Related Experiment Video
Updated: Nov 8, 2025
Establishment of Orthotopic Patient-derived Xenograft Models for Brain Tumors using a Stereotaxic Device
Published on: May 2, 2025
The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa
Jaques van Heerden1,2, Marc Hendricks3,4, Janet Poole5
1Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Jaques.vanheerden@uza.be.
Insights
Developing a standardized neuroblastoma treatment protocol in South Africa proved complex but feasible. This initiative aims to improve childhood cancer survival rates in resource-limited settings by harmonizing treatment approaches.
Area of Science:
- Pediatric Oncology
- Health Services Research
- Implementation Science
Background:
- The World Health Organization aims to increase childhood cancer survival to 60% by 2030 in low- and middle-income countries.
- Standardized, evidence-based national treatment protocols are crucial for achieving this goal.
- The South African Children's Cancer Study Group (SACCSG) initiated a treatment harmonization process.
Purpose of the Study:
- To describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol.
- To assess the feasibility of a national pediatric cancer treatment protocol in a resource-limited setting.
Main Methods:
- Utilized the Consolidated Framework for Implementation Research (CFIR) to evaluate implementation factors.
- Examined five interactive CFIR domains: intervention characteristics, inner setting, outer setting, individual/team characteristics, and implementation process.
Main Results:
- Protocol development took 26 months, involving 26 physicians.
- Key phases included organization, resource identification, development, and ethics approval.
- Challenges encountered were national inertia, variable ethics approval processes, and uncoordinated clinical trial implementation.
Conclusions:
- Implementing a national pediatric cancer treatment protocol is complex.
- Standardized protocols, adapted to local expertise and resources, are feasible in limited settings.
- This study highlights the intricacies of harmonizing cancer treatment nationally.
Purpose:
The aim of the World Health Organization-International Paediatric Oncology Society is to improve childhood cancer survival in low- and middle-income countries to 60% by 2030. This can be achieved using standardised evidence-based national treatment protocols for common childhood cancers. The aim of the study was to describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol as part of the treatment harmonisation process of the South African Children's Cancer Study Group.
Methods:
The Consolidated Framework for Implementation Research was used to identify factors that could influence the implementation of the national NB protocol as a health care intervention. The evaluation was done according to five interactive domains for implementation: intervention characteristics, inner setting, outer setting, individual or team characteristics and the implementation process.
Results:
The protocol was developed over 26 months by 26 physicians involved in childhood cancer management. The process included an organisational phase, a resource identification phase, a development phase and a research ethics approval phase. Challenges included nationalised inertia, variable research ethical approval procedures with delays and uncoordinated clinical trial implementation.
Conclusion:
The implementation of the national NB protocol demonstrated the complexity of the implementation of a national childhood cancer treatment protocol. However, standardised paediatric cancer treatment protocols based on local expertise and resources in limited settings are feasible.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
02:56Treatment Resistant Cancers