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. Introduction
The role and need for radiation therapy (RT) of childhood cancer
treatment is well established.(1) Despite declining trends of use over
time,(2) it remains a critical part of multimodality treatment for
several childhood cancers.(1) Modern treatment protocols are complex and
multidisciplinary and often prescribe in detail the indication, the
timing, the field and the dose of RT with additional guidance on
managing toxicity.
The delivery of RT thus needs a level of coordination and planning which
can be challenging in resource-limited settings.(3) This is because
globally access to RT is not uniform and there are deficiencies in
availability of RT machines, trained staff, as well as aspects of
quality like input of interdisciplinary RT teams, treatment planning
protocols, and quality assurance.(3,4) This is an under-researched area
in low and middle-income countries (LMIC) including India where most of
the childhood cancer cases occur.
In this retrospective study we audit the profile of children undergoing
RT at our centre and analyze deviation from accepted norms during their
treatment. This information will provide us guidance on how to further
improve the delivery of our RT services.