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OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA
BACKGROUND: Pediatric central nervous system tumors (CNS) are the second commonest childhood malignancy and the commonest solid tumor in children. Brain tumors are the commonest cause of death among all childhood cancers. OBJECTIVES: To describe the challenges in managing children with CNS tumors in...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616564/ http://dx.doi.org/10.1093/noajnl/vdad121.026 |
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author | Katasi, Victoria Naitala, Ronald Muwonge, Peter Wasswa Munube, Deo Namazzi, Ruth Nabaggala, Catherine Zungu, Jennifer Nyesiga, Amos Ssali, Alex |
author_facet | Katasi, Victoria Naitala, Ronald Muwonge, Peter Wasswa Munube, Deo Namazzi, Ruth Nabaggala, Catherine Zungu, Jennifer Nyesiga, Amos Ssali, Alex |
author_sort | Katasi, Victoria |
collection | PubMed |
description | BACKGROUND: Pediatric central nervous system tumors (CNS) are the second commonest childhood malignancy and the commonest solid tumor in children. Brain tumors are the commonest cause of death among all childhood cancers. OBJECTIVES: To describe the challenges in managing children with CNS tumors in Uganda, treated at Mulago National Referral Hospital (MNRH) from March 2019 to March 2023, using a subset of patients with the diagnoses of medulloblastoma, pineoblastoma and ependymoma. METHODS: A retrospective study was conducted in MNRH, in patients below 18 years of age, admitted with one of the three histological diagnoses. The data included time to presentation to a tertiary health center from occurrence of initial symptoms, time to surgery from time to presentation to a tertiary health center, time to a histological diagnosis from time to presentation to a tertiary health center and time to starting radiotherapy from time to presentation to a tertiary health center. RESULTS: The total number of patients was 32(44% had medulloblastoma, 37% had pineoblastoma). Of 30 patients with a recorded date of occurrence of initial symptoms, the median time to presentation to a tertiary health center was 2.5 months (95% median Cl- 1.702,3,711), with the maximum at 30 months. The median time to surgery for 24 patients was 0.92 months995%Cl- 0.460, 2.143), with a maximum of 13.8 months. The median time to a histological diagnosis for 30 patients was 1.39 months (95%median Cl- 0.680, 2.163). The median time to starting radiotherapy for 16 patients was 6.5 months (95%median Cl- 3.168, 8.724) and a maximum of 23 months. The overall one-year survival for children with ependymoma was at 62.5% (95%CI- 14.2,89.3), followed by medulloblastoma at 39.5%(95%CI-12.9,65.6) and pineoblastoma at 37.45%(95%CI-9.5,67.0). CONCLUSION: The management of pediatric CNS tumors in Uganda is still sub-optimal due to referral, diagnostic and treatment challenges. |
format | Online Article Text |
id | pubmed-10616564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106165642023-11-01 OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA Katasi, Victoria Naitala, Ronald Muwonge, Peter Wasswa Munube, Deo Namazzi, Ruth Nabaggala, Catherine Zungu, Jennifer Nyesiga, Amos Ssali, Alex Neurooncol Adv Final Category: Other BACKGROUND: Pediatric central nervous system tumors (CNS) are the second commonest childhood malignancy and the commonest solid tumor in children. Brain tumors are the commonest cause of death among all childhood cancers. OBJECTIVES: To describe the challenges in managing children with CNS tumors in Uganda, treated at Mulago National Referral Hospital (MNRH) from March 2019 to March 2023, using a subset of patients with the diagnoses of medulloblastoma, pineoblastoma and ependymoma. METHODS: A retrospective study was conducted in MNRH, in patients below 18 years of age, admitted with one of the three histological diagnoses. The data included time to presentation to a tertiary health center from occurrence of initial symptoms, time to surgery from time to presentation to a tertiary health center, time to a histological diagnosis from time to presentation to a tertiary health center and time to starting radiotherapy from time to presentation to a tertiary health center. RESULTS: The total number of patients was 32(44% had medulloblastoma, 37% had pineoblastoma). Of 30 patients with a recorded date of occurrence of initial symptoms, the median time to presentation to a tertiary health center was 2.5 months (95% median Cl- 1.702,3,711), with the maximum at 30 months. The median time to surgery for 24 patients was 0.92 months995%Cl- 0.460, 2.143), with a maximum of 13.8 months. The median time to a histological diagnosis for 30 patients was 1.39 months (95%median Cl- 0.680, 2.163). The median time to starting radiotherapy for 16 patients was 6.5 months (95%median Cl- 3.168, 8.724) and a maximum of 23 months. The overall one-year survival for children with ependymoma was at 62.5% (95%CI- 14.2,89.3), followed by medulloblastoma at 39.5%(95%CI-12.9,65.6) and pineoblastoma at 37.45%(95%CI-9.5,67.0). CONCLUSION: The management of pediatric CNS tumors in Uganda is still sub-optimal due to referral, diagnostic and treatment challenges. Oxford University Press 2023-10-31 /pmc/articles/PMC10616564/ http://dx.doi.org/10.1093/noajnl/vdad121.026 Text en © The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Final Category: Other Katasi, Victoria Naitala, Ronald Muwonge, Peter Wasswa Munube, Deo Namazzi, Ruth Nabaggala, Catherine Zungu, Jennifer Nyesiga, Amos Ssali, Alex OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title | OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title_full | OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title_fullStr | OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title_full_unstemmed | OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title_short | OTHER-05 THE CHALLENGES IN MANAGING CHILDREN WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA |
title_sort | other-05 the challenges in managing children with primary central nervous system tumors in uganda |
topic | Final Category: Other |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616564/ http://dx.doi.org/10.1093/noajnl/vdad121.026 |
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