Improved outcome at end of treatment in the collaborative Wilms tumour Africa project

Trijn Israels, Vivian Paintsil, Dalida Nyirenda, Francine Kouya, Glenn Mbah Afungchwi, Peter Hesseling, Clara Tump, Gertjan Kaspers, Liz Burns, Ramandeep Singh Arora, George Chagaluka, Philippa Nana, Lorna Renner, Elizabeth Molyneux

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Background: The Collaborative Wilms Tumour (WT) Africa Project has implemented an adapted WT treatment guideline in sub-Saharan Africa as a multi-centre prospective clinical trial. A retrospective, baseline evaluation of end-of-treatment outcome was performed for a 2-year period prior to the introduction of this guideline. The collaborative project aims to reduce both treatment abandonment and death during treatment to less than 10% for improving survival. Procedure: All participating centres obtained local Institutional Research Board (IRB) approval and implemented the adapted WT treatment guideline. End-of-treatment outcome was documented for 2 years. It was divided into alive without evidence of disease, treatment abandonment, death during treatment and persistent disease. The outcome of children enroled in the first 2 years of the prospective clinical trial has been compared to the outcome before the start of the project. Results: One hundred twenty-two patients were included in the baseline evaluation (2011–2012) and 133 in the first 2 years of the collaborative clinical trial (2014–2015). The percentage of patients alive without evidence of disease at the end of treatment increased from 52% (63/122) to 68% (90/133; P = 0.01). Treatment abandonment decreased from 23% (28/122) to 13% (17/133; P = 0.03). Death during treatment decreased from 21% (26/122) to 13% (17/133; P = 0.07). Conclusion: This collaboration, using relatively simple and low-cost interventions, led to a significant decrease in treatment abandonment and increase in survival without evidence of disease at the end of treatment.
Original languageEnglish
Article numbere26945
JournalPediatric Blood and Cancer
Issue number5
Publication statusPublished - 2018

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