Context
There is a growing need for standardized survivorship care for childhood cancer patients in India. While global guidelines such as those developed by the Children’s Oncology Group (COG) provide comprehensive frameworks, they often require adaptation to align with the local healthcare infrastructure, available resources and regional patient needs in Indian Context.
Purpose
The Delphi Consensus initiative was undertaken to adapt the COG guidelines to the Indian context through an evidence informed and consensus driven process. The goal is to develop practical, feasible and contextually relevant guidelines that address long-term follow-up and late effects in childhood cancer survivors across diverse healthcare settings in India.
Activities Undertaken
As part of this initiative, a Round 1 Survey titled “Delphi Consensus for Guidelines on Survivors of Childhood Leukemia in India” was conducted to gather expert opinions on key aspects of survivorship care.
To review and discuss the results of this survey, a two-day meeting was organized at AIIMS, New Delhi, on August 3 to 4, 2024, in collaboration with the INPHOG Late Effects Subcommittee and PHO members. The meeting focused on reviewing Phase II proposals, ongoing and future studies on cancer survivorship and late effects, and developing Delphi-based guidelines for long-term follow-up on ALL, AML, and CML, which are key projects under the Survivorship Taskforce.
Survivorshop & Late Effects Meeting - AIIMS, New Delhi, 23rd August 2024
Survivorshop & Late Effects Meeting - AIIMS, New Delhi, 4th August 2024
Following the analysis of the first round, a Round 2 Survey was conducted in October 2024, incorporating revised questions based on feedback from the initial round. Experts received aggregated responses from Round 1 and were asked to reconsider their ratings in light of collective insights and discussions. This iterative process helped refine and align recommendations to achieve a national consensus on adapted childhood cancer survivorship guidelines for India.
Additionally, Lymphoma Round 1 was conducted online, and the results were shared with participants, followed by an online discussion session. Lymphoma Round 2 is now being planned to further build consensus and finalize the adapted guidelines for this cancer type.
Next Steps
Building upon the progress achieved, upcoming Delphi consensus rounds are planned for CNS Tumours & Retinoblastoma, Abdominal Tumours, and Sarcomas, which are expected to be completed by 2026. These efforts aim to create comprehensive, Childhood cancer survivorship guidelines in India.