ID #816 Understanding Pediatric Neuro-Oncology Care in Latin America: A Multicenter Survey-Based Study
Jessica Rodrigues, Diana Santos, Lorena Baroni, Rosdali Diaz-Coronado, Regina Campo, Natalia Dassi, Violeta Rivera, Mohamed Abdelbaki, Andrea CappellanoAbstract
Background
Pediatric neuro-oncology care in Latin America (LATAM) is heterogeneous and poorly characterized. We report the results of a multicenter survey evaluating resources and challenges across the region.
Methods
Two online surveys were distributed to LATAM centers via SIOP Latin America (March 2025–January 2026).
Results
Forty-eight centers from 17 LATAM countries responded. The mean annual number of newly diagnosed pediatric brain tumors was 29 (range, 1–150). Most institutions had limited capacity, with fewer than 20 inpatient oncology beds, and only 18.2% had a dedicated pediatric neuro-oncology unit. Basic critical care infrastructure was widely available, including intensive care units (93.9%) and blood banks (90.9%). In-house pediatric neurosurgery was present in 72.7% of centers, yet only 60.6% routinely performed postoperative MRI. Few centers had access to operating microscopes, neuronavigation systems, and audiological evaluation. Surgery and chemotherapy were available in nearly all institutions. Radiotherapy was reported in 25 centers, but only 48.5% provided on-site services; IMRT/3D techniques predominated, while two centers still used cobalt-based radiotherapy. Standard protocols were implemented in 90.9%, although 51.5% reported restricted access to essential medications, and targeted therapies were available in only 21.2%. Multidisciplinary tumor boards existed in 69.7%. Supportive care services were broadly available (>80%), including psychosocial support, palliative care, and specialized nursing. Most centers reported access to key pediatric subspecialists, including neurology, endocrinologists and nephrology.Molecular diagnostics were limited, with FISH being the most common test. Although many centers lacked on-site transplant units, most ensured access through referral networks. Major challenges included shortages of specialized personnel, infrastructure gaps, and limited medication access, with workforce training identified as the highest priority.
Conclusions
Despite dedicated teams, major disparities persist in workforce, infrastructure, and radiotherapy capacity. Regional collaboration and training, with urgent radiotherapy strengthening are needed to strengthen pediatric neuro-oncology care and improve equity and outcomes across Latin America.