Analysis of the Pediatric Radiotherapy Landscape in Mexico and a Subsequent Educational e-Contouring Intervention

Area of Science:

• Oncology
• Radiation Therapy
• Pediatric Cancer

Background:

• Mexico and Central America exhibit the highest childhood cancer incidence in the Western Hemisphere.
• Disparities in pediatric oncology knowledge contribute to this incidence.
• Understanding the current state of pediatric radiation oncology in Mexico is crucial.

Purpose of the Study:

• To assess the self-identified treatment patterns and needs of pediatric radiation oncologists in Mexico.
• To pilot an educational workshop aimed at enhancing contouring accuracy for pediatric radiation oncology.

Main Methods:

• A 35-question survey was distributed to radiation oncologists via the Sociedad Mexicana de Radioterapeutas (SOMERA) listserv.
• A contouring workshop focused on challenging pediatric malignancies (high-grade glioma, medulloblastoma, Hodgkin lymphoma).
• The Dice metric was used to quantify improvements in target volume accuracy before and after the workshop, with statistical analysis via the Wilcoxon sign-rank test.

Main Results:

• Out of 94 respondents, 79 completed the survey; 76% felt comfortable treating pediatric patients, and 62% knew national pediatric treatment protocols.
• Access to supportive services varied, with limited availability of fertility (14%) and neurocognitive (27%) support, and minimal child-life support (1%).
• The contouring workshop demonstrated statistically significant improvements in all target volumes.

Conclusions:

• This study presents the first national assessment of pediatric radiotherapy capacity in Mexico.
• A Latin American e-contouring educational intervention using pre- and post-workshop Dice metrics showed significant improvements.
• Partnership with SOMERA and Continuing Medical Education (CME) incentives enhanced participation and educational outcomes.