Resources for the practice of pediatric neuro-oncology in Mexico: a cross-sectional evaluation
Por:
Arce-Cabrera, D, Escamilla-Asiain, G, Nájera-Castillo, MF, del Campo, RMNM, Ortiz-Azpilcueta, M, Pantoja-Guillén, FJ, Gonzalez, FEA, Zapata-Sosa, I, Lugo-Juárez, JZ, Cortez, DS, Morales-La Madrid A, Moreira, DC and Benito-Reséndiz, AE
Publicada:
21 jun 2024
Resumen:
Background The evaluation of existing resources and services is key to identify gaps and prioritize interventions to expand care capacity for children with central nervous system (CNS) tumors. We sought to evaluate the resources for pediatric neuro-oncology (PNO) in Mexico.Methods A cross-sectional online survey with 35 questions was designed to assess PNO resources and services, covering aspects including number of patients, infrastructure, human resources, and diagnostic and treatment time intervals. The survey was distributed to the members of the Mexican Association of Pediatric Oncology and Hematology (AMOHP) who belong to the nation's many different health systems.Results Responses were obtained from 33 institutions, distributed throughout the country and part of the many health systems that exist in Mexico. Twenty-one (64%) institutions had less than 10 new cases of pediatric CNS tumors per year. Although 30 (91%) institutions saw pediatric patients up to the age of 18 years, 2 (6%) had a cutoff of 15 years. Twenty-four (73%) institutions had between 1 and 3 pediatric oncologists providing care for children with CNS tumors. Six (18%) institutions did not have a neurosurgeon, while 19 (57%) institutions had a pediatric neurosurgeon. All centers had a pathology department, but 13 (39%) institutions only had access to basic histopathology. Eleven (33%) institutions reported histopathological diagnoses within one week, but 3 (9%) took more than 4 weeks. Radiotherapy for pediatric CNS tumors was referred to outside centers at 18 (55%) institutions. All centers had access to conventional cytotoxic chemotherapy, but only 6 (18%) had access to targeted therapy. Eighteen (55%) respondents estimated a survival rate of less than 60%. Fifteen (45%) centers attributed the main cause of mortality to non-tumor related factors, including infection and post-surgical complications.Conclusions This is the first national assessment of the resources available in Mexico for the treatment of CNS tumors. It shows disparities in resource capacity and a lack of the specific and efficient diagnoses that allow timely initiation of treatment. These data will enable the prioritization of collaborative interventions in the future.
Filiaciones:
Arce-Cabrera, D:
Sinaloa Pediat Hosp, Pediat Oncol Dept, Culiacan, Sinaloa, Mexico
Escamilla-Asiain, G:
Teleton Childrens Hosp Oncol, Pediat Oncol Dept, Queretaro, Queretaro, Mexico
Nájera-Castillo, MF:
Hosp Children Toluca, Maternal & Child Inst State Mexico, Pediat Oncol Dept, Toluca, Estado de Mexic, Mexico
del Campo, RMNM:
Civil Hosp Guadalajara Dr Juan I Menchaca, Pediat Oncol Dept, Guadalajara, Jalisco, Mexico
Ortiz-Azpilcueta, M:
Natl Med Ctr 21st Century Mexican Social Secur Ins, Pediat Oncol Dept, Pediat Hosp, Mexico City, Mexico
Pantoja-Guillén, FJ:
Agustin OHoran Gen Hosp, Pediat Oncol Dept, Merida, Yucatan, Mexico
Gonzalez, FEA:
Natl Med Ctr November 20 ISSSTE, Pediat Oncol Dept, Mexico City, Mexico
Zapata-Sosa, I:
Zacatecas Gen Hosp, Pediat Oncol Dept, Zacatecas, Zacatecas, Mexico
Lugo-Juárez, JZ:
Teleton Childrens Hosp Oncol, Pediat Oncol Dept, Queretaro, Queretaro, Mexico
Cortez, DS:
Natl Med Ctr November 20 ISSSTE, Pediat Oncol Dept, Mexico City, Mexico
Morales-La Madrid A:
St Joan Deu Hosp, Barcelona Pediat Oncol Ctr, Barcelona, Spain
Moreira, DC:
St Jude Childrens Res Hosp, Dept Global Pediat Med, Memphis, TN USA
Benito-Reséndiz, AE:
Natl Med Ctr November 20 ISSSTE, Pediat Oncol Dept, Mexico City, Mexico
Green Submitted, gold
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