a colleague recently drew my attention to some interesting
statistics: In the USA >70% of paediatric patients with cancer are
entered into at least one clincal trial; only 2% of adults with
cancer are entered into trials
internationally (in the developed world at least) most children with
cancer are treated according to a defined protocol - And, systems
exist to facilitate sharing experience.
In the past 25 years survival times and side-effects from treatment
have improved dramatically for children with cancer (eg from 40% to
70% cure rates) in contrast to minor improvements for adult with
cancer even though there have been no new "frontline" therapeutic
agents.
it seems that paediatric oncologists have been doing EBM for a
quarter of a century: putting evidence into practice and getting
practice into evidence although they do not use the language of the
EBM/H/P community.
this raises 2 questions which (at the risk of exposing my ignorance)
i should like to ask:
1) why haven't EBM-ers looked to see why the paediatric oncology
community seem to have go it right?
2) why have other specialities not followed the example of the
paediatric oncologists
michael power
some references:
Bleyer WA. The US pediatric cancer clinical trials programmes:
International implications and the way forward. European Journal of
Cancer 1997; 33: 1439-1447
Philip T. Lymphoblastic lymphoma and Burkitt's lymphoma in Caucasian
adults: Please don't forget the pediatric experience. Annals of
Oncology 1995; 6: 414-416
Simone JV, Lyons J. The evolution of cancer care for children and
adults. Journal of Clincal Oncology 1998; 16: 2904-2905
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Dr Michael Power, Department of Paediatrics and Child Health,
University of Cape Town & Red Cross Children's Hospital,
Rondebosch 7700, Cape Town, South Africa
Tel (27 21) 658 5111 Fax (27 21) 689 1287
email [log in to unmask]
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