Mapping Pediatric Oncology Clinical Trial Collaborative Groups on the Global Stage

Disparities in Global Authorship and Data Source in the Pediatric Blood and Cancer Journal 2011-2021: Realities and Strategies for Improvement

BACKGROUND

Research expands knowledge and improves outcomes. Research is needed in all settings, but most often occurs in high-income countries (HIC) compared to low- and middle-income countries (LMICs). Publication in scientific peer-reviewed journals and authorship position are important for academic/clinical advancement. We explored the current state of global authorship and data source distribution for publications in the Pediatric Blood and Cancer (PBC) journal.

PROCEDURE

LMIC-affiliated author inclusion and position in selected article categories of the PBC (2011-2021) were recorded. Articles with at least one LMIC-affiliated author (first-listed affiliation) and 5% of exclusively HIC-authored articles were verified. Descriptive statistical analysis was performed.

RESULTS

Of 4504 articles reviewed, 593 (13%) included at least one LMIC-affiliated author (517/593 [87%] as first author and 488/593 [82%]) as senior author. In a subset of articles with LMIC-sourced data, 148/675 (22%) included exclusively HIC authors. Within the LMIC-sourced data subset, 81/675 (12%) articles were mixed HIC/LMIC affiliation and 446/675 (66%) were exclusively LMIC-affiliated. The frequency of LMIC-affiliated authors as first or senior author within HIC/LMIC-affiliated collaborations was 31/81 (38%) and 9/81 (11%), respectively.

CONCLUSION

As more than 80% of children live in LMICs and the WHO Global Initiative for Childhood Cancer is increasingly engaged across LMICs, all researchers/clinicians must justly be given an opportunity to conduct, write, publish, and be recognized for their research. PBC is uniquely poised to promote equitable publishing practices and opportunities for professional recognition by drawing on emerging best practices for equitable authorship, including potentially restructuring authorship guidelines and requirements.

International Society of Paediatric Oncology (SIOP) Global Mapping Program: Analysis of healthcare centers in countries of the Latin American Society of Pediatric Oncology (SLAOP)

BACKGROUND

The International Society of Paediatric Oncology Society Global Mapping Program aims to describe the local pediatric oncology capacities. Here, we report the data from Latin America.

METHODS

A 10-question survey was distributed among chairs of pediatric oncology services. Centers were classified according to patient volume into high- (HVC; 100 or more new cases per year), medium- (MVC; 31-99 cases), and low-volume centers (LVC; 30 cases or less), respectively. National referral centers (NRC) were identified.

RESULTS

Total 307 centers in 20 countries were identified (271 responded), and 264 responses were evaluable, accounting for 78% of the expected cases (21,359 cases per year). Seventy-seven percent of patients are treated in public centers, including additional support by civil society organizations. We found that 66% of the patients are treated in 70 centers of excellence, including 21 NRC. There was a median of one pediatric oncologist every 21 newly diagnosed patients (44 for NRC), and in 84% of the centers, nurses rotated to other services. A palliative care team was lacking in 25% of the centers. LVC with public funding have significantly lower probability of having a palliative care team or trained pediatric oncology surgeons. Psychosocial, pharmacy, and nutrition services were available in more than 93% of the centers. No radiotherapy facility was available on campus in nine of 21 NRC.

CONCLUSIONS

Most children with cancer in Latin America are treated in public HVC. There is a scarcity of pediatric oncologists, specialized nurses and surgeons, and palliative care teams, especially in centers with public funding.

Building RECOVERY: development of the registry of eating disorders and their co-morbidities OVER time in youth

BACKGROUND

Eating disorder (ED) research is limited by the lack of longitudinal cohort studies, particularly those in adolescents, and the lack of inclusion of multiple perspectives and diagnoses. The objective of this study was to describe the development of a longitudinal cohort of adolescents/young adults representing varied ED diagnoses and including perspectives of parents and multi-disciplinary clinicians in addition to those of patients.

METHODS

Patients of an outpatient ED program who were age 10-27 years, along with their parents and clinicians, were recruited to participate in a longitudinal web-based study. Using univariate, bivariate, and multivariate analyses, we assessed rates of participation among different groups (i.e., parents, patients, different clinical disciplines) as well as factors related to attrition.

RESULTS

71% of patients, 75% of parents, 56% of adolescent medicine providers, 20% of primary care physicians, 83% of dietitians, and 80% of mental health clinicians invited agreed to participate. At 12 months, 32% of patient participants had not completed their on-line surveys. Attrition rates were higher for parents (55%) and clinicians (45% of nutritionists, 55% of primary care physicians, 51% of Adolescent/Young Adult providers, and 64% of mental health providers) at 12 months.

CONCLUSIONS

A longitudinal registry of patients with EDs is feasible and efficient when using web-based surveys. However, clinician participation is particularly hard to secure and maintain.

International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report

BACKGROUND

Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level.

METHODS

As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment.

RESULTS

Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology.

CONCLUSION

Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.

Harmonica consensus, controversies, and future directions in radiotherapy for pediatric Wilms tumors

Radiotherapy (RT) is essential for multimodality treatment of pediatric renal tumors, particularly in higher-risk and metastatic disease. Despite decades of use, particularly for Wilms tumor, there remain controversies regarding RT indications, timing, dose, and targets. To align global management, we address these issues in this international HARMONIsation and CollAboration (HARMONICA) project. There are multiple knowledge gaps and opportunities for future research including: (1) utilization of advanced RT technologies, including intensity-modulated RT, proton beam therapy, combined with image-guided RT to reduce target volumes; (2) impact of molecular biomarkers including loss of heterozygosity at 1p, 16q, and 1q gain on RT indications; (3) mitigation of reproductive toxicity following RT; (4) promotion of RT late effects research; and (5) support to overcome challenges in RT utilization in low- and middle-income countries where 90% of the world's children reside. Here, we outline current status and future directions for RT in pediatric renal tumors.

How Can Genomic Innovations in Pediatric Brain Tumors Transform Outcomes in Low- and Middle-Income Countries?

Pragmatic ways to apply molecular innovation to childhood brain cancer diagnosis and therapy in LMICs