{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T13:06:07Z","timestamp":1779541567231,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stark disparities in pediatric cancer outcomes persist between high and low sociodemographic index (SDI) regions due to fragmented healthcare systems and limited subspecialty expertise. In Pakistan, where pediatric radiation oncology expertise is not widely available, ensuring quality assurance (QA) is critical to mitigate errors that can lead to suboptimal treatment outcomes and long\u2010term consequences in children. To address this, virtual Pediatric Radiation Oncology Peer Review Meetings (PROPRMs) were initiated in 2022 to foster collaborative decision\u2010making and standardize treatment across the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyzed data from June 2022 to March 2025 from virtual PROPRM sessions organized by the Aga Khan University Hospital. Multidisciplinary meetings involving radiation and pediatric oncologists from multiple centers across the country transitioned from monthly to fortnightly. Case volume, clinical diagnoses, and management adjustments were documented and analyzed using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 130 cases were reviewed across 46 sessions. The most common diagnostic categories were soft\u2010tissue sarcomas (33.8%) and bone tumors (16.2%). Notably, consensus\u2010driven changes in management were recommended in 70.8% of cases. The primary modifications (43.1%) directly involved radiation therapy (RT) planning, specifically regarding radiotherapy dose, technique, and organ\u2010at\u2010risk (OAR) constraints. The sessions also identified recurring educational gaps and systemic needs for improved multidisciplinary coordination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The virtual PROPRM model is a feasible and effective strategy for centralizing specialized expertise and improving QA in resource\u2010limited settings. By identifying systemic gaps and standardizing care, this framework offers a sustainable pathway toward reducing global disparities in childhood cancer outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70213","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:41:07Z","timestamp":1773639667000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Experience of Pediatric Radiation Oncology Peer Review Meetings: First Step Toward Centralizing Pediatric Radiotherapy in Pakistan"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-7628","authenticated-orcid":false,"given":"Bilal Mazhar","family":"Qureshi","sequence":"first","affiliation":[{"name":"Radiation Oncology Section Department of Oncology Aga Khan University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maheen","family":"Zakaria","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section Department of Oncology Aga Khan University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tariq","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section Department of Oncology Aga Khan University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Hina","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section Department of Oncology Aga Khan University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tooba","family":"Ali","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section Department of Oncology Aga Khan University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Nisar","sequence":"additional","affiliation":[{"name":"Department of Oncology Atomic Energy Cancer Hospital (AECH) NORI  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamila","family":"Shuja","sequence":"additional","affiliation":[{"name":"Department of Oncology CENAR Hospital Pakistan Atomic Energy Commission (PAEC)  Quetta Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7746-0724","authenticated-orcid":false,"given":"Kashif Ali","family":"Sarwar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Combined Military Hospital and National University of Medical Sciences  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Atif","family":"Munawar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northwest General Hospital and Research Centre  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muneeb Uddin","family":"Karim","sequence":"additional","affiliation":[{"name":"Department of Clinical &amp; Radiation Oncology Shaukat Khanum Memorial Cancer Hospital and Research Centre  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naureen","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Section Department of Oncology Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Combined Military Hospital and National University of Medical Sciences  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheela","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Oncology Atomic Energy Medical Center (AEMC)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafia","family":"Toor","sequence":"additional","affiliation":[{"name":"Department of Oncology Atomic Energy Cancer Hospital (AECH) NORI  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology INMOL Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taskheer","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Saleem Memorial Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Gul","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology CyberKnife and Tomotherapy Centre Jinnah Postgraduate Medical Center (JPMC)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Imam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology National Institute of Child Health (NICH)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumna","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology CyberKnife and Tomotherapy Centre Jinnah Postgraduate Medical Center (JPMC)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natia","family":"Esiashvili","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.6376"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30339\u20100"},{"key":"e_1_2_8_4_1","unstructured":"Cancer Today. 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