Dr. Trisha Soosay Raj and Dr. Daniel Moreira (Members, SIOP Education and Training Committee)
On behalf of the
SIOP Education and Training Committee and IPA SAG on NCD
The SIOP CEDAR Project is improving the knowledge and
understanding of healthcare providers who are involved in the initial care,
diagnostic workup, and referral of pediatric patients suspected of having
cancer.The fourth CEDAR webinar, “Diagnosis and referral of Pediatric
Brain Tumor” is taking place on 16 December. SIOP and IPA encourage
Pediatricians, Ophthalmologists, Family Practitioners, Community Nurses, and
other healthcare professionals who are involved in the care of children with
cancer to register for this
webinar.
What is Low-Grade Glioma?
Pediatric
brain tumors are the second most common type of childhood cancer and the most
common cause of death in children with cancer. Gliomas are the most common type
of brain tumor in children, comprising 40% of all childhood brain tumors. Children
with low-grade gliomas have an excellent prognosis, especially when substantial
surgical resection is achieved. Low-grade glioma is one of the six designated
index cancers of the World Health Organization (WHO) Global Initiative for
Childhood Cancer (GICC).
Diagnosis
of Low-Grade Glioma
The clinical presentation of pediatric brain tumors including low-grade gliomas is dependent on the tumor location and presence of any raised intracranial pressure. Since these are slow growing tumor, symptoms can be present for many months. Spinal cord involvement can occur in up to 10% of children with low-grade glioma, and may in these cases present with back pain, difficulty mobilizing, and bowel or bladder disturbance.
In most cases the cause of low-grade gliomas is unknown. However,
some can be associated with neurofibromatosis type 1 and tuberous sclerosis, as
these patients have a predisposition to develop low-grade glioma.
Investigations comprising CT or MRI scans are required for
appropriate staging, with multidisciplinary involvement necessary for treatment.
Due to this need for comprehensive care for these patients, prompt referral to
centers with the appropriate expertise is important to help ensure an accurate
diagnosis and best possible treatment.
Treatment of Low-Grade Glioma
The treatment of low-grade glioma depends on the tumor location,
staging and age of the child, and may involve a combination of surgery,
radiotherapy and chemotherapy. Surgery is used for diagnosis, management of
raised intracranial pressure and resection where possible, with gross total
resection of the tumor being frequently curative. The chemotherapy used for
treatment of low-grade glioma is usually well tolerated when required. Local
radiotherapy may be required for incompletely resected tumors or for salvage
treatment after chemotherapy. Ongoing
surveillance for recurrence is required, with close to 40% of patients
experiencing disease progression or recurrence, as well as monitoring for
long-term adverse effects from treatment. A collaborative approach to
management is required to ensure the best outcome for these patients.
SIOP CEDAR PROJECT:
The
International Society of Pediatric Oncology (SIOP) has
launched “Childhood Cancer Early Diagnosis and Appropriate Referral” (CEDAR)
project in collaboration with the International Pediatric Association (IPA). In the first phase of the CEDAR project, SIOP and IPA are
organizing a series of monthly webinars (started in September 2022) to
highlight the importance of early diagnosis, with a focus on the six WHO
index cancers (acute lymphoblastic leukemia, Hodgkin lymphoma, Burkitt’s
lymphoma, Wilms tumor, retinoblastoma, and low-grade glioma). Each CEDAR
webinar is accredited by the European Accreditation Council for Continuing
Medical Education (EACCME) with 1 credit point. These webinars are free to
attend and open to everyone, and we are offering simultaneous Spanish
translation.
Recordings of
the first two webinars are available on the following links:
1.
Webinar
1: Outcomes of childhood cancers: Gaps and
Disparities to be addressed
https://www.youtube.com/watch?v=3d2U0sajKr4
2.
Diagnosis and Referral of Acute Leukemia
3. Diagnosis and Referral of Acute
Leukemia
https://www.youtube.com/watch?v=nFQMMh-2GlE
CEDAR WEBINAR – Diagnosis and
referral of Retinoblastoma:
The fourth CEDAR webinar is
scheduled for 16th December 2022 at 2-3 PM UTC/GMT on “Diagnosis and referral
of Pediatric Brain Tumors”. This webinar will be co-moderated by SIOP Education
and Training Committee members Dr. Daniel Moreira (USA), Dr. Trisha Soosay Raj
(Australia) and Co-Chair IPA SAG on NCD Dr. Mychelle Farmer (USA). The agenda
of this educational session is as follows:
1.
Case presentation: Dr. Farah Bashir (Pakistan)
2.
When to suspect Brain Tumor? : Dr. Eric Bouffet (Canada)
3.
Approach for diagnosis, initial management, and referral: Naureen
Mushtaq (Pakistan)
4.
Panel Discussion with Expert Panelists
a.
Dr. Anthony Figaji (South Africa)
b.
Dr. Shaarna Whitton (United Kingdom)
c.
Dr. Hikari
Ambara Sjakti (Indonesia)
Link for registration: http://bit.ly/3V1rMMZ
FUTURE CEDAR WEBINARS:
Please save
the dates and register for our future CEDAR webinars:
|
Webinar 5: 20th January 2023 |
Diagnosis and Referral of
Hodgkin Lymphoma |
|
|
Webinar 6: 3rd February 2023 |
Diagnosis and Referral of
Burkitt’s Lymphoma |
|
|
Webinar 7: 10th March 2023 |
Diagnosis and Referral of
Wilms Tumor |
For queries
or further information, please visit siop-online.org/cedar
or email info@siop-online.org
Trisha Soosay Raj (MBBS FRACP) is a paediatric
oncologist at the Queensland Children’s Hospital, Brisbane, Australia. She is
passionate about improving medical education and training, and is an active
member of the SIOP Education and Training Committee and the SIOP CEDAR project.
Dr. Daniel Moreira (MD MEd) is paediatric
neuro-oncologist at St. Jude Children’s Research Hospital, Memphis, USA. He is
passionate about improving care for children with CNS tumors around the world
and increasing workforce capacity around the world. He is an active member of
the SIOP Education and Training Committee and the SIOP Cedar project.
SIOP
The International Society of Paediatric Oncology (SIOP) is the
only global multidisciplinary society entirely devoted to pediatric and
adolescent cancer. SIOP, as a non-state actor in official relations with WHO,
is committed to contribute substantially to WHO Global Initiative for Childhood
Cancer. We have over 2,600 members worldwide including doctors, nurses, other
healthcare professionals, scientists, and researchers.
Visit siop-online.org
for more information.
IPA
The International Pediatric Association (IPA) exists to create a
world where all children, regardless of age, location, or family situation can
live healthy lives. IPA advocates globally, nationally, and locally for
high-quality, evidence-based, and child-centered pediatric care. We are a
respected partner of WHO and UNICEF and provide global leadership on emerging
child health issues through our work with leading global health players. Visit ipa-world.org
for more information.
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