Organization of Medical Care for Children with Cancer in the Arkhangelsk Region

Abstract

Introduction: Malignant tumors (MT) in children are not common but contribute significantly to infant mortality . Materials and methods: We evaluate the available equipment and the competence of the staff of the Oncology Department of cancer chemotherapy at the SBPHF AR Regional Children's Hospital (ARCH) in accordance with the requirements of the Annexes 5-6 to the Order of Ministry of Health of the Russian Federation № 560n dated October 31, 2012 (as amended September 02, 2013 № 608n) “On approval of procedures for the provision of healthcare services in the profile ‘Pediatric oncology’”. The analysis of the case histories of patients with solid tumors (except brain tumors) treated in the period from 2011 to 2015 was also performed. Results: During the period from 2011 to 2015 specialized and symptomatic treatment was provided to 49 patients (23 (46.9%) girls and 26 (53.1%) boys, mean age, 5.9 years; range 1 month – 17 years) with solid malignant tumors (excluding brain tumors). Out of 49 patients, eleven (22.4%) had neuroblastomas, ten (20.4%) – nephroblastomas, six (12.2%) – liver tumors, five (10.2 %) – thyroid cancer, three (6.1%) – osteosarcomas, three (6.1%) – rhabdomyosarcoma (RMS), two (4%) – Ewing's sarcoma, two (4%) – organ RMC, two (4%) – retinoblastomas, one (2%) – synovial sarcoma, one (2%) – fibrosarcoma, one (2%) – juvenile granulosa cell tumor, one (2%) – primitive neuroectodermal tumor, one (2%) – testicular cancer. Seven (14.3%) patients presented with stage I disease, twenty-two (44.9%) – with stage II, five (10.2%) – with stage III, fourteen (28.6%) – with stage IV, and one (2%) patient with unidentified tumor stage. Currently, forty (81.6%) patients from the analyzed group are alive: four (10%) continued treatment and thirty-six (90%) achieved remission. Nine (18.4%) patients died from the progression of the underlying disease. Conclusion: Medical facilities of the Arkhangelsk Region have the opportunities to provide specialized medical care for children with the majority of malignant tumors. The specialized department can provide chemotherapy and surgery, excluding complex organ preservation surgery (in patients with bone sarcomas) as it requires professionals with extensive experience.