The organization of care in pediatric radiotherapy across SIOP Europe affiliated centers: A multicenter survey in the framework of the 'Joint Action on Rare Cancers' project

Geert O Janssens*, Beate Timmermann, Anne Laprie, Henry Mandeville, Laetitia Padovani, Cyrus Chargari, Pamela Kearns, Olga Kozhaeva, Leila Kameric, Anita Kienesberger, Peter S N van Rossum, Tom Boterberg, Yolande Lievens, Gilles Vassal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

BACKGROUND/PURPOSE: To reduce inequalities among SIOPE-affiliated countries, standard and optional levels to deliver 'Good Clinical Practice' compliant treatment in pediatric radiation oncology have been published. The aim of this project was to map the availability of pediatric radiotherapy resources across SIOPE-affiliated radiotherapy departments.

MATERIALS/METHODS: An online survey with 34 questions was distributed to 246 radiotherapy departments across 35 SIOPE-affiliated countries. In addition to demographic data, 15 general items related to the organization of the radiotherapy process, and 10 radiotherapy-specific items were defined. For each of the 25 items, sum scores were calculated per center and country. Mann-Whitney U tests were used to analyze associations.

RESULTS: Between March-June 2019, 121 departments (49 %) out of 31 countries (89 %) completed the survey. At center level, involvement of core disciplines in tumor boards (28 %), and integration of dedicated pediatric radiation therapy technologists (24 %) are limited, while rare & complex brachytherapy procedures are performed in many centers (23 %). For general and radiotherapy-specific items respectively, a relevant variation of sum scores was observed across countries (Δgeneral: ≤10 points; ΔRT_specific: ≤5 points) and among centers within a country (Δgeneral: ≤9 points; ΔRT_specific: ≤6 points). Sum scores for general and radiotherapy-specific items were higher in countries with a high-income (p < 0.01) and higher health development index (p < 0.01). A larger annual number of irradiated pediatric patients was associated with higher sum scores for general items (p < 0.01).

CONCLUSION: This survey demonstrates the disparities in organization of pediatric radiotherapy departments between SIOPE-affiliated countries and centers within the same country. Investment is needed to reduce inequalities in pediatric radiotherapy care.

Original languageEnglish
Article number110075
Number of pages7
JournalRadiotherapy & Oncology
Volume191
Early online date28 Dec 2023
DOIs
Publication statusPublished - Feb 2024

Bibliographical note

Funding:
This research was supported by the joint action ‘724161/JARC’ which has received funding from the European Union’s Health Program (2014–2020).

Copyright:
© 2023 The Author(s). Published by Elsevier B.V.

Keywords

  • Pediatric
  • Radiotherapy
  • SIOP Europe
  • JARC
  • Rare cancers
  • Organization

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