SynthesisThe Lancet. Oncology2023
Treatment-related mortality in children with cancer in low-income and middle-income countries: a systematic review and meta-analysis.
Synthesis in The Lancet. Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07632014 (Improving Cancer Outcomes for Children, Adolescents, and Young Adults), which is not on this map. Cited by 49 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Cancer Outcomes for Children, Adolescents, and Young Adults: A Multicenter Prospective Cohort Study on Treatment Failure and Toxicity in Low- and Middle-Income Countries.
Who cites it
49 citing papers in PubMed, 59 citations in OpenAlex.
- Global burden and inequalities of Hodgkin and non-Hodgkin lymphoma among children aged 0-14 years, 1990-2021: a GBD 2021 analysis with forecasts to 2035.Jornal de pediatria · 2026Article
- Territorial Socioeconomic Vulnerability and Clinical Outcomes in Pediatric Cancer at a Colombian Referral Center.Children (Basel, Switzerland) · 2026Article
- Toxicity during induction of pulsed versus continuous prednisolone in children with acute lymphoblastic leukaemia: a multi-centre, open label, randomised, phase 3 trial from India (2016-2022).The Lancet regional health. Southeast Asia · 2026Article
- CARE study: prospective cohort study on supportive care among paediatric oncology patients in western Kenya-a study protocol.BMJ open · 2026Article
- Cancer survival and its social determinants among children with a migrant background: systematic review protocol.BMJ open · 2026Article
- Implementation of an electronic registry to monitor quality of care for febrile episodes in pediatric patients with cancer in Central America and the Caribbean.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach.Global implementation research and applications · 2026Article
- Treatment Decision Making at Diagnosis for Children Presenting With Advanced Cancer in Low- and Middle-Income Countries.JCO global oncology · 2026Article
- Outcomes of Methotrexate-Based Therapy for Paediatric Osteosarcoma: A Decade of Experience from a Cancer Centre in Pakistan.Journal of cancer & allied specialties · 2026Article
- Article
- Burden of haematological malignancies among children, adolescents and young adults: Global and high-income region insights from the GBD 2021 study.British journal of haematology · 2026Article
- Childhood cancer in India: Progress achieved, persisting gaps, challenges, and the road ahead.The Indian journal of medical research · 2026Article
- Risk factors for early mortality (within 6 weeks of diagnosis) in Chinese children with acute leukemia: a single-center retrospective cohort study.Annals of hematology · 2026Article
- Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.Critical care science · 2026Article
- Evaluating a Global Clinical Nutrition Program for Pediatric Oncology in Resource-Limited Settings.Annals of global health · 2026Article
- Patient pathways, presentation time, time to diagnosis, and early survival outcomes in pediatric acute lymphoblastic leukemia at Muhimbili National Hospital, Dar es Salaam, Tanzania.Frontiers in pediatrics · 2026Article
- Editorial: Innovations in supportive care in global pediatric oncology.Frontiers in oncology · 2026Article
- Optimising door-to-needle-time in children with febrile neutropenia in the paediatric emergency unit-a quality improvement study.Ecancermedicalscience · 2026Article
- Analysis of Causes and Risk Factors for Deaths Among Pediatric Oncology Patients: A 20-Year Observation.Cancer management and research · 2026Article
- Circulating Tumor DNA and microRNA-Based Liquid Biopsy for Longitudinal Treatment Monitoring and Recurrence Prediction in Pediatric Sarcomas: A Prospective Cohort Study.Oncology research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundApproximately 90% of children with cancer live in low-income and middle-income countries (LMICs), where 5-year survival is lower than 20%. Treatment-related mortality in high-income countries is approximately 3-5%; however, in LMICs, treatment-related mortality has been reported in up to 45% of children with cancer. This study aimed to systematically explore the burden of treatment-related mortality in children with cancer in LMICs and to explore the association between country income level and treatment-related mortality.
methodsFor this systematic review and meta-analysis we identified articles published between Jan 1, 2010, and June 22, 2021, describing treatment-related mortality in paediatric patients (aged 0-21 years) with cancer in LMICs. We searched PubMed, Trip, Web of Science, Embase, and the WHO Global Metric Index databases. The search was limited to full-text articles and excluded case reports (<10 patients) and haematopoietic stem-cell transplantation recipients. Two reviewers independently screened studies for eligibility, extracted data from included publications, and evaluated data quality. Random and mixed-effects models were used to estimate treatment-related mortality burden and trends. The Cochran-Q statistic was used to assess heterogeneity between studies. This study is registered on PROSPERO (CRD42021264849).
findingsOf 13 269 identified abstracts, 501 studies representing 68 351 paediatric patients with cancer were included. The treatment-related mortality estimate was 6·82% (95% CI 5·99-7·64), accounting for 30·9% of overall mortality (4437 of 14 358 deaths). Treatment-related mortality was inversely related to country income. Treatment-related mortality was 14·19% (95% CI 9·65-18·73) in low-income countries, 9·21% (7·93-10·49) in lower-middle-income countries, and 4·47% (3·42-5·53) in upper-middle-income countries (Cochran-Q 42·39, p<0·0001). In upper-middle-income countries, the incidence of treatment-related mortality decreased over time (slope -0·002, p=0·0028); however, outcomes remained unchanged in low-income (p=0·21) and lower-middle-income countries (p=0·16).
interpretationApproximately one in 15 children receiving cancer treatment in LMICs die from treatment-related complications. Although treatment-related mortality has decreased in upper-middle-income countries over time, it remains unchanged in LMICs. There is an urgent need for targeted supportive care interventions to reduce global disparities in childhood cancer survival.
fundingAmerican Lebanese Syrian Associated Charities and National Cancer Institute.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.