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Children's Hospital Cancer Study Finds Adolescents And Young Adults Don't Get Same Access To Cutting-Edge Treatment As Younger Patients
The overall survival rate from
cancer now is lower in older adolescents and young adults with cancer than
in younger children, in part because of a lack of access to clinical trials
nationally for the older age group, according to a study by pediatric
oncologists at Children's Hospital of Pittsburgh of UPMC.
Nationally, cure rates in children younger than 15 with cancer have
improved dramatically over the last 30 years, increasing from 60 percent to
approximately 85 percent at five years from the time of diagnosis. In
contrast, similar improvements in survival rates have not been seen in
adolescents and young adults ages 15-22, with cure rates remaining steady
at approximately 70 percent throughout the same time period.
This can be attributed to the fact that adolescents and young adults
don't have the same access to cutting-edge cancer treatments provided
though clinical trials, according to the study led by Peter Shaw, MD, a
pediatric hematologist/oncologist at Children's Hospital and the director
of the hospital's Adolescent and Young Adult (AYA) Oncology Program.
The study is published in the December issue of the Journal of
Pediatric Hematology/Oncology.
"Research has shown that patients who are enrolled in clinical trials
offering the most advanced cancer treatments do better than patients who
receive conventional treatment," Dr. Shaw said. "Adolescents and young
adults with cancer are less likely than younger children to be enrolled in
clinical trials for two important reasons: the first factor is that AYA
patients are frequently treated by adult oncologists at hospitals that
aren't participating in clinical trials designed for cancers occurring in
the pediatric and adolescent age groups. Our study demonstrated the second
reason, which is that nationally, there are many more clinical trials
available for the types of malignancies that most often occur in the
younger patients
Drs. Shaw and study co-author A. Kim Ritchey, MD, chief of the Division
of Pediatric Hematology/Oncology at Children's and vice chair of Clinical
Affairs in the Department of Pediatrics, studied 640 new oncology patients
treated at Children's between July 1, 2001, and June 30, 2006. The patients
ranged in age from birth to 22 years old. The study found that:
-- 38 percent of patients younger than 15 were enrolled in a clinical
trial.
-- 27 percent of AYA patients were enrolled in a clinical trial.
-- 41 percent of patients younger than 15 were not treated on a clinical
trial because one was not available.
-- 57 percent of AYA patients were not treated on a clinical trial because
one was not available.
"These findings underscore the need for AYA patients to be treated at
centers such as children's hospitals that are involved in national
cooperatives offering clinical trials of new treatments for pediatric and
adolescent cancers," Dr. Ritchey said. "There also is a need for more
national trials to be opened for AYA patients and the types of malignancies
most common to them."
The national Children's Oncology Group -- of which Children's is a
member -- has an AYA subcommittee on which Dr. Shaw serves that currently
is evaluating the types of cancers affecting AYA patients and ways to
increase clinical trials available to these patients, according to Drs.
Shaw and Ritchey.
One strategy for ensuring that AYA patients are treated by oncologists
who are most up-to-date on clinical trials and cutting-edge treatment
programs is for pediatric oncology divisions to establish AYA oncology
programs in cooperation with adult oncology counterparts.
In 2006, Children's partnered with colleagues from the University of
Pittsburgh Cancer Institute to establish an unparalleled AYA Oncology
Program. It combines the latest and most effective treatment options with a
comprehensive family-centered approach to care that addresses the physical,
psychological and emotional needs of adolescents and young adults diagnosed
with cancer.
For more information on Children's AYA Oncology Program, visit
http://www.chp.edu/aya.
Children's Hospital of Pittsburgh of UPMC
http://www.chp.edu/aya
Children's Hospital Rac Studiul Gãseºte adolescenþi ºi adulþi tineri sã nu fie acelaºi acces la ultimã orã de tratament, pacienþii tineri - Children's Hospital Cancer Study Finds Adolescents And Young Adults Don't Get Same Access To Cutting-Edge Treatment As Younger Patients - articole medicale engleza - startsanatate