nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.17650/2311-1267-2014-0-1-9-24nodgo-10Research ArticleПрогресс в детской гематологии-онкологии в XXI векеГлобальные достижения в детской онкологииGlobal challenges in pediatric oncologyРодригез-ГалиндоКарлосRodriguez-GalindoC.

Отдел гематологии-онкологии, Бостон, Массачусетс, США;

отделение педиатрии, Бостон, Массачусетс, США

Division of Hematology-Oncology;

Department of Pediatrics, Boston, Massachusetts, USA

carlos_rodriguezgalindo@dfci.harvard.eduФридрихП.FriedrichP.

Отдел гематологии-онкологии, Бостон, Массачусетс, США;

отделение педиатрии, Бостон, Массачусетс, США

Division of Hematology-Oncology;

Department of Pediatrics, Boston, Massachusetts, USA

МорриссиЛ.MorrisseyL.

Отдел гематологии-онкологии, Бостон, Массачусетс, США

Division of Hematology-Oncology

ФрейзерЛ.FrazierL.

Отдел гематологии-онкологии, Бостон, Массачусетс, США;

отделение педиатрии, Бостон, Массачусетс, США

Division of Hematology-Oncology;

Department of Pediatrics, Boston, Massachusetts, USA

Детский центр рака и заболеваний крови Дана-Фарбер; Медицинская школа Гарвардского университетаСоединённые Штаты АмерикиDana-Farber / Children’s Hospital Cancer Center; Harvard Medical SchoolUnited StatesДетский центр рака и заболеваний крови Дана-ФарберСоединённые Штаты АмерикиDana-Farber / Children’s Hospital Cancer CenterUnited States20143103201501924Copyright © Родригез-Галиндо К., Фридрих П., Моррисси Л., Фрейзер Л., 20152015Родригез-Галиндо К., Фридрих П., Моррисси Л., Фрейзер Л.Rodriguez-Galindo C., Friedrich P., Morrissey L., Frazier L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/10Цель данного обзора

Цель данного обзора. Снижение детской смертности является одним из вызовов начала тысячелетия; для достижения этой цели в странах низкого и среднего уровня доходов появилась необходимость формирования программ для снижения бремени неинфекционных заболеваний, включающих злокачественные новообразования.

Опубликованные данные

Опубликованные данные. Около 200 000 детей и взрослых по всему миру заболевают раком каждый год; около 80 % из них живут в странах с низким и средним уровнем доходов, в которых летальность от данного недуга достигает 90 %. Отсутствие работающих популяционных канцер-регистров в данных странах ограничивает получение информации по эпидемиологии. Однако доступные данные позволяют говорить о том, что вариации в уровне заболеваемости могут быть обусловлены не только генетическими факторами, но и условиями окружающей среды, что может служить ключом к пониманию проблемы. Исход болезни у детей с онкологическим заболеванием в странах с низким и средним уровнем доходов определяется поздней диагностикой, неправильно установленными диагнозами, высоким уровнем беспризорности, преобладанием плохого питания и другими коморбидными факторами. Кроме того, существует проблема неоптимальной сопроводительной терапии и паллиативной помощи, а также лимитированного доступа к патогенетической терапии. Инициативные интегрированные образовательные программы для медицинских работников и сотрудников, работающих в исследовательских проектах, доказали свою успешность на региональном уровне. Кроме того, были разработаны программы по интенсивному внедрению новых лечебных стандартов на основании местной специфики.

Резюме

Резюме.

Детские онкологические заболевания являются одной из проблем в странах с низким и средним уровнем доходов; глобальные инициативы, направленные на лечение данной группы заболеваний и контроль их распространения, крайне необходимы в современных условиях. Кроме того, показало свою эффективность и международное партнерство, которое ставит своей задачей создание потенциала для улучшения терапии онкологических заболеваний у детей с учетом эпидемиологии и уровня развития системы здравоохранения, а также реализации образовательных научно-практических программд

Purpose of review

Purpose of review. Reduction of child mortality is one of the Millennium Development Goals; as low-income and middle-income countries (LMICs) advance toward the achievement of this goal, initiatives aimed at reducing the burden of noncommunicable diseases, including childhood cancer, need to be developed.

Recent findings

Recent findings. Approximately 200 000 children and adolescents are diagnosed with cancer every year worldwide; of those, 80 % live in LMICs, which account for 90 % of the deaths. Lack of quality population-based cancer registries in LMICs limits our knowledge of the epidemiology of pediatric cancer; however, available information showing variations in incidence may indicate unique interactions between environmental and genetic factors that could provide clues to cause. Outcome of children with cancer in LMICs is dictated by late presentation and underdiagnosis, high abandonment rates, high prevalence of malnutrition and other comorbidities, suboptimal supportive and palliative care, and limited access to curative therapies. Initiatives integrating program building with education of healthcare providers and research have proven to be successful in the development of regional capacity. Intensity-graduated treatments adjusted to the local capacity have been developed.

Summary

Summary. Childhood cancer burden is shifted toward LMICs; global initiatives directed at pediatric cancer care and control are urgently needed. International partnerships facilitating stepwise processes that build capacity while incorporating epidemiology and health services research and implementing intensity-graduated treatments have been shown to be effective.

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The authors declare that there are no conflicts of interest present.