Aims: This study aims to evaluate the knowledge and referral practices regarding pediatric palliative radiotherapy (PRT) among Radiation Oncologists (ROs) and Pediatric Oncologists (POs) in Italy, focusing on identifying knowledge gaps, referral patterns, and barriers to the optimal utilization of PRT in pediatric oncology. Methods: A national survey, initiated by AIRO and AIEOP, was conducted from September 2022 to February 2023. Separate questionnaires for ROs and POs were developed and distributed, focusing on the indications for PRT, current utilization practices, and perceived barriers. The data collected were analyzed using the SPSS software, employing Chi-square tests for statistical significance and univariate analysis to explore correlations between respondent characteristics and their perspectives on pediatric PRT. Results: Out of 70 ROs and 23 POs who responded, 24.3% of ROs and 91.3% of POs treated between one to five pediatric patients with PRT annually. A significant gap was found in the self-assessed knowledge of pediatric PRT, with 57% of ROs considering their understanding inadequate, in contrast to 30% of POs. The survey highlighted a perceived underutilization of PRT, with 70% of ROs and 65% of POs advocating for its more frequent application. Barriers identified included logistical challenges, with 78% of POs citing distance to the RT department as a primary obstacle, and concerns over potential side effects, particularly among ROs (60%). Conclusion: The survey underscores a critical need for enhanced education and interdisciplinary collaboration to improve the understanding and utilization of pediatric PRT. Addressing identified knowledge gaps, standardizing patient selection methods, and overcoming logistical and perceived barriers could significantly advance the quality of pediatric palliative care.

Background: Music therapy (MT) is a complementary therapy offered to children, young adults and their families in pediatric oncology and palliative care. We performed a survey to collect information about MT in pediatric oncology in Italy. The outbreak of COVID-19 unavoidably changed the scenario of MT, suggesting some considerations presented in this survey. Methods: 27/32 (84,4%) Centres belonging to the Italian Association of Pediatric Hematology and Oncology (AEIOP) completed in 2 different time points (T1 and T2) an online survey on MT, before and after Covid-19 pandemia. Results: Different kinds of music approach were used taking care of patients in 21/27 centers, while in 14/21 (66%) a specific project of MT conducted by a music therapist was present. In 6/14 Centres MT activities were delivered for <3 hours/week, in 3 Centres for >3 and <10 hours/week, in the remaining 5 for >3 hours/week. MT sessions were in different areas, day hospital or ward (patient rooms, operating rooms, waiting rooms), on an individual basis or by groups. Patients were invited to MT by psychologists, caring physician or nurse, or on equipé decision. MT was evaluated with tools self-made by Music therapist in 11/14 centres. After Covid-19. MT has been withdrawal in 3 centres, sessions in the waiting rooms were reduced, individual sessions were preferred and enrollment by multidisciplinary teams increased. Conclusion: This survey represents the starting platform to compare and discuss different experience of MT in AIEOP Centres, to implement MT in pediatric oncology for a more qualified assistance to patients and to improve quality of care.