Lmic-18. Resources for the Practice of Pediatric Neuro-Oncologyin Mexico: A Cross-Sectional Evaluation

Abstract 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 pediatrc neuro-oncology (PNO) in Mexico. METHODS A cross-sectional online survey with 35 items was designed to assess PNO resources and services. The survey was distributed to the members of the Mexican Association of Pediatric Oncology and Hematology (AMOHP). RESULTS Overall, responses from 33 institutions were obtained. Responding institutions covered 9 healths systems in Mexico, including private and public institutions. Most of the participating centers have at least 2 pediatric oncologists, so in up to 42% of cases, the approach to children with brain tumors is initiated by a pediatric oncologist. Only half of the responding centers have complete chemotherapy treatments. Only 18% of the centers had access to targeted therapy. The majority (88%) of institutions had a blood bank, but 4 of the participating centers did not have a PICU. All centers have a pathologist but only perform basic immunohistochemistry techniques and have an average diagnostic timeframe of 2 weeks. Surgical treatment is usually available 8 to 14 days after the patient is admitted in 45% of centers. Some centers have radiotherapy available at the facility, others must be sent to other hospitals, but most (42%) can start radiotherapy within the first week after treatment is requested. Infectious processes are a common cause of death in children with brain tumors and only the centers have a half-integrated palliative care team. CONCLUSIONS This is the first situational overview of the resources available in Mexico, showing disparities in resource capacity and lack of a specific and efficient diagnosis that allow early initiation of treatmen. These data will allow for the prioritization of interventions.