Introduction: Oral mucositis (OM) is a common complication associated with cancer treatment, and it can range from mild to severe degree. Up to 80% of children undergoing chemotherapy will experience some degree of OM, which can get to increase mortality by up to 40% in severe cases. Although OM incidence differs according to cancer type and treatment regimen, children with hematological malignancies experience higher incidence and prevalence than children diagnosed with solid tumors. According to the above, OM is likely to represent a major cause for common protocol-indicated dose reduction and, hence, for treatment delay. Therefore, this work analyzes approaches that been used to impact on OM prevention and opportune treatment, in addition to contributing to yet-unpublished national statistics. Material and Methods: This was a retrospective, descriptive study of 157 cancer-diagnosed pediatric patients attended to during the period from September 2014 to June 2016 and who were at risk for experiencing an OM event during their treatment stage. Results: OM occurrence was 21.6% and annual prevalence was 2.6% out of a total of 1731 assessments. Conclusions: Our results are promising, and expanding the sample size, as well the perspective of collaboration with other institutions is suggested in order to promote a standardized oral care protocol for children diagnosed with cancer. (creativecommons.org/licenses/by-nc-nd/4.0/). KEYWORDSOral mucositis; Pediatric cancer; Oral care protocol Protocol for the prevention and care of oral mucositis in pediatric patients diagnosed with cancer 97

Resumen Introducción: La mucositis oral (MO) es una complicación frecuente asociada al tratamiento oncológico, y puede ir desde un grado leve a uno grave. Hasta el 80% de los niños sometidos a quimioterapia experimentarán algún grado de MO, que puede llegar a incrementar la mortalidad hasta en un 40% en los casos graves. Aunque la incidencia de MO difiere de acuerdo con el tipo de cáncer y el régimen de tratamiento, los niños con neoplasias hematológicas experimentan una incidencia y una prevalencia mayores que aquellos niños con diagnóstico de tumores sólidos. De acuerdo con lo anterior, la MO llega a representar una causa importante en la reducción de dosis común protocolizada y por lo tanto un retraso en el tratamiento, por lo que este trabajo analiza el impacto que se ha tenido en la prevención y el tratamiento oportuno de la MO, además de contribuir a estadísticas nacionales que aún no se encuentran reportadas. Material y métodos: Estudio retrospectivo y descriptivo de 157 pacientes con diagnóstico oncológico pediátrico atendidos durante el periodo de septiembre de 2014 a junio de 2016 con riesgo de presentar un evento de MO durante su etapa de tratamiento. Resultados: La presentación de MO fue del 21.6% y la prevalencia anual fue del 2.6%, del total de 1731 valoraciones. Conclusiones: Nuestros resultados son prometedores y se propone ampliar el tamaño de la muestra, así como la perspectiva de colaboración con otras instituciones, para promover un protocolo estandarizado del cuidado bucal en niños con diagnóstico oncológico. (creativecommons.org/licenses/by-nc-nd/4.0/). ARTÍCULO ORIGINALImpacto de un protocolo de prevención y atención de mucositis oral en pacientes con diagnóstico oncológico pediátrico

Background: Pediatric cancer incidence in Mexico is 160/million/year with leukemias making 49.8% of the cases. While survival rates have been reported in various Mexican studies, no data is available from the Telethon Pediatric Oncology Hospital-HITO, a nonprofit private institution specialized exclusively in comprehensive pediatric oncology care in the country that closely follows high-income countries' advanced standards of cancer care. Aim: To determine overall survival (OS) and relapse-free survival (RFS) in patients treated at HITO between December 2013 and February 2018. Methods and results: Secondary analysis of data extracted from medical records. It included 286 children aged 0-17 years diagnosed with various cancers grouped into three categories based on location: (1) Acute lymphoblastic leukemia (ALL), ( 2) tumors within the central nervous system (TWCNS), and (3) tumors outside the CNS (TOCNS). OS and RFS rates for patients who completed 1 (n = 230) and 3 (n = 132) years of follow-up after admission were computed by sex, age, and cancer location, and separately for a subsample (1-year = 191, 3-years = 110) who fulfilled the HITO criteria (no prior treatment, underwent surgery/chemotherapy when indicated, and initiated therapy). TOCNS accounted for 45.1%, but ALL was the most frequent single diagnosis with 28%. Three-year OS for patients with ALL, TWCNS, and TOCNS who fulfilled the HITO criteria were 91.9%, 86.7%, and 79.3%, respectively; for 3-year RFS these were 89.2%, 60%, and 72.4%. Boys showed slightly higher OS and RFS, but no major differences or trends were seen by age group. Conclusion:This study sets a relevant reference in terms of survival and relapse for children with cancer in Mexico treated at a private oncology center that uses a comprehensive and integrated therapeutic model.

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BACKGROUND Central nervous system (CNS) tumors are the most common solid neoplasms in the pediatric age, they comprise about a quarter of all cancers at this age. Little is known about the specific epidemiology of this group in Mexico and there are no reports of results focused on the Performance Status of patients who are treated in a multidisciplinary setting. OBJECTIVE To describe the Performance Status of CNS pediatric patients after being treated with a multidisciplinary approach in a tertiary center. METHODS We report a retrospective chart review of all pediatric patients who presented to the Neuro-Oncology Clinic at Teleton Pediatric Oncology Hospital in Queretaro, Mexico, from December 2014 to January 2020. We analyzed age, gender, the extent of surgical resection and histopathology. Performance Status was assessed using ECOG and Karnofsky/Lansky scores during every patient’s last follow-up visit. RESULTS A total of 56 patients were treated, epidemiology and histopathology variants are similar to those described in the international literature. With a median follow-up of 33 months, 35 patients are alive (62.5%), 28 of them (74.2%) have an excellent Performance Status (ECOG score 0 or Lansky/Karnofsky ≥ 90), 5 (14.2%) scored ECOG 1–2 and only 4 (11.4%) scored ECOG 3–4. CONCLUSIONS A multidisciplinary approach with a focus on Performance Status and the potential for neurological recovery is essential in the management of pediatric patients with CNS tumors. Efforts should be aimed at reducing post-surgical morbidity and early rehabilitation to reintegrate patients into society in the long term.