{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:59:58Z","timestamp":1790171998993,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"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":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with Ewing sarcoma (ES) and rhabdomyosarcoma (RMS) across Asia, the Middle East and Africa often require cross\u2010border referral for advanced radiotherapy, risking a disruption of multimodality care. We evaluated whether a structured referral network could deliver advanced radiotherapy while preserving treatment continuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010centre study included 54 consecutive children (27 ES, 27 RMS) treated in India between 2019 and 2025, referred from 13 countries and 11 Indian states. Primary endpoints were radiotherapy completion, treatment interruptions, chemotherapy continuity, treatment abandonment and follow\u2010up retention. Survival outcomes were secondary endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 7 years (range, 1\u201318), and 87% received proton beam therapy. All patients completed planned radiotherapy; interruptions occurred in only three patients, all \u22644 days. There was no treatment abandonment, and loss to follow\u2010up was 2%. Planned chemotherapy was completed in all patients, with shared delivery between referring and treating centres in 80%. Median time from chemotherapy initiation to radiotherapy was 23.3 weeks for ES and 17.7 weeks for RMS. Among patients receiving definitive radiotherapy, treatment began within 15 weeks of chemotherapy start in 72% of ES and 88% of RMS patients. After radiotherapy, 63% resumed chemotherapy within 14 days and 78% within 21 days. Three\u2010year overall survival and progression\u2010free survival were 89.7% and 55.0% for ES (100% and 66.4% in localised disease) and 82.5% and 69.7% for RMS (90.0% and 74.2% in localised disease).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a single\u2010centre cohort of children referred across state and national borders, a structured referral network enabled the delivery of advanced radiotherapy while preserving multimodality treatment continuity. Although survival outcomes are descriptive and derived from a selected cohort, this model may inform access strategies in regions without local advanced radiotherapy capability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70657","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:35:27Z","timestamp":1789047327000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced Radiotherapy Across a Multi\u2010Geography Referral Network for Children With Ewing Sarcoma and Rhabdomyosarcoma: Treatment Delivery and Early Outcomes\u2014A Single\u2010Centre Experience"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-7935","authenticated-orcid":false,"given":"Srinivas","family":"Chilukuri","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhilasha","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sham","family":"Sundar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu","family":"Ramanujan","sequence":"additional","affiliation":[{"name":"Bone &amp; Soft tissue Management Team Apollo Proton Cancer Centre Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Uppuluri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology &amp; Oncology Apollo Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revathi","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology &amp; Oncology Apollo Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhakrishnan","family":"Satheesan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Apollo Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indumathi","family":"D.","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1612-1144","authenticated-orcid":false,"given":"Anand","family":"Murugesan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhilipkumar","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4447-3083","authenticated-orcid":false,"given":"Godson","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Jawahar","sequence":"additional","affiliation":[{"name":"Department of Radiology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0318-5536","authenticated-orcid":false,"given":"Rakesh","family":"Jalali","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Apollo Proton Cancer Centre  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00053"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00358"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.41.5703"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.3768"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-023-01817-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2024.1801"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.jcrt_775_22"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28604"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijc.ijc_1149_21"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/927123"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29081"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ortho.IJOrtho_388_17"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23861"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110270"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.11.048"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.07.1989"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00915"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.7207"},{"key":"e_1_2_9_20_1","volume-title":"ASTRO Model Policies: Proton Beam Therapy (PBT)","author":"American Society for Radiation Oncology","year":"2023"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30337-1"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2019.01.002"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00236-3"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2018.02.032"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.04.024"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135230"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.02.001"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00129"}],"container-title":["Pediatric Blood &amp; 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