Abstract

BUENDIA-HERNANDEZ, Amparo; LOBOGUERRERO-COMPAGNOLI, José  and  LOZANO-LEON, Juan Manuel. Pediatric cancer results in a population with limited resources in Bogota, Colombia. Bol. Med. Hosp. Infant. Mex. [online]. 2010, vol.67, n.6, pp.518-535. ISSN 1665-1146.

Background. Despite remarkable progress achieved for pediatric cancer, >60% of children affected worldwide have little or no access to effective therapy. This study assessed the results of a pediatric cancer program in a limited resources setting. Methods. A historical descriptive study with analytic component was conducted between 1990 and 2007 in 242 children <16 years of age at Clínica Infantil Colsubsidio in Bogotá, Colombia. Measures included international protocol-based therapy, day-hospital system for chemotherapy and blood-cell support provided by trained nurses, pediatric oncologist and hematologist staffed 8-h with 24-h on-site physician coverage, as well as rapid administrative support. Treatment failure rates and survival were compared during the study. Results. An increase (40.5% to 63.3%) in survival (p =0.021) and a reduction in the referral for treatment (22.4% to 8.9%) to other centers (p =0.025) were observed during the study. There were also tendencies towards reduction in mortality due to acute complications (16.3-9.9%) and in frequency of those who refused or abandoned therapy (5.2 to 3%).The 10-year event-free-survival for acute lym-phoblastic leukemia was 65%. Conclusions. The strategy provided encouraging survival outcomes in a limited resources setting.

Keywords : antineoplastic combined chemotherapy protocols; pediatric acute lymphoblastic leukemia; health care quality; oncologic nursing; brain neoplasm; child health services.