that the material will impact their practice. Group discussions were highlighted by 73% as being a most effective aspect. The top 3 voted themes for future workshops were statistical analysis (64%), writing & publishing (45%), and quality improvement (39%).
Conclusions
This workshop demonstrates the potential for HIC-LMIC network partnerships in targeting research training gaps. Lessons learned will be applied to the planning of future workshops to strengthen research in LMICs.
SOCIOECONOMIC STATUS HAS NO LONGER IMPACT ON OS AND EFS OF CHILDHOOD ALL IN YOGYAKARTA, INDONESIA AFTER INTRODUCTION OF UNIVERSAL HEALTH CARE ACT
- Claudia P. Adelin (Indonesia)
Abstract
Background and Aims
About 60% of our patients come from low socioeconomic status (SES). Our previous study showed that low SES negatively affected the outcome of children with ALL. This study aimed to re-examine whether SES influences the outcome of treatment in children with ALL after the implementation of the Universal Health Care Act (UHC).
Methods
Since February 2013 until November 2018, 362 children with ALL were registered in Sardjito General Hospital Yogyakarta, 174 using ALL2013 protocol and 188 using ALL2016 protocol. They were divided into two groups: low SES and higher SES. Families with a monthly income of less than 2.5 million IDR (approximately US 5 a day) or treated in third class ward were labeled low SES. The 4-year pOS and pEFS were analyzed using Kaplan Meier method.
Results
Among 362 children, 241 (66.6%) come from low SES families. The 4-year-pOS of the low SES and the higher SES in ALL2013 were 48.4% and 54.2% respectively (P= 0.346) and in ALL2016 59.1% and 61.6% (P= 0.504). The 4-year-pEFS of the low SES and the higher SES in ALL2013 were 34.9% and 41.7% (P= 0.305), and in ALL2016 48.7% and 50.7% (p=0.668). The number of abandonments decreased significantly compared to our previous study (35% in 2006, 11.5% in ALL2013; P<0.001, and 5.9% in ALL2016; P<0.001). After the implementation of UHC, more people from lower SES could access health facilities and were less hindered by financial problems.
Conclusions
After free access to healthcare facilities, economic factors seemed to no longer significantly affect the outcome of children with ALL.
MULTI-CENTER, PHASE 3, RANDOMIZED CONTROLLED TRIAL, COMPARING DAUNORUBICIN AND ARAC (DA) VERSUS ARAC, DAUNORUBICIN, AND ETOPOSIDE (ADE) INDUCTION CHEMOTHERAPY IN PEDIATRIC ACUTE MYELOID LEUKEMIA (INPOG-AML-01-14).
- Venkatraman Radhakrishnan (India)
Abstract
Background and Aims
The benefit of three-drug induction chemotherapy over a two-drug induction has not been evaluated in pediatric acute myeloid leukemia (AML). We, therefore, conducted a multi-center, open-label, investigator-initiated phase III randomized controlled trial to ascertain the benefit of a three-drug induction regimen in pediatric AML.
Methods
Patients aged between 1-18 years with newly diagnosed AML were recruited in the study between 22nd May 2014 and 14th November 2019 across three sites in India. They were randomized to two cycles of induction chemotherapy with daunorubicin and ara-C (DA) or two cycles of ara-C, daunorubicin, and etoposide (ADE). After completing the induction, patients in both arms received consolidation with two cycles of high-dose ara-C. The study's primary objective was to compare the event-free survival (EFS) between the two arms. The secondary objectives were to compare the complete-remission (CR) rates, overall survival (OS), and toxicities.
Results
The study randomized 149 patients, 77 patients in the DA and 72 in the ADE arm. The median age was 8.7 years, and 92 (62%) patients were males. The median follow-up was 50.9 months. After the first induction, the CR rate in the DA and ADE arm were 65% and 68% (P=0.68), respectively, while it was 82% and 79% (P=0.68) after the second induction. There were 13 (17%) induction deaths in the DA arm, of which nine were treatment-related, and 12 (17%) in the ADE arm, of which seven were treatment-related (P=0.97). Forty patients relapsed in DA arm and 37 in ADE (P=0.94). The 5-year EFS in the DA and ADE arm was 34.5% and 34.5%, respectively (P=0.66). The 5-year OS in the DA and ADE arm was 41.4% and 42.1%, respectively (P=0.77). There were no significant differences in toxicities between the regimens.
Conclusions
ADE induction regimen did not improve EFS, OS, and CR in pediatric AML compared to DA regimen.
PEDCAN: ACCEPTABILITY AND FEASIBILITY OF A MOBILE APPLICATION BY PRIMARY HEALTH-CARE WORKERS TO RECOGNIZE CHILDREN WITH CANCER IN UGANDA
- Barnabas Atwiine (Uganda)
Abstract
Background and Aims
Early diagnosis of cancer in children is dependent on a high index of suspicion and referral by primary health care workers (PHCW) to cancer specialists at tertiary centres. The aim of this study was to assess the acceptability and feasibility of PEDCan mobile application by primary health care workers to recognize children with cancer-related clinical features, initiate remote consultations with specialists and refer them timely for diagnosis.
Methods
We developed a mobile application, called PEDCan, to aid PHCWs recognize children with cancer, hold remote consultations with specialists and refer them to cancer centres. In May 2021, we conducted a cross-sectional descriptive study among consented PHCWs in southwest Uganda to collect data about knowledge regarding childhood cancer, smart phone ownership and internet usage. After training them on the use of the application using mock clinical scenarios, their ease and readiness to use it was assessed. Descriptive statistics were used to calculate proportions of participants able and willing to use it. Ethical approval was provided by Research and Ethics Committee of Mbarara University of Science and Technology
Results
Forty-four PHCWs participated in the study. Twenty-five (56.8%) were nurses/midwives, 8 (18.2%) clinical officers, 3 (6.8%) general doctors and 8 (18.2%) other cadres. All had heard about childhood cancer and 28 (63.6%) had ever seen a child suspected to have cancer. Thirty-eight (86.4%) participants owned a smart phone and used internet and 12 (31.6%) had access to internet all the time. Thirty-eight (86.3%) participants found the use of PEDCan very easy or easy and all were willing to use it.
Conclusions
PHCWs were able and willing to use PEDCan application to recognize children with cancer and initiate remote expert consultations. A pilot study with real patients would further demonstrate effectiveness in real life clinical settings.