Abu-Arja Mohammad H, Rojas Del Río Nicolás, Morales La Madrid Andres, Lassaletta Alvaro, Coven Scott L, Moreno Rosa, Valero Miguel, Perez Veronica, Espinoza Felipe, Fernandez Eduardo, Santander José, Tordecilla Juan, Oyarce Veronica, Kopp Katherine, Bartels Ute, Qaddoumi Ibrahim, Finlay Jonathan L, Cáceres Adrián, Reyes Mauricio, Espinoza Ximena, Osorio Diana S
Department of Pediatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY.
Department of Pediatrics, Division of Hematology Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile.
JCO Glob Oncol. 2021 Mar;7:425-434. doi: 10.1200/GO.20.00430.
Pediatric neuro-oncology resources are mostly unknown in Chile. We report the human and material resources available in Chilean hospitals providing pediatric neuro-oncology services.
A cross-sectional survey was distributed to 17 hospitals providing pediatric neuro-oncology services (Programa Infantil Nacional de Drogas Antineoplásicas [PINDA] hospitals, 11; private, 6).
Response rate was 71% (PINDA, 8; private, 4). Pediatric neuro-oncology services were mainly provided within general hospitals (67%). Registries for pediatric CNS tumors and chemotherapy-related toxicities were available in 100% and 67% of hospitals, respectively. CNS tumors were treated by pediatric oncologists in 92% of hospitals; none were formally trained in neuro-oncology. The most used treatment protocols were the national PINDA protocols. All WHO essential medicines for childhood cancer were available in more than 80% of the hospitals except for gemcitabine, oxaliplatin, paclitaxel, and procarbazine. The median number of pediatric neurosurgeons per hospital was two (range, 2-6). General neuroradiologists were available in 83% of the centers. Pathology specimens were sent to neuropathologists (58%), adult pathologists (25%), and pediatric pathologists (17%). Intensity-modulated radiotherapy, conformal radiotherapy, and cobalt radiotherapy were used by 67%, 58%, and 42% of hospitals, respectively. Only one private hospital performed autologous hematopoietic cell transplant for children with CNS tumors.
A wide range of up-to-date treatment modalities are available for children with CNS tumors. Our survey highlights future directions to improve the pediatric neuro-oncology services available in Chile such as the expansion of multidisciplinary clinics, palliative care services, long-term cancer survivorship programs, dedicated clinical research support teams, establishing standardized mechanism for sending pathologic specimen for second opinion to international specialized centers, and establishing specialized neuro-oncology training program.
智利的儿科神经肿瘤资源大多不为人知。我们报告了智利提供儿科神经肿瘤服务的医院所具备的人力和物力资源。
对17家提供儿科神经肿瘤服务的医院(国家儿童抗肿瘤药物计划[PINDA]医院11家;私立医院6家)进行了横断面调查。
回复率为71%(PINDA医院8家;私立医院4家)。儿科神经肿瘤服务主要在综合医院提供(67%)。100%的医院有儿科中枢神经系统肿瘤登记册,67%的医院有化疗相关毒性登记册。92%的医院由儿科肿瘤学家治疗中枢神经系统肿瘤;没有人接受过神经肿瘤学的正规培训。最常用的治疗方案是国家PINDA方案。除吉西他滨、奥沙利铂、紫杉醇和丙卡巴肼外,80%以上的医院备有世界卫生组织所有儿童癌症基本药物。每家医院儿科神经外科医生的中位数为2名(范围为2 - 6名)。83%的中心有普通神经放射科医生。病理标本被送往神经病理学家(58%)、成人病理学家(25%)和儿科病理学家(17%)处。分别有67%、58%和42%的医院使用调强放疗、适形放疗和钴放疗。只有一家私立医院为中枢神经系统肿瘤患儿进行自体造血细胞移植。
患有中枢神经系统肿瘤的儿童可获得广泛的最新治疗方式。我们的调查突出了智利改善儿科神经肿瘤服务的未来方向,如扩大多学科诊所、姑息治疗服务、长期癌症幸存者计划、专门的临床研究支持团队、建立将病理标本送往国际专业中心寻求二次意见的标准化机制,以及建立专门的神经肿瘤学培训计划。