Rev. Bras. Hematol. Hemoter. vol.39 número3

rev bras hematol hemoter. 2017;39(3):266–268

w w w . r b h h . o r g

Revista

Brasileira

de

Hematologia

e

Hemoterapia

Brazilian

Journal

of

Hematology

and

Hemotherapy

Review

article

Partnership

of

the

Sociedade

Brasileira

de

Oncologia

Pediátrica

and

International

Society

of

Pediatric

Oncology

to

improve

nutritional

care

for

children

with

cancer

in

Brazil

Karina

Viani

,

Vicente

Odone

Filho

,

Sima

Ferman

,

Teresa

Cristina

Cardoso

Fonseca

,

Vanessa

da

Cunha

Oliveira

_,

_Priscila

_dos

_Santos

_Maia

_Lemos

_,

_Ronald

_D.

_Barr

_,

Elena

J.

Ladas

a_{UniversidadedeSãoPaulo(USP),SãoPaulo,SP,Brazil}

b_{InstitutoNacionaldeCâncer(INCA),RiodeJaneiro,RJ,Brazil}

c_{UniversidadeEstadualdeSantaCruz(UESC),Ilhéus,BA,Brazil}

d_{UniversidadeFederaldeSãoPaulo(Unifesp),SãoPaulo,SP,Brazil}

e_{McMasterChildren’sHospital,Hamilton,Ontario,Canada}

f_{ColumbiaUniversityMedicalCenter,NewYork,USA}

a

r

t

i

c

l

e

i

n

f

o

Articlehistory:

Received21August2016

Accepted10October2016

Availableonline21February2017

Keywords: Nutrition

Pediatriconcology

Brazil

Low-andmiddle-incomecountries

a

b

s

t

r

a

c

t

TheauthorspresentaproposalofapartnershipbetweentheSociedadeBrasileirade

Oncolo-giaPediátrica(SOBOPE)andtheInternationalSocietyofPediatricOncology(SIOP)topromote

thestandardizationandimprovementofnutritionalcareofkidsundercancertreatmentin

Brazil.TheresultsofthefirstmeetinginBrazilaswellasplansforfuturemeetingsare

described.

©2017Associac¸ ˜aoBrasileiradeHematologia,HemoterapiaeTerapiaCelular.Published

byElsevierEditoraLtda.ThisisanopenaccessarticleundertheCCBY-NC-NDlicense

(http://creativecommons.org/licenses/by-nc-nd/4.0/).

∗ _{Correspondingauthorat:InstitutodaCrianc¸a,HospitaldasClínicas,FaculdadedeMedicina,UniversidadedeSãoPaulo(ICr/HCFMUSP),}

148RuaGalenodeAlmeida,01409-001SãoPaulo,SP,Brazil.

E-mailaddress:viani.karina@gmail.com(K.Viani).

http://dx.doi.org/10.1016/j.bjhh.2016.10.003

1516-8484/©2017Associac¸ ˜aoBrasileiradeHematologia,HemoterapiaeTerapiaCelular.PublishedbyElsevierEditoraLtda.Thisisan

revbrashematolhemoter.2017;39(3):266–268

267

Background

Incomparisontomany low-andmiddle-incomecountries,

significant advances in the treatment ofchildhood cancer

havebeenobtainedinBrazil.Asignificantnumberofthe

chil-drenreceivetreatmentusingmodernprotocols.Additionally,

hematopoieticstemcelltransplantationisavailableinseveral

urbancentersthroughoutthecountry.Withincreased

avail-abilityofmoderntreatmentprotocols,theneedforsupportive

care,includingnutrition,becomesanessentialcomponentin

comprehensivecancercare.

Anumberofnutritional conditionsare observedamong

healthychildreninBrazil.Althoughdifferencesareobserved

between regions, the prevalence of undernutrition among

under5-year-oldchildrendecreasedfrom37%in1974–1975to

7%in2006–2007.Thishasbeenobservedalongsideamarked

increase in the prevalence of 6-to 11-year-old overweight

children–atrendthat isrecognizedgloballyamongmany

low-andmiddle-incomecountries.Otherpublichealthissues

relatedtonutritionalmorbiditiesincludevitaminAdeficiency,

iodinedeficiencydisorders,aswellasanemia,whichaffects

approximately25%ofBrazilianchildren.1–3

Amongchildrenwithcancer,thereisapaucityofevidence

about nutritional challenges and their implications on the

deliveryofcancercaretoBrazilianchildren.Veryfew

stud-ies have been published on nutritionin Brazilian children

withcancer; nutritional issues havebeen demonstrated in

thispopulation,suchasahigherprevalenceof

undernutri-tion,decreasedgrowthrateanddecreasedcopper andzinc

levels.4–7

Objectives

of

the

meeting

The“3rd InternationalSocietyofPediatricOncology–

Pedi-atricOncologyinDevelopingCountries(SIOP-PODC)workshop

onNutritioninChildrenwithCancer”washeldinSaoPaulo,

Brazil onNovember 13, 2015.This event wasorganized by

theInstitutodeTratamentodoCâncerInfantil(ITACI)ofthe

Institutoda Crianc¸adoHospitaldas Clínicas,Faculdadede

Medicina,UniversidadedeSãoPauloincollaborationwiththe

SociedadeBrasileirade OncologiaPediátrica(SOBOPE). This

meeting was attended by 102 pediatric oncologists,

hema-tologists, dietitians, nurses and other health professionals

workinginthefieldofpediatriconcologyfromthestatecapital

(48%),otherpartsofSaoPauloState(32%)andotherregions

ofBrazil (20%),aswell asexpertsinnutritionfrom foreign

institutions.

Theobjective ofthis SIOP-PODC initiative was toget a

betterunderstanding ofthe regionalfacilitators and

barri-erstonutritionalcareofchildrenwithcancerandestablisha

regionalinfrastructuretoimproveboththedeliveryofclinical

services and toadvance knowledge.Specifically, the

nutri-tionalworkshopinBrazilaimedto:

(1) Assessknowledgeonnutritionalissuesandstandardsof

practiceamonghealthprofessionalsprovidingnutritional

caretochildrenwithcanceracrossBrazil;

(2) Identify research opportunities and possible

collabora-tionsthroughtheSIOP-PODCcommittee;

(3) Determinethestandardofcareamonginstitutionsof

dif-ferentlevelsofnutritionalcare;and

(4) Determinethestateofthescienceonnutritionand

pedi-atriconcologyinBrazil.8

Outcomes

and

next

steps

Outcomesofthemeetingandnextstepstowardachievingthe

aforementionedobjectivesare:

(1) TodevelopapartnershipbetweenSIOPandSOBOPE;

(2) Toexpandexistingprojectsonnutritioninchildrenwith

cancerwiththesupportofbothSIOPandSOBOPE;

(3) Toplananutritionsurveyofallpediatriconcologycenters

inBrazilthroughSOBOPE;

(4) Toassesstherelationshipbetweennutritionand

abandon-mentofBrazilianchildrenwithcancer;

(5) To plan the succeeding workshop in Brazil during the

next SOBOPE conference with the aim of achieving

better national visibility and raise awareness about

nutrition.

ThepartnershipbetweenSIOPandSOBOPEtoimprovethe

nutrition ofBrazilian childrenwith cancer is very

promis-ing, especially as Brazil has a large number of children

being treated for cancer and very few research protocols

on nutrition. The scientific support of both the

Brazil-ian and the international societies will most certainly

advance research on nutrition in children with cancer in

Brazil.

Conflicts

of

interest

This project is sponsored and supported by Nutricia

and Josephine Garvey, Danone team and the Fundac¸ão

Crianc¸a.

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2.VictoraCG,AquinoEM,doCarmoLealM,MonteiroCA,Barros FC,SzwarcwaldCL.MaternalandchildhealthinBrazil: progressandchallenges.Lancet.2011;377(9780):1863–76.

3.MinistériodaSaúde(MS).PNDS2006.PesquisaNacionalde DemografiaeSaúdedaCrianc¸aedaMulher.Brasilia: MinistériodaSaúde;2008.

4.SgarbieriUR,FisbergM,ToneLG.Nutritionalassessmentand serumzincandcopperconcentrationinleukemicchildren. SaoPauloMedJ.1999;117(1):13–8.

5.GarófoloA,LopezFA,PetrilliAS.Highprevalenceof malnutritionamongpatientswithsolidnon-hematological tumorsasfoundbyusingskinfoldandcircumference measurements.SaoPauloMedJ.2005;123(6):277–81.

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