Mr Stiller and his colleagues analysed data on 25,853 children (66% of all registered childhood cancers) diagnosed before the age of 15 in Britain during 1978-2005. In total there were 39,067 children with cancer, but this study focused on the two-thirds for whom there was a multi-centre trial of first-line treatment open to entry during a total of at least 10 years within the period of the study.
For each diagnostic category, there was an annual reduction in the risk of death that ranged from 2.7% for rhabdomyosarcoma (a cancer of soft tissues such as muscle) to 12% for germ cell tumours of the testes and ovaries. The percentage of children enrolled in trials varied widely between different cancers and at different times during the study period, but there was a tendency for entry rates to be higher in more recent times for most cancers.
"Examples of cancers where a really big difference was seen over the study period are acute lymphoblastic leukaemia (ALL) and hepatoblastoma," said Mr Stiller. "ALL is the most frequent cancer in children. In 1978 only 49% of children survived for five years, but survival increased steadily throughout the study period and from each trial era to the next. By the end of this study, 90% of children were surviving five years from diagnosis and most of them could be considered cured.
"Hepatoblastoma is one of the rarer childhood cancers, with less than 20 cases per year in the UK far too few for any one country to run a clinical trial on its own. In the years before the first worldwide trial for treatment of the disease, two-thirds of children with this tumour died, whereas now three-quarters survive. This illustrates what can be achieved with strong commitment to international collaboration, even for comparatively rare tumours."
Kathy Pritchard-Jones, Professor of Paedia
|Contact: Emma Mason|
European Society for Medical Oncology