loading page

Deviation From Delivery Of Radiation Therapy To Childhood Cancer Patients: A Retrospective Audit
  • +1
  • Rashi Agrawal,
  • Vineeta Goel,
  • Anil Anand,
  • Ramandeep Arora
Rashi Agrawal
Max Super Speciality Hospital Vaishali
Author Profile
Vineeta Goel
Max Super Speciality Hospital Shalimar Bagh
Author Profile
Anil Anand
Max Super Speciality Hospital Saket
Author Profile
Ramandeep Arora
Max Super-Speciality Hospital
Author Profile

Abstract

Background The delivery of Radiation therapy (RT) needs a level of coordination and planning which can be challenging in resource-limited settings. In this retrospective study we describe the profile of children undergoing radiation and analyze deviation from accepted norms. Procedure Data on all children (< 18 years age) with cancer who completed RT from Jan 2009 to Dec 2019 were retrieved. Diagnostic groups with more than 5 patients, were included in the analysis for deviations in RT (Time to start (TTS); total dose delivered (TDD) in Grays; and time to complete (TTC)). We investigated reasons for deviation. Results 207 received RT as front-line treatment (68% Indian, 59% male and 32% received treatment preceding RT outside). Most common diagnosis were brain tumors (44%), lymphoma (13%). leukemia and soft tissue sarcoma (10% each). 23.6% had deviation in TTS, 6.0% in TDD and 24.7% in TTC while 43.4% had at least one deviation in any of these three parameters. Deviation in TTS varied significantly by location of preceding treatment and by cancer (greatest deviation in sarcomas) with issues around access to healthcare the most common reason. Deviation in TTC varied significantly by cancer (greatest deviation in sarcomas and medulloblastoma) with myelotoxicity the most common reason. Conclusions Our study adds to the limited literature on RT quality for children with cancer in LMIC. Certain cancers (sarcomas and medulloblastoma) and patient groups (preceding treatment outside our institute) had the maximum deviation. Barriers to accessing care and myelotoxicity were the two main reasons for this deviation.

Peer review status:UNDER REVIEW

27 Mar 2021Submitted to Pediatric Blood & Cancer
27 Mar 2021Assigned to Editor
27 Mar 2021Submission Checks Completed
12 Apr 2021Reviewer(s) Assigned
30 May 2021Review(s) Completed, Editorial Evaluation Pending