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Current Status and Challenges in Pediatric Radiation Therapy in China: A Nationwide Survey
JunFang Liao1, Tie Xu1, Peng Chen1
1Department of Radiation Oncology, National Cancer Center/National Clinical Cancer Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Insights
Pediatric radiation therapy (RT) in China faces significant challenges, including workforce shortages and limited access to advanced technology. Improving these areas is crucial for better pediatric cancer patient outcomes.
Area of Science:
- Oncology
- Radiation Therapy
- Pediatric Care
Background:
- Pediatric radiation therapy (RT) is a critical component of cancer treatment for children.
- Ensuring equitable access to high-quality pediatric RT services is a global health priority.
Purpose of the Study:
- To comprehensively evaluate the current state of pediatric RT in China.
- Identify challenges in infrastructure, workforce, and technology access.
- Explore opportunities for improving pediatric RT care delivery.
Main Methods:
- An online survey was distributed to radiation oncologists and clinical teams across China.
- 123 responses were collected from 103 hospitals, covering various aspects of pediatric RT services.
- The survey assessed hospital characteristics, equipment, staffing, patient care, and support systems.
Main Results:
- Only 66.0% of hospitals offer pediatric RT, with few dedicated departments or pediatric radiation oncologists.
- While advanced techniques like IMRT/VMAT are common, proton therapy and specialized rooms are scarce.
- Inadequate anesthesia resources, limited clinical research participation, and inconsistent protocol adherence were noted.
Conclusions:
- Significant gaps exist in China's pediatric RT services, affecting workforce, technology, and holistic support.
- Addressing these deficiencies is essential for improving care and outcomes for pediatric cancer patients.
- Recommendations include workforce development, increased access to advanced RT, and enhanced support systems.
Purpose:
This study aims to provide a comprehensive evaluation of the current state of pediatric radiation therapy (RT) in China, identifying key challenges in infrastructure, workforce, and access to advanced technologies while exploring opportunities for improving care delivery.
Methods And Materials:
A 29-item online questionnaire was distributed to radiation oncologists and clinical teams across China, with 123 responses from 103 hospitals. The survey explored six domains: hospital characteristics, radiotherapy equipment and techniques, pediatric oncology staffing, patient admission and treatment status, treatment and follow-up, and social work support and charitable partnerships.
Results:
Among the 103 hospitals, 66.0% provide pediatric RT, but only 7.4% have dedicated pediatric RT departments, and 57% lack a pediatric radiation oncologist. Advanced techniques like intensity-modulated radiation therapy (IMRT) and volume intensity-modulated radiotherapy (VMAT) are widely used (95.1%), but only 11.7% of hospitals offer proton therapy, and just 8.7% have pediatric-specific radiotherapy treatment room. Anesthesia resources are inadequate, with only 27.2% of hospitals equipped for sedation. Furthermore, 78% of hospitals have not participated in clinical research, and only 33% adhere to standardized treatment protocols. Social work support and charitable partnerships are present in just 44% of facilities.
Conclusions:
Significant gaps in pediatric RT services, including shortages in workforce, advanced technologies, and holistic support systems, hinder equitable care. Addressing these deficiencies through workforce development, increased access to advanced RT modalities, and enhanced support systems is essential to improving outcomes for pediatric cancer patients in China.
