Abstract
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.