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    Dr. Kavuma Awusi Dr. Kanyike Daniel and Dr. Luutu Israel Radiotherapy Department Uganda Cancer Institute, P.O Box 3935 Kampala - Uganda

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    The study analyzed 304 pediatric cancer patients referred for radiotherapy in Uganda between 2015-2018. The most common cancers were Wilms tumor (23.4%), sarcomas (22.4%), and lymphomas (18.2%). Most patients presented with advanced disease (stages III-IV) and poor performance status. Only 61.3% were treated with radical intent while 34.2% received palliative care. Treatment outcomes were poor with only 67.7% completing the prescribed radiation doses and over half dead or lost to follow up within a year. The study highlights challenges with late stage presentation and limited diagnostic and treatment resources for pediatric cancer patients in low-resource settings.

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    Dr. Kavuma Awusi Dr. Kanyike Daniel and Dr. Luutu Israel Radiotherapy Department Uganda Cancer Institute, P.O Box 3935 Kampala - Uganda

    Uploaded by

    Sumanta
    51 views1 page
    The study analyzed 304 pediatric cancer patients referred for radiotherapy in Uganda between 2015-2018. The most common cancers were Wilms tumor (23.4%), sarcomas (22.4%), and lymphomas (18.2%). Most patients presented with advanced disease (stages III-IV) and poor performance status. Only 61.3% were treated with radical intent while 34.2% received palliative care. Treatment outcomes were poor with only 67.7% completing the prescribed radiation doses and over half dead or lost to follow up within a year. The study highlights challenges with late stage presentation and limited diagnostic and treatment resources for pediatric cancer patients in low-resource settings.

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    The study analyzed 304 pediatric cancer patients referred for radiotherapy in Uganda between 2015-2018. The most common cancers were Wilms tumor (23.4%), sarcomas (22.4%), and lymphomas (18.2%). Most patients presented with advanced disease (stages III-IV) and poor performance status. Only 61.3% were treated with radical intent while 34.2% received palliative care. Treatment outcomes were poor with only 67.7% completing the prescribed radiation doses and over half dead or lost to follow up within a year. The study highlights challenges with late stage presentation and limited diagnostic and treatment resources for pediatric cancer patients in low-resource settings.

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    51 views1 page

    Dr. Kavuma Awusi Dr. Kanyike Daniel and Dr. Luutu Israel Radiotherapy Department Uganda Cancer Institute, P.O Box 3935 Kampala - Uganda

    Uploaded by

    Sumanta
    The study analyzed 304 pediatric cancer patients referred for radiotherapy in Uganda between 2015-2018. The most common cancers were Wilms tumor (23.4%), sarcomas (22.4%), and lymphomas (18.2%). Most patients presented with advanced disease (stages III-IV) and poor performance status. Only 61.3% were treated with radical intent while 34.2% received palliative care. Treatment outcomes were poor with only 67.7% completing the prescribed radiation doses and over half dead or lost to follow up within a year. The study highlights challenges with late stage presentation and limited diagnostic and treatment resources for pediatric cancer patients in low-resource settings.

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    The distribution and treatment outcomes of paediatric cancer patients referred for

    radiotherapy in low and middle-income countries (LMIC) – The Uganda experience


    Dr. Kavuma Awusi1, Dr. Kanyike Daniel1 and Dr. Luutu Israel1 1Radiotherapy Department Uganda Cancer Institute, P.O Box 3935 Kampala – Uganda
    * Corresponding author: kavumawusi@yahoo.com

    Figure 1: Distribution of Paediatric Cancers referred for Radiotherapy


    • Background and Objective Results
    • Cancer is one of the major causes of death for paediatrics and most paediatrics ❑ A total of 4178 patients were referred for RT, 304 (7.3%) were
    die due to social economic factors e.g: poverty, limited treatment facilities, limited paediatrics. The M:F ratios was 1.2:1.
    access to education / information, scattered rural populations, scarcity of ❑ Figure 1 show the distribution pattern of the cancers referred for RT
    oncology experts, etc. ❑ Overall, the four most common cancers were Wilms (23.4%), Sarcomas
    • LMIC have younger populations, proportion of children with cancer is (22.4%), Lymphomas (18.2%) and NPC (11.6%).
    significant. ❑ 65.8% presented in ECOG status 0–1 and 34.2% in ECOG 2-3.
    ❑ Only 12% presented with stages I-II, the rest resented with stages III-IV.
    • The burden of paediatric tumours in our radiotherapy resource-challenged
    ❑ 61.3% were planned & treated with radical intention.
    center, is not well documented; hence the main objective of this study was to
    ❑ Wilms tumours presented mainly with stage III disease, post-surgery /
    evaluate the distribution and treatment outcomes of paediatric tumours and to
    chemotherapy and treated radically with 1.8 Gy daily doses for 6 
    propose strategies that could improve outcomes.
    ❑ The prescribed radical doses ranged from 36.0 Gy for lymphomas to
    70.0Gy in extremity soft-tissue sarcomas.
    ❑ In 65% of the palliative treatments, single doses of 6.0Gy, 8.0Gy and
    Methods 10.0Gy were prescribed; others were 20.0Gy/5 and 30 Gy/10.
    o To evaluate the distribution and treatment outcomes of Paediatric ❑ Because large numbers presented relatively with advanced diseases and
    cancers referred for Radiotherapy, we retrospectively reviewed all the in poor ECOG status, 67.7% completed the prescribed doses.
    patient’s records/files referred to our department, from January 2015 ❑ For those who completed their treatments, their conditions at discharge
    to December 2018. were 52.7% in ECOG 0-1, 25.8.7% in ECOG 2-3 and 21.5% in ECOG 4.
    ❑ After 6 months and one year of follow-ups, 47.7% and 56.8%
    o The study involved patients aged 21 years and below with confirmed
    respectively have been confirmed dead or lost to follow-up.
    histological diagnosis referred for radiotherapy.
    o The American Academy of Paediatrics categorises paediatric:
    Discussion and Conclusions
    ▪ Infancy (birth-2), Childhood (2–12) & Adolescence (12–21) yrs of age
    o Paediatric tumours comprised of a wide-range of cancers, accounting for ≈8% of all referrals and ≈90% present with advanced diseases and nearly
    o Information retrieved from patients records/files included age, sex,
    40% are treated palliatively which impedes on treatment outcomes.
    histological diagnosis, stage, pre-treatment received, ECOG status,
    o Precise diagnosis including pathology and imaging procedures to identify the stage - the foundation on which all subsequent management decisions
    treatment intent, radiation dosages (fractionation/total-dose) and are based is not readily available in most rural areas.
    follow-up at 3, 6 and 12months o One radiotherapy facility with long waiting times also resulted in some patients giving-up or failing to complete treatment. Logistical problems like
    transport/finances, cultural beliefs and alternative medicines, etc caused delayed referrals and presentations.

    1. Cristina D. Stefan. Patterns of Distribution of Childhood Cancer in Africa . J.Trop.Pediatr 2015, 61, 165–173
    References 2. Qureshi SS, et al. A cross-sectional study of the distribution of pediatric solid tumors at an Indian tertiary cancer center. Indian J Cancer 2018;55:55-60

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