JCO Global Oncology最新文献

{"title":"Indonesian Society of Gynecologic Oncology Cancer Registration Information System: 10 Years of Implementation, Challenge, and Future.","authors":"Tricia Dewi Anggraeni, Hari Nugroho, Ali Budi Harsono, Tofan Widya Utami, Brahmana Askandar Tjokroprawiro","doi":"10.1200/GO.24.00176","DOIUrl":"https://doi.org/10.1200/GO.24.00176","url":null,"abstract":"<p><strong>Purpose: </strong>Indonesia still faces high disease burden from cancer and needs valid gynecologic cancer epidemiology data. The Indonesian Society of Gynecologic Oncology (INASGO) established a web-based gynecologic cancer registry. This research aims to observe and report the situation of INASGO cancer registration information system from 2011 to 2021 and provide the most recent data.</p><p><strong>Methods: </strong>This is a quality assurance research using nonexperimental design and did not perform data manipulation. This study will evaluate comparability, validity, and completeness of cancer registry data. Information was obtained by registration files, direct observation, and interviewing cancer registry supervisors in Cipto Mangunkusumo Hospital, Jakarta.</p><p><strong>Results: </strong>This cancer registry coded its data according to international standards with many participants and large cases registered. A total of 28,692 cases were reported to the cancer registry. Cervical cancer ranked highest (68.6%) with stage III being the most common found. The most frequent age group at diagnosis is 36-55 years. The most valid basic diagnostic of gynecologic cancer is histology of primary malignancy. The main challenge of the INASGO cancer registry is the lack of data validity and completeness because of poor coordination and financial support.</p><p><strong>Conclusion: </strong>INASGO cancer registration information system has good prospects to provide data information of patients with gynecologic cancer in policy or research matters. Poor coordination and limited financial support have to be anticipated for the sake of this cancer registry existence in the future.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400176"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clip and Blue-An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation.","authors":"Teena Sleeba, Subi Ts, Latha Abraham, Sanju Cyriac, Arun Philip, Aswin Joy, Anju Prathap, Naveen George, Susan John, Anand Ebin Thomas","doi":"10.1200/GO-24-00242","DOIUrl":"https://doi.org/10.1200/GO-24-00242","url":null,"abstract":"<p><strong>Purpose: </strong>Breast conservation after systemic therapy requires accurate localization of the lesion and its margins, especially in nonpalpable tumors. The present study aims to describe a cost-effective technique of tumor localization using the combination of surgical clips and methylene blue.</p><p><strong>Methods: </strong>A minimum of three or four clips were inserted into the tumor to allow easy visualization of the clip mass. After insertion, measurements of the clips from the nipple and pectoral muscles were recorded to assess for clip migration. After chemotherapy, the disease and clip mass were localized intra-operatively using blue dye. A single-center review of breast conservations performed after neoadjuvant chemotherapy that used the above-described localization technique was undertaken. The primary aim was to assess successful detection and margin-negative resection rates.</p><p><strong>Results: </strong>The study included 65 patients, and the clip mass was detected on ultrasound following chemotherapy in all patients without clip migration. This detection was accurate even in cases of complete pathological and radiological response. Importantly, there were no procedure-related complications. Postchemotherapy disease localization was successfully achieved in all patients using the readily available and cost-effective methylene blue dye. No patient had an invasive margin positive at resection.</p><p><strong>Conclusion: </strong>The combination of using multiple surgical clips and methylene blue is not only an extremely cheap and accurate technique for tumor site localization but also ensures precise surgical removal. The technique allows tumor localization even in low-income economies.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400242"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional National Survey of Practice Patterns in Radiotherapy for Rectal Cancer: A Snapshot of India.","authors":"Rahul Krishnatry, Ashwathy Mathew, Sayan Das, Shagun Misra, Divya Khosla, Jeba Karunya Ramireddy, Shirley Lewis","doi":"10.1200/GO-24-00410","DOIUrl":"https://doi.org/10.1200/GO-24-00410","url":null,"abstract":"<p><strong>Purpose: </strong>The information on the practice of radiotherapy, including intensity-modulated radiotherapy (IMRT) use for rectal cancer in India, is lacking. This national survey was planned to understand the current status of knowledge, attitudes, and practice among radiation oncologists, specifically concerning the practice of IMRT for rectal cancers.</p><p><strong>Materials and methods: </strong>A national survey was sent to radiation oncologists through e-mail or a WhatsApp message, where feasible, with a request letter containing the link to the survey questionnaire. The survey questionnaire was adapted from the UK IMRT survey with permission from the authors. It explored rectal cancer management, IMRT use, reasons for nonadoption, total neoadjuvant therapy (TNT), dose fractionation schedules and radiotherapy processes like radiotherapy simulation, target volume/organ at risk definition, and treatment planning, evaluation, and verification. Descriptive statistics is used to present the results.</p><p><strong>Results: </strong>Over 300 radiation oncologists were approached, and 182 (60.6%) of the 153 institutes responded. Around 88% (160 of 182) indicated using IMRT or volumetric modulated arc therapy (VMAT) to treat rectal cancer, of whom 32% used exclusively IMRT/VMAT in all their patients. The reasons for not adopting IMRT were affordability/lack of insurance, resource constraints, and lack of guidelines. Long-course chemoradiation (capecitabine-based) followed by surgery was the most common neoadjuvant approach, with short course and TNT in less than a third of patients. Daily verification feasibility was reported by 60%. Seventy-three percent emphasized the need for a national IMRT guidance document.</p><p><strong>Conclusion: </strong>This national survey from India indicates a scope of routine implementation of IMRT in rectal cancer, highlighting the urgent need for a national IMRT guidance document, which could significantly enhance the quality of care for patients with rectal cancer in India.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400410"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Debisa Eshatu Wendimu, Mosisa Bekele Degefa, Daniel Legese Achalu, Biniyam Tedla Mamo, Derese Bekele Daba, Solomon Getnet Meshesha","doi":"10.1200/GO-24-00263","DOIUrl":"10.1200/GO-24-00263","url":null,"abstract":"<p><strong>Purpose: </strong>Low breast cancer survival rates are often linked to late-stage diagnosis. The patient interval, the time between symptom detection and the first health care visit, is a key indicator of early diagnosis. This study aimed to assess the prevalence of patient delay and its associated factors in Ethiopia.</p><p><strong>Methods: </strong>This systematic review used a combined approach of meta-analysis and meta-synthesis of quantitative and qualitative data, respectively. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.</p><p><strong>Results: </strong>Eleven studies that satisfied the eligibility criteria were included in the review. More than half (58.48%) of the patients with breast cancer delayed seeking medical help at health facilities, with a median delay time of 120 days. Presence of a painful breast ulcer/wounded mass (odds ratio [OR], 0.23 [95% CI, 0.09 to 0.58]), having swelling or a lump in the armpit (OR, 0.27 [95% CI, 0.15 to 0.46]), residing in urban area (OR, 0.27 [95% CI, 0.15 to 0.49]), and having a secondary school education or higher (OR, 0.28 [95% CI, 0.12 to 0.64]) were less likely to delay in seeking formal health care. However, patients who travel more than 5 km (OR, 6.33 [95% CI, 4.10 to 9.75]) were more likely to delay in our meta-analysis. Moreover, the meta-synthesis showed that the nature and progression of symptoms, symptom disclosure, social support, emotional responses, use of alternative therapies, misconceptions about breast cancer, financial limitations, accessibility issues, and other personal-environmental factors were associated with patient delay.</p><p><strong>Conclusion: </strong>Nearly three fifths of patients with breast cancer delayed seeking health care at health facilities. Inaccessibility, low awareness, cultural beliefs, and socioeconomic factors contributed to these delays. Increasing public awareness, especially in rural areas, and improving health care access could encourage earlier presentation.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400263"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access of Low-Resource Areas to ASCO Quality Initiatives: Initial Experience and Lessons Learned.","authors":"Abdul Rahman Jazieh, Jackson Orem, Gerardo Umanzor, Julia Tomkins","doi":"10.1200/GO.24.00140","DOIUrl":"https://doi.org/10.1200/GO.24.00140","url":null,"abstract":"<p><p>With the aim of improving the quality of cancer care globally, ASCO began to offer its quality improvement programs to interested international oncology practices. In this manuscript, we describe the experiences with ASCO quality initiatives in low- and middle-income countries (LMICs). The experience acquired from different practices in Latin America and Africa was reviewed and various action steps were summarized. Encountered challenges and implemented solutions to mitigate these challenges were identified to list as lessons learned for oncology practices in LMICs or low-resource settings to use in their future quality improvement initiatives and providing a proactive approach for those practices considering starting quality improvement programs. Having programs tailored to LMICs may facilitate the participation of more practices and help them take advantage of these programs to enhance patient care. The preliminary data and learning are promising and demonstrate that participation in quality improvement activities can have a positive effect. Although this early experience is encouraging, each country and resource-limited practice will have its own unique challenges as highlighted in this article. Having more practices participate will further enhance the knowledge base, build experience in addressing challenges, and enable oncology patients to reap the benefits worldwide.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400140"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Tourism for Cancer Treatment: Trends, Trajectories, and Perspectives From African Countries.","authors":"Fidel Rubagumya, Laura Carson, Daniel Afolayan, Eulade Rugengamanzi, Godwin Abdiel Nnko, Omar Abdihamid, Verna Vanderpuye, Nazik Hammad","doi":"10.1200/GO.24.00131","DOIUrl":"10.1200/GO.24.00131","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer continues to be a significant public health concern. Sub-Saharan Africa (SSA) struggles with a lack of proper infrastructure and adequate cancer care workforce. This has led to some countries relying on referrals of cancer care to countries with higher income levels. In some instances, patients refer themselves. Some countries have made it their goal to attract patients from other countries, a term that has been referred to as medical tourism. In this article, we explore the current status of oncology-related medical tourism in SSA.</p><p><strong>Methods: </strong>This was a cross-sectional study. The study participants included oncologists, surgeons, and any other physicians who take care of patients with cancer. A predesigned questionnaire was distributed through African Organization for Research and Training in Cancer member mailing list and through study team personal contacts and social media.</p><p><strong>Results: </strong>A total of 52 participants from 17 African countries with a 1.6:2 male to female ratio responded to the survey. Most (55.8%) of the respondents were from Eastern African countries. The majority (92%) of study participants reported that they knew patients who referred themselves abroad, whereas 75% referred patients abroad, and the most common (94%) referral destination was India. The most common (93%) reason for referral was perception of a higher quality of care in foreign health institutions.</p><p><strong>Conclusion: </strong>The findings suggest the need to improve local health care systems including building trust of the system among general population. The study highlights potential financial toxicity, and it adds to the current emphasis on return of investment on homegrown workforce and cancer treatment infrastructure.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400131"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building an Effective International Medical Evacuation Program for Ukrainian Patients With Cancer Amid Prolonged Military Conflict.","authors":"Inesa Huivaniuk, Viacheslav Kopetskyi, Taras Ivanykovych, Andrei Nikiforchin, Darya Kizub, Marta Antoniv, Ali Dzhemiliev, Brittany Powell, Saar Yaniuta, Arman Kacharian, Anna Podolianko, Nelya Melnitchouk","doi":"10.1200/GO-24-00363","DOIUrl":"10.1200/GO-24-00363","url":null,"abstract":"<p><strong>Purpose: </strong>During military conflicts, the immediate response to a severely disrupted health care system often overlooks the needs of patients with cancer who require continuous specialized care. The full-scale Russian invasion of Ukraine in February 2022 was no exception, leaving many Ukrainian patients without access to essential care.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study to assess the impact of the MedEvac program, facilitating the transfer of Ukrainian patients with cancer to European Union (EU) institutions for treatment, and to describe its components. Patient data from the Ministry of Health of Ukraine (MOH) database (April 2022-April 2023) were analyzed.</p><p><strong>Results: </strong>Of 639 applications in the MOH database, 339 (53.1%) had sufficient data for analysis and, of those, 281 (82.9%) were evacuated to EU hospitals. Median age of evacuated patients was 47 (IQR, 38-58) years and most were newly diagnosed (94.0%, n = 264). Predominantly, patients were evacuated for systemic cancer therapy (81.9%, n = 230). Multivariate logistic regression analysis revealed that a good performance status (Eastern Cooperative Oncology Group 0-2) was the most significant factor associated with evacuation (odds ratio [OR], 9.64 [95% CI, 3.08 to 30.23]). Patients with melanoma were more likely to be evacuated, even after adjustment for performance status (OR, 2.56 [95% CI, 1.14 to 5.72]), while patients with head and neck cancer were significantly less so (OR, 0.20 [95% CI, 0.06 to 0.72]).</p><p><strong>Conclusion: </strong>MedEvac program provides a viable model for medical evacuation and management of patients with cancer amid prolonged military conflict, highlighting the importance of international cooperation and setting a precedent for other crisis responses. Continuous evaluation and adaptation are essential to ensure the program's effectiveness and sustainability.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400363"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of Project Management Training for Cancer Research in Sub-Saharan Africa.","authors":"Elima Jedy-Agba, Caroline Andrews, Emeka Odiaka, Temitope Olukomogbon, Hayley Irusen, Isabella Rockson, Temilade Sorungbe, Marjorie Quarchie, Mohamed Jalloh, Alash'le Abimiku, Timothy R Rebbeck","doi":"10.1200/GO.24.00088","DOIUrl":"10.1200/GO.24.00088","url":null,"abstract":"<p><strong>Purpose: </strong>Globally, there were 19.3 million new cancer cases and 10 million cancer deaths, with the African continent contributing approximately 1.1 million new cases and over 700,000 deaths to the global cancer burden in 2020. High quality research is required to understand the etiology and risk factors for common cancers in the region to develop context specific strategies aimed at minimizing the future cancer burden in Africa. Our study addresses a significant gap in the knowledge and resources available for training a project management (PM) workforce for cancer research in Africa.</p><p><strong>Methods: </strong>We developed and evaluated a training program to strengthen the research capacity of project managers involved in cancer research in Africa. This workshop was held in collaboration with the Men of African Descent and Carcinoma of the Prostate (MADCaP) Consortium. The PM working group of the MADCaP Consortium had previously developed a project manager toolkit to provide a structured approach to PM for cancer research in Africa. We implemented and evaluated this training toolkit in a hybrid workshop in Nigeria.</p><p><strong>Results: </strong>Among 29 participants from 10 African institutions, PM skills improved after training by 16.6% compared with pretraining levels. In a 1-year follow-up survey, training skills remained better (80.8%) than before the training (70.8%). The training program successfully upskilled the trainees with a significant improvement in knowledge of PM practices including planning, execution, monitoring, and evaluation of projects. The majority (80%) reported an excellent training experience.</p><p><strong>Conclusion: </strong>PM skills training can be successfully implemented in Africa with long-term retention of knowledge geared toward developing a workforce critical for the implementation of cancer research in the region.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400088"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Default of Treatment and Follow-Up Among Patients With Cancer: A Cross-Sectional Study From a Lower-Middle-Income Country.","authors":"Deepak Sundriyal, Mayank Kapoor, Preeti Antil, Sweety Gupta, Parmod Kumar, Ujjawal Kumar Shriwastav, Amit Sehrawat","doi":"10.1200/GO-24-00411","DOIUrl":"10.1200/GO-24-00411","url":null,"abstract":"<p><strong>Purpose: </strong>Desirable outcomes during the treatment of patients with cancer require adherence to evaluation, treatment, and follow-up. This study aimed to evaluate the factors associated with default in patients with cancer.</p><p><strong>Materials and methods: </strong>We included patients with a histologically confirmed diagnosis of cancer who defaulted during evaluation, treatment, and follow-up. All patients' detailed demographic and clinical data were recorded. Those lost to follow-up were interviewed telephonically. The factors associated with default were noted. Descriptive statistics were used to compute the demographic and clinical characteristics.</p><p><strong>Results: </strong>In total, 172 patients were included. Geriatric and female patients were 38.9% and 37.2%, respectively. Fifty-eight percent of the patients lived in rural areas, whereas 45.9% were illiterate. More than one third (34.3%) of the patients who defaulted received the curative-intent treatment, whereas 62.1% of patients had a good performance status immediately before default. The average distance traveled by the patients to reach the cancer facility was 143 ± 13.15 km. The most common reasons for default were the lack of social support, financial constraints, difficulty in commuting, and too sick to come in 45 (26.2%), 35 (20.3%), 28 (16.3%), and 23 (13.4%) patients, respectively. Twenty-nine (16.9%) patients reported more than one reason for default.</p><p><strong>Conclusion: </strong>Lack of social support, financial constraints, transportation barriers, and inadequate counseling by the health care provider serve as barriers to uninterrupted cancer care. These factors are often interrelated and can be attenuated by adopting the hub and spoke model. Simultaneously, a good relationship between the patient and the health care provider fostered by appropriate counseling is imperative to increase adherence to cancer treatment and improve the outcome.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400411"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning to Predict Interim Response in Pediatric Classical Hodgkin Lymphoma Using Affordable Blood Tests.","authors":"Jennifer A Geel, Artsiom Hramyka, Jan du Plessis, Yasmin Goga, Anel Van Zyl, Marc G Hendricks, Thanushree Naidoo, Rema Mathew, Lizette Louw, Amy Carr, Beverley Neethling, Tanya M Schickerling, Fareed Omar, Liezl Du Plessis, Elelwani Madzhia, Vhutshilo Netshituni, Katherine Eyal, Thandeka V Z Ngcana, Tom Kelsey, Daynia E Ballott, Monika L Metzger","doi":"10.1200/GO.23.00435","DOIUrl":"10.1200/GO.23.00435","url":null,"abstract":"<p><strong>Purpose: </strong>Response assessment of classical Hodgkin lymphoma (cHL) with positron emission tomography-computerized tomography (PET-CT) is standard of care in well-resourced settings but unavailable in most African countries. We aimed to investigate correlations between changes in PET-CT findings at interim analysis with changes in blood test results in pediatric patients with cHL in 17 South African centers.</p><p><strong>Methods: </strong>Changes in ferritin, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), albumin, total white cell count (TWC), absolute lymphocyte count (ALC), and absolute eosinophil count were compared with PET-CT Deauville scores (DS) after two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine in 84 pediatric patients with cHL. DS 1-3 denoted rapid early response (RER) while DS 4-5 denoted slow early response (SER). Missing values were imputed using the k-nearest neighbor algorithm. Baseline and follow-up blood test values were combined into a single difference variable. Data were split into training and testing sets for analysis using Python scikit-learn 1.2.2 with logistic regression, random forests, naïve Bayes, and support vector machine classifiers.</p><p><strong>Results: </strong>Random forest analysis achieved the best validated test accuracy of 73% when predicting RER or SER from blood samples. When applied to the full data set, the optimal model had a predictive accuracy of 80% and a receiver operating characteristic AUC of 89%. The most predictive variable was the differences in ALC, contributing 21% to the model. Differences in ferritin, LDH, and TWC contributed 15%-16%. Differences in ESR, hemoglobin, and albumin contributed 11%-12%.</p><p><strong>Conclusion: </strong>Changes in low-cost, widely available blood tests may predict chemosensitivity for pediatric cHL without access to PET-CT, identifying patients who may not require radiotherapy. Changes in these nonspecific blood tests should be assessed in combination with clinical findings and available imaging to avoid undertreatment.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2300435"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}