BACKGROUND: In the absence of population based cancer registries, hospital records can only highlight the importance of collection and analysis of data to address the burden of cancer among children. For this purpose, a hospital-based registry’s pediatric cancer data (individuals aged 0-18 at diagnosis) from 2010 to 2019 was compiled and analyzed at AKUH in Karachi, Pakistan. METHODS: A paper-based system is used to record all interactions with patients at the hospital. A dedicated team of Cancer Registrars transcribe this data onto a US based registry software; CNExT. Registry data was extracted through software generated reports and compiled for analysis. RESULTS: The total number of children presented at our center was 2,694, out of which 1,673 were males while 1,021 were females. Top 5 sites were bone marrow (n=887), central nervous system (n=481), lymphoid tumors (n=294) bone (n=255) and soft tissues (n=145). All other sites contributed to 632 cases, 23.5% of the total patient population. Furthermore, 806 patients were aged 0-4, 627 were aged 5-9, 684 were aged 10-14 while 966 patients were 15-19 years old.. A consistent increase of 210% was noted during the 10-year period. CONCLUSION: Our database analysis shows that the top cancer sites are consistent with other databases around the world. Increase in numbers may reflect awareness and referral pattern emphasizing the need for capacity building at the national level to accommodate patients locally so families don’t have to travel over provincial and international borders to receive treatment.

Background: This study aims to improve practices in pediatric radiation oncology in LMIC by sharing an institutional experience of radiation therapy (RT) for pediatric cancer at the Aga Khan University Hospital. Methods: All patients from January 2009 to December 2020 who received radiation therapy at Aga Khan University Hospital were included. Records were retrospectively reviewed from hospital information management system (HIMS) and radiation oncology information system were searched to identify children aged up to 19 years of age who received RT based on the pediatric protocol. Data was reviewed for frequencies and percentages were calculated for demographics, clinical characteristics, and treatment-related variables. Results: A total of 496 patients were offered RT for soft tissue and extra osseous sarcomas (n=115 patients, 23.2%), lymphomas and reticuloendothelial neoplasms (n=88 patients, 17.7%) and CNS and miscellaneous intracranial and intraspinal neoplasms (n=86 patients, 17.3%) and malignant bone tumors (n=77, 15.5% patients). The most common regions for radiation were head and neck (n=144, 29%) and CNS (n= 123, 24.3%). General anesthesia was used for radiation planning and/or execution of treatment in 122 (26.8%) patients. More than half the patients (n=261, 53.16%) received RT in the postoperative setting, 89 (18.13%) had RT as consolidative treatment. 30 (6.1%) leukemia patients received prophylactic radiation therapy and 103 (20.98%) received RT as a definitive treatment modality. Conclusions: Our study reinforces the use of radiation therapy in multidisciplinary management of different pediatric tumors. A multi-level pediatric cancer registry is required to assess the utilization of radiotherapy for different pediatric tumors. This will help in planning systems to cater to the needs of pediatric oncology management and survivorship.