Puerta Cristian, Chidiac Charbel, Besse Casandra E, Klipstein Arturo, Brown Lawrence, Fierro Juan Carlos, Phan Paul, Thistlethwaite Patricia A, Rhee Daniel S, Shalkow-Klincovstein Jaime
Department of Surgery, Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Berkeley, CA, USA.
Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Pediatr Surg Int. 2025 May 30;41(1):152. doi: 10.1007/s00383-025-06050-6.
Pediatric cancer outcomes have improved significantly in recent decades, importantly through multidisciplinary collaboration. Multidisciplinary Tumor Boards (MTBs) foster cross-specialty discussions, leading to refined treatment plans. However, their use in low- and middle-income countries (LMICs) remains underexplored. This systematic review aims to assess existing literature on pediatric MTBs in LMICs to elucidate their current status and identify strategies that enhance their adoption and impact patient outcomes. Following PRISMA guidelines, we searched PubMed, Google Scholar, and SciELO for quantitative and qualitative studies on pediatric MTBs in LMICs. Interventional and observational studies were included, while adult-only research, those set in high-income countries, or lacking results were excluded. Eight out of 2699 studies met inclusion criteria. Risk of bias was assessed using the Newcastle-Ottawa Scale. Collectively, 1063 pediatric patient cases were evaluated, with 90-min MTBs being most common. Attendees included pediatric oncologists, pediatric surgeons, radiologists, radiation oncologists, and pathologists. MTBs improved patient care and standardized treatment. However, LMICs faced challenges such as limited resources, lack of protected time, and unreliable internet access. Despite these barriers, MTBs remain vital for advancing pediatric cancer care in LMICs. Strengthening institutional support and policy frameworks is essential to sustaining and scaling MTBs, ultimately improving cancer care and outcomes for children in resource-constrained settings.
近几十年来，儿科癌症治疗结果有了显著改善，这在很大程度上得益于多学科协作。多学科肿瘤委员会（MTBs）促进了跨专业讨论，从而制定出更完善的治疗方案。然而，它们在低收入和中等收入国家（LMICs）的应用仍未得到充分探索。本系统综述旨在评估关于LMICs中儿科MTBs的现有文献，以阐明其当前状况，并确定能够促进其采用并影响患者治疗结果的策略。按照PRISMA指南，我们在PubMed、谷歌学术和SciELO上搜索了关于LMICs中儿科MTBs的定量和定性研究。纳入了干预性和观察性研究，而仅针对成人的研究、在高收入国家开展的研究或缺乏结果的研究则被排除。2699项研究中有8项符合纳入标准。使用纽卡斯尔-渥太华量表评估偏倚风险。总共评估了1063例儿科患者病例，其中90分钟的MTBs最为常见。参会人员包括儿科肿瘤学家、儿科外科医生、放射科医生、放射肿瘤学家和病理学家。MTBs改善了患者护理并使治疗标准化。然而，LMICs面临着资源有限、缺乏专用时间和互联网接入不可靠等挑战。尽管存在这些障碍，MTBs对于推进LMICs的儿科癌症护理仍然至关重要。加强机构支持和政策框架对于维持和扩大MTBs至关重要，最终可改善资源受限环境中儿童的癌症护理和治疗结果。
