在儿科癌症护理的变化范式-当代景观和印度的观点。

IF 1.3 Q4 ONCOLOGY
ecancermedicalscience Pub Date : 2025-06-24 eCollection Date: 2025-01-01 DOI:10.3332/ecancer.2025.1931
Badira Cheriyalinkal Parambil, Nirmalya Roy Moulik, Venkata Rama Mohan Gollamudi, Shyam Srinivasan, Chetan Dhamne, Akanksha Chichra, Gaurav Narula, Mukta Ramadwar, Sumeet Gujral, Tanuja Shet, Epari Sridhar, Poonam Panjwani, Uma Sakhadeo, Siddhartha Laskar, Nehal Khanna, Jifmi Jose Manjali, Sajid Qureshi, Vasundhara Patil, Akshay Baheti, Sneha Shah, Kunal Gala, Pappagudi Subramanian, Prashant Tembhare, Nikhil Patkar, Gaurav Chatterjee, Sweta Rajpal, Dhanlaxmi Shetty, Maya Prasad, Girish Chinnaswamy
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引用次数: 0

摘要

儿童癌症的诊断和管理方面的进展大大提高了生存率,80%能够获得当代治疗的儿童有望活到成年。结合高强度细胞毒性化疗和放疗的多模式方案可能与急性和延迟不良反应增加相关,从而损害生活质量。此外,在转移性、复发或难治性疾病以及罕见肿瘤实体的背景下,治愈性治疗选择仍然有限。这促使了当代儿科肿瘤治疗的范式转变,包括癌症易感、免疫治疗、精准医学和生存等多个领域,旨在优化生存,同时将治疗相关的毒性降到最低,提高生活质量。虽然这些进展在高收入国家日益明显,但在低收入和中等收入国家实施这些战略方面仍存在一些障碍和挑战。主要障碍包括较新的和先进的诊断方式和治疗药物的可及性和可负担性有限,基础设施不足,无法获得靶向药物和较新的免疫治疗药物,后勤和监管障碍,临床试验的可及性有限以及长期随访不足。必须进行实质性的改革,以促进将这些不断变化的范例转化为印度和中低收入国家的现实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changing paradigms in pediatric cancer care - the contemporary landscape and perspectives for India.

Advances in the diagnosis and management of childhood cancers have significantly improved survival, and 80% of those who have access to contemporary treatment are expected to survive into adulthood. Multimodality protocols incorporating high-intensity cytotoxic chemotherapy and radiotherapy may be associated with increased acute and delayed adverse effects, thereby compromising the quality of life. Furthermore, curative therapeutic options remain limited in the context of metastatic, relapsed or refractory disease as well as rare tumour entities. This has prompted a paradigm shift in pediatric oncology care in the contemporary era, encompassing multiple domains including cancer predisposition, immunotherapy, precision medicine and survivorship, aimed at optimising survival while minimising treatment-related toxicity and improving quality of life. While these advances are increasingly evident in high-income countries, several hurdles and challenges exist in the implementation of these strategies in low-income and middle-income countries (LMICs). Key barriers include restricted accessibility and affordability of newer and advanced diagnostic modalities and therapeutic agents, deficient infrastructure, non-availability of targeted agents and newer immunotherapy drugs, logistical and regulatory hurdles, limited access to clinical trials and inadequate long-term follow-up. Substantial changes are requisite to facilitate the translation of these changing paradigms into reality in India and LMICs.

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来源期刊
CiteScore
3.80
自引率
5.60%
发文量
138
审稿时长
27 weeks
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