Pediatric low-grade glioma in Africa: a baseline study before the implementation of Global Initiative for Childhood Cancer strategies.

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dc.contributor.authorvan Heerden, Jaques
dc.contributor.authorEsterhuizen, Tonya Marianna
dc.contributor.authorJbebli, Elhem
dc.contributor.authorFedhila, Faten
dc.contributor.authorRhayem, Samar
dc.contributor.authorChabchoub, Imène
dc.contributor.authorTogo, Boubacar
dc.contributor.authorVan Zyl, Anel
dc.contributor.authorNeethling, Beverley
dc.contributor.authorThomas, Karla
dc.contributor.authorCharlton, Robyn
dc.contributor.authorNgcana, Thandeka
dc.contributor.authorNaidu, Gita
dc.contributor.authordu Plessis, Jan
dc.contributor.authorNyeko, Richard
dc.contributor.authorBalagadde-Kambugu, Joyce
dc.contributor.authorHessissen, Laila
dc.contributor.authorZeyad, Abdel Aziz
dc.contributor.authorGamal, Aya
dc.contributor.authorAmany, Mohamed Ali
dc.contributor.authorHamdy, Rana
dc.contributor.authorAsfour, Hosam Y.
dc.contributor.authorElayadi, Moatasem
dc.contributor.authorGeel, Jennifer
dc.contributor.authorParkes, Jeannette
dc.contributor.authorDavidson, Alan
dc.date.accessioned2025-02-13T11:11:01Z
dc.date.available2025-02-13T11:11:01Z
dc.date.issued2025
dc.description.abstractIntroduction: Pediatric low-grade glioma (LGG) is a World Health Organization (WHO) Global Initiative for Childhood Cancer (GICC) index tumor constituting up to a third of pediatric central nervous system (CNS) tumors. The baseline characteristics, survival, and management resources for pediatric LGG in Africa are unknown. We aimed to evaluate the pediatric neuro- oncology multidisciplinary team resources, epidemiology, and survival outcomes of pediatric LGG in Africa to document baseline information prior to GICC implementation. Methods: The study consisted of two parts: a survey completed by African pediatric oncology units (POU) to evaluate the local resources and a retrospective evaluation of data to determine the 5-year overall survival (OS) for patients under 18 years diagnosed with LGG between 2008 and 2018. Data were described in frequencies and percentages. Survival was expressed with Kaplan–Meier curves. Results: Five-hundred and eighty-eight patients were included from fifteen POUs in six countries: South Africa (45.9%), Egypt (30.8%), Morocco (12.6%), Mali (4.4%), Tunisia (3.6%) and Uganda (2.7%). The median age was 4.4 years (interquartile range 2.4–7.3 years). The most common primary tumor site was the brainstem (n = 125, 21.3%), the most common histology was pilocytic astrocytoma (n = 270, 47.5%), the majority of tumors (n = 292, 93%) were localized, and 40 (6.8%) patients had neurofibromatosis. Complete resection was obtained in 99 (16.8%) cases, incomplete resection in 179 (30.4%), and no surgery or biopsy only was performed in 310 (52.7%) cases. One hundred and forty- seven (25.3%) of the 580 patients with a documented radiotherapy status, were irradiated, and 320 (54.4%) received chemotherapy. Only 259 (15.3%) patients received chemotherapy of which the most common chemotherapy regimen was vincristine-carboplatin (n = 220, 84.9%). The 5-year OS was 90.5% ± 1.6%. The 5- year OS in Tunisia was 95.1% ± 1.1%, 92.4% ± 2.1% in Egypt, 89.0% ± 3.2% in South Africa, 70.7% ± 6.7% in Morocco and 66.7% ± 15.7% in Uganda (p < 0.001). Four of the 41 (9.8%) responding countries reported having pediatric neuro-oncology subspecialists, and four (9.8%) had national pediatric LGG protocols. In Africa there is one radiotherapy center per 2,235,125 children and one neurosurgeon per 304,685 children, with ∼70% of these resources accessible in four countries. Discussion: Due to several resource challenges and developing treatment centers, only fifteen pediatric oncology units from six countries participated. We documented a baseline 5-year OS of 94.9% for LGG in African children. To obtain an accurate estimation of pediatric LGG survival in Africa, increasing participation from a wider range of countries, especially poorly resourced settings, is necessary. KEYWORDS Africa, low-grade glioma, children, outcomes, systems, GICCen_US
dc.identifier.citationvan Heerden, J., Esterhuizen, T., Jbebli, E., Fedhila Ben Ayed, F., Rhayem, S., Chabchoub, I., ... & Davidson, A. Pediatric low-grade glioma in Africa: A baseline study before the implementation of Global Initiative for Childhood Cancer strategies. Frontiers in Cancer Control and Society, 3, 1528695.en_US
dc.identifier.uriDOI 10.3389/fcacs.2025.1528695
dc.identifier.urihttp://ir.lirauni.ac.ug/xmlui/handle/123456789/873
dc.language.isoenen_US
dc.publisherFrontiers in Cancer Control and Societyen_US
dc.subjectAfricaen_US
dc.subjectlow-grade gliomaen_US
dc.subjectchildrenen_US
dc.subjectoutcomesen_US
dc.subjectsystemsen_US
dc.subjectGICCen_US
dc.titlePediatric low-grade glioma in Africa: a baseline study before the implementation of Global Initiative for Childhood Cancer strategies.en_US
dc.typeArticleen_US

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