Recommendations for the treatment of children with radiotherapy in low‐ and middle‐income countries (LMIC): A position paper from the Pediatric Radiation Oncology Society (PROS‐LMIC) and Pediatric Oncology in Developing Countries (PODC) working groups of the International Society of Pediatric Oncology (SIOP)

Abstract

Pediatric radiotherapy is a critical part of pediatric oncology protocols and the quality of the radiotherapy may determine the future quality of life for long-term survivors. Multidisciplinary team decision making provides the basis for high-quality care. However, delivery of highquality radiotherapy is dependent on resources. This article provides guidelines for delivery of good quality radiation therapy in resource-limited countries based on rational procurement and maintenance planning, protocol development, three-dimensional planning, quality assurance, and adequate staff numbers and training. K E Y W O R D Sadapted treatment regimen, low and middle income countries, LMIC, Pediatric radiotherapy, PODC, PROS

Science and health for all children with cancer

“…Ideally, these factors should be considered in the planning of adapted treatment regimensfor instance, by planning medicines that can be substituted for commonly unavailable or unaffordable medicines, or including funding for a clinical coordinator/patient navigator to help reinforce adherence to the treatment regimen. The International Paediatric Oncology Society (SIOP, www.SIOP-online.org) has established procedures to develop and deploy such regimens (28,41,(56)(57)(58).…”

Deviation From Delivery Of Radiation Therapy To Childhood Cancer Patients: A Retrospective Audit

“…(3) This is because globally access to RT is not uniform and there are deficiencies in availability of RT machines, trained staff, as well as aspects of quality like input of interdisciplinary RT teams, treatment planning protocols, and quality assurance. (3,4) This is an under-researched area in low and middleincome countries (LMIC) including India where most of the childhood cancer cases occur.…”

Establishing a pediatric radiation oncology department in a low‐ and middle‐income country: Major challenge in implementing the Global Initiative for Childhood Cancer

“…Our experience highlights the multiple difficulties that LMICs face in establishing radiation treatment facilities 23 . MAHAK's experience shows that to implement RT services for childhood cancers, several requirements must be met beyond the procurement of the equipment 34 . In particular, training knowledgeable and skilled workforce with communication skills and implementing a family‐friendly environment are major endeavors that may take years to succeed 35 .…”