Evaluation of Potential Risk for Developing Treatment Associated Late Effects Among Childhood Cancer Survivors at Bugando Medical Centre, Mwanza, Tanzania.
Goodluck Issa Nchasi CUHAS/MD/4002546/T/18
Evaluation of Potential Risk for Developing Treatment Associated Late Effects Among Childhood Cancer Survivors at Bugando Medical Centre, Mwanza, Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2023 - 40 Pages Includes References and Appendicies
Abstract:
Global advancement in pediatric cancer treatment has significantly increased survival rates for children with cancer. Childhood cancer survivors (CCS) now represent a growing population at risk of potentially debilitating late effects of their treatment. This study evaluates the potential risk for long-term complications related to cancer therapy among childhood cancer survivors who completed treatment in Tanzania at Bugando Medical Centre (BMC), and compares the relative risk assessment of childhood cancer survivors at BMC as compared to the published British Childhood Cancer Survivor Study (BCCSS) cohort.
This was a retrospective cohort study that was conducted at Bugando Medical Centre among childhood cancer survivors who completed treatment from 2016 to 2022. Extracted data included patient demographics, primary disease diagnosis and site, treatment received, and cumulative treatment doses. BCCSS risk assessment was assigned and predicted long term follow up surveillance needs were extrapolated from published Children’s Oncology Group Long-Term Follow-Up Guidelines.
190 patients were initially identified, with 17 excluded due to missing treatment information. Among remaining 173 patients, the mean age was 7yo, 47% were female (n=82), and the most common diagnoses were Wilms tumor (30%, n=52) and Burkitt’s Lymphoma (26%, n=45). 98% received chemotherapy (n=170), 42% (n=73) underwent tumor resection, and 8% (n=18) received radiation. Distribution of BCCSS late effect risk assessment included 6% low risk (n=10), 80% moderate risk (n=139) and 14% (n=24) high risk. This was a higher rate of moderate/ severe risk (94%) compared to the published UK BCCSS cohort (84%). Based on treatment received, the late effects with highest potential risk were cardiomyopathy (57% of patients, n=98), bladder and urinary tract toxicity (50%, n=87), and ototoxicity (22%, n=38).
Childhood cancer survivors at BMC have a higher risk of late effects as compared to published survivor cohorts in high-income countries. There is a need to develop and improve long-term follow-up care for survivors by enhancing patient and provider education to promote early detection of late effects. Based on risk assessment, survivorship programs in Tanzania should at a minimum include the capacity to perform echocardiograms, urinalysis, renal ultrasound, audiological evaluation, fundoscopic and neurological exams, and renal function testing.
Wurzburg Road 35, BMC Premises, Post Code: 33102 : P. O. Box 1464, Mwanza – Tanzania : Phone: +255 28 298 3384 : Fax: +255 28 298 3386 : Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Community Medicine --Pathology --Hematology
Evaluation of Potential Risk for Developing Treatment Associated Late Effects Among Childhood Cancer Survivors at Bugando Medical Centre, Mwanza, Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2023 - 40 Pages Includes References and Appendicies
Abstract:
Global advancement in pediatric cancer treatment has significantly increased survival rates for children with cancer. Childhood cancer survivors (CCS) now represent a growing population at risk of potentially debilitating late effects of their treatment. This study evaluates the potential risk for long-term complications related to cancer therapy among childhood cancer survivors who completed treatment in Tanzania at Bugando Medical Centre (BMC), and compares the relative risk assessment of childhood cancer survivors at BMC as compared to the published British Childhood Cancer Survivor Study (BCCSS) cohort.
This was a retrospective cohort study that was conducted at Bugando Medical Centre among childhood cancer survivors who completed treatment from 2016 to 2022. Extracted data included patient demographics, primary disease diagnosis and site, treatment received, and cumulative treatment doses. BCCSS risk assessment was assigned and predicted long term follow up surveillance needs were extrapolated from published Children’s Oncology Group Long-Term Follow-Up Guidelines.
190 patients were initially identified, with 17 excluded due to missing treatment information. Among remaining 173 patients, the mean age was 7yo, 47% were female (n=82), and the most common diagnoses were Wilms tumor (30%, n=52) and Burkitt’s Lymphoma (26%, n=45). 98% received chemotherapy (n=170), 42% (n=73) underwent tumor resection, and 8% (n=18) received radiation. Distribution of BCCSS late effect risk assessment included 6% low risk (n=10), 80% moderate risk (n=139) and 14% (n=24) high risk. This was a higher rate of moderate/ severe risk (94%) compared to the published UK BCCSS cohort (84%). Based on treatment received, the late effects with highest potential risk were cardiomyopathy (57% of patients, n=98), bladder and urinary tract toxicity (50%, n=87), and ototoxicity (22%, n=38).
Childhood cancer survivors at BMC have a higher risk of late effects as compared to published survivor cohorts in high-income countries. There is a need to develop and improve long-term follow-up care for survivors by enhancing patient and provider education to promote early detection of late effects. Based on risk assessment, survivorship programs in Tanzania should at a minimum include the capacity to perform echocardiograms, urinalysis, renal ultrasound, audiological evaluation, fundoscopic and neurological exams, and renal function testing.
Wurzburg Road 35, BMC Premises, Post Code: 33102 : P. O. Box 1464, Mwanza – Tanzania : Phone: +255 28 298 3384 : Fax: +255 28 298 3386 : Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Community Medicine --Pathology --Hematology