LMI-01DEVELOPMENT OF CLINICAL GUIDELINES FOR THE TREATMENT OF LOW GRADE GLIOMAS IN LOWER AND LOWER MIDDLE INCOME COUNTRIES – A SIOP PODC INITIATIVE

Abstract

The treatment of children with low grade gliomas remains a major challenge with many different treatment options available. In lower and lower middle income countries (LMIC) clinical trials are seldom available, and there are limitations in which treatments can be offered. The International Society of Paediatric Oncology (SIOP) has a committee named Paediatric Oncology in Developing Countries (PODC) which has a number of working groups. The SIOP PODC Adapted Treatment Regimens Working Group produces recommendations for themanagement of childhoodcancers inLMIC, and guidelines for their implementation as well as for continuous quality improvement based on local outcome data. A group of clinicians from various specialities who treat children with CNS tumours in LMIC from around the globe, as well as a number of clinicians from high income countries (HIC) with experience of LMIC, was convened and met monthly via the C4K teleconference facility. Evidence applicable to all aspects of care including diagnosis, surgery, radiotherapy, chemotherapy, relapse treatment, late effects and follow up was discussed and a consensus was reached. The guidelines were stratified according to the facilities and personnel available via SIOP PODC standardised service levels for the care of patientswith lowgrade gliomas.The recommendationswill be circulatedwidely and discussed at a SIOPPODCmeeting.They will then be ratified by the SIOP ScientificCommittee prior to submission for publication. Guidelines such as these provide valuable support and guidance for those working in LMIC, and may be a valuable contribution to standardisation of care.