Pediatric Neuro-Oncology in Countries with Limited Resources

Pediatric central nervous system tumors are a leading cause of cancer-related mortality and morbidity in high-income countries. Limited data are available concerning the incidence of these tumors in low-income countries, due to lack of proper cancer registries and shortage of publications. The management of childhood brain tumors faces several challenges in countries with limited resources. Delayed presentation, insufficient number of specialists (pediatric neurosurgeons, pediatric oncologists, and radiation oncologists), and shortage of radiological diagnostic tools like MRI, of neurosurgical equipment, or of radiation machines are significant obstacles. In addition, abandonment of treatment and loss of follow-up are common, mostly for social or economic reasons. Pediatric neuro-oncology is relatively a new subspecialty and requires close multidisciplinary teamwork. This is attempted but not efficiently executed in many developing countries. Some of these difficulties can be managed by enriching the resources through international collaborations; others may need shared experience with more advanced countries through twinning programs. Successful experiences have been conducted in the recent years that demonstrate the possibility to improve the care of children with brain tumors in countries with limited resources.