RESULTS
A total of 496 patients under the age of 19 received radiation therapy as part of their cancer treatment at the Aga Khan University between 2009 and 2020. All patients received radiation therapy after discussion in a pediatric tumor board meeting\sout. These patients’ constitutes about 5 % of the total 9,920 patients who received RT during the same time period at Radiation Oncology facility of Aga Khan University. A total of 269 out of these 496 were referred to our hospital for radiation therapy only. Among the study group, 326 patients (65.72%) were male and 170 (34.27%) were female. There were 104 patients (21%) less than 5 years. The most common age group was 5-9 years (166 patients, 32.7%) followed by those between the ages of 10-14 years (121 patients, 24.2%). There were 129(26%) patients treated with general anesthesia. However, the most frequent utilization of general anesthesia was found in children with age group 1-5 years (88 patients). The age-wise distribution of all the patients included is shown in Figure 1.
The most common diagnoses for which patients were given RT were soft tissue and other extra osseous sarcomas (n=115 patients, 23.2%), specifically rhabdomyosarcomas (n=93, 18.7%) followed by lymphomas and reticuloendothelial neoplasms (n=88 patients, 17.7%) specifically Hodgkin’s lymphomas (n=84, 16.9%), CNS and miscellaneous intracranial and intraspinal neoplasms (n=86 patients, 17.3%) and Malignant bone tumors (n=77, 15.5% patients). The most common sites for radiation were head and neck (n=144, 29%) and CNS (n= 123, 24.3%). Tumor-wise and site-wise distribution of patients are shown in Figure 2 and 3, respectively.
The use of general anesthesia was required for radiation planning and/or execution in 122 patients (26.8%) and were all under the age of 13 as shown in Figure 2. 118 patients had unplanned gap in treatment, with 36 patients having a break of more than 7 days with the longest gap of 15 days.
Almost half the patients (n=261, 53.16%) received RT in the postoperative setting, 89 (18.13%) for consolidative treatment, and 5 (1%) patients received radiation therapy as palliative treatment. 103 (20.98%) received RT as part of definitive treatment and 30 (6.1%) leukemia patients received prophylactic radiation therapy to CNS. This study showed that the use of radiation therapy as part of pediatric cancer treatment has consistently increased over the last few years as evident in figure 04.