Achievements of pediatric oncology in Azerbaijan

Abstract

Relevance. Pediatric oncology is increasingly important today and deserves the special attention of physicians of all specialties treating children. Situated at the intersection of various disciplines, pediatric oncology is rapidly developing, and all new advanced technologies in medicine and biology are finding their way into it. Study Objective: To briefly describe the achievements achieved since the opening of the pediatric oncology department. Materials and Methods: In 2012, the first pediatric oncology department was opened in Azerbaijan at the National Oncology Center (NOC). From 2013 to 2024, 1,533 children under 18 years of age with various oncological diseases received treatment and consultations. An analysis of tumor treatment outcomes in children for selected tumor sites was conducted. Patient survival rates were assessed using the Kaplan-Meier method. NHL treatment was administered according to the protocols of the BFM Group (Germany). In B-NHL (n = 85), the B NHL-BFM 04 programs were used, and rituximab was also included. Patients with L-NHL (n = 25) were treated according to the ALL IC-BFM 2002 protocol. In ALCL 6, the patient received treatment according to the B-NHL-BFM 04 protocol and the ALCL 99 program. The stages and prognostic risk groups of NHL were established in accordance with the recommendations of the BFM group. Nephroblastoma was treated according to the SIOP WT-2001, UMBRELLA 2018 protocol. The study included 59 children. For CNS tumors, depending on the histological form and degree of malignancy, the LGG-2004 (SIOP), HIT-HGG-2007, HIT-2000, HIT-MET 2018 (Germany) protocols were used. Survival rates were studied in 50 children with medulloblastoma. Treatment outcomes for 60 children with neuroblastoma were analyzed using the TPOG-NB 2009 and TPOG-NB 2020 (Turkey) protocols. Children with extracranial germ cell tumors received treatment using the MAKEY program. For nasopharyngeal carcinoma, the GPOH NPC-2003 program was used, etc. Results and discussion. Overall and event-free 5-year survival (OS and EFS) for all NHLs (116 patients) were 80% ± 4% and 78% ± 4%, respectively. For nephroblastoma, 5-year survival (OS and EFS) were 87% ± 5% and 84% ± 5%, respectively. It should be noted that of the 59 treated patients, 33 children (55.9%) had stage III-IV disease, which undoubtedly influenced the outcome. For stages I-II, OS and OS rates were 96% ± 4%. Wilms tumor treatment can be considered a paradigm for the multimodal treatment of malignant solid tumors in childhood. For medulloblastoma, OS and OS rates for all children (n=50) were 74% ± 7% and 63% ± 8%, respectively. These same rates for children in the standard-risk group (33 children) were 85% ± 9%. For neuroblastoma, the initial results are encouraging given the clinical characteristics of the children (stage IV disease was diagnosed in 39 children, representing 63.9% of all patients). The five-year OS and DFS for all patients (n=60) were 50.6% ± 7% and 40% ± 7%, respectively. In children in the standard-risk group, these rates were 59% ± 13%. Patients with extracranial germ cell tumors are successfully treated according to the 2005 MAKEI protocol; the five-year DFS was 95% ± 4%. Conclusion. The results achieved since the opening of the Pediatric Oncology Department at the National Cancer Center demonstrate that the implementation of modern therapeutic approaches and international treatment protocols offers these children a good chance of achieving complete remission and guarantees good survival.

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