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Radiotherapy Utilization and Treatment Continuity of Pediatric Patients With Brain Tumor in Egypt: A Decade of Data
Breana Wayne1, Mohamed Saad Zaghloul2, Mohamed El-Beltagy3
1Department of Public Health, Washington University in St Louis Brown School of Public Health, St Louis, MO.
Insights
Radiotherapy use for pediatric brain tumors in Egypt varied by tumor type. Urban patients had higher radiotherapy completion rates than rural patients, highlighting healthcare access disparities.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Public Health
Background:
- Pediatric brain tumors are a significant health concern.
- Radiotherapy (RT) is a critical treatment modality for many pediatric brain tumors.
- Understanding RT utilization and completion is essential for optimizing patient outcomes.
Purpose of the Study:
- To assess radiotherapy utilization and completion rates among pediatric patients with brain tumors treated at Children's Cancer Hospital Egypt (CCHE).
- To identify factors influencing RT utilization and completion, including tumor type and geographic residence.
Main Methods:
- Retrospective analysis of pediatric brain tumor patients treated at CCHE from 2009-2020.
- Categorization based on demographics, tumor types, RT status, and urban/rural residence.
- Statistical comparison of RT utilization and completion rates using chi-square tests.
Main Results:
- 58.5% of 3,977 pediatric brain tumor patients were prescribed RT.
- Highest RT utilization seen in diffuse intrinsic pontine glioma (98.2%) and germinoma (98.0%).
- Lowest RT utilization in nonoptic low-grade glioma (11.2%) and optic pathway glioma (2.0%).
- 97.2% of prescribed RT patients completed treatment; highest noncompletion in atypical teratoid rhabdoid tumor (6.7%) and nonoptic LGG (9.7%).
- Urban patients (98.3%) had higher RT completion than rural patients (95.9%).
Conclusions:
- RT utilization and completion rates significantly varied by pediatric brain tumor type.
- Geographic disparities in RT completion indicate healthcare inequities in Egypt.
- Targeted interventions, such as decentralized RT delivery and public health strategies, are needed to improve access and adherence, especially for underserved populations.
Purpose:
We assessed radiotherapy (RT) utilization and completion among pediatric patients with brain tumor treated at Children's Cancer Hospital Egypt (CCHE).
Methods:
A retrospective analysis was conducted among pediatric patients with brain tumor treated at CCHE between 2009 and 2020. Patients were categorized on the basis of demographics, tumor types, RT utilization status (prescribed, not prescribed, and did not complete), and geographic place of residence (urban v rural). RT utilization was stratified by tumor type and geographic region and compared using chi-square tests.
Results:
Among 3,977 pediatric patients with brain tumor, 2,327 (58.5%) were prescribed RT. The highest RT utilization was observed among patients with diffuse intrinsic pontine glioma (DIPG; 98.2%) and germinoma (98.0%), while nonoptic low-grade glioma (LGG; 11.2%) and optic pathway glioma (OPG; 2.0%) had the lowest among patients prescribed RT, 2,264 (97.2%) completed treatment. The highest noncompletion was observed in patients with atypical teratoid rhabdoid tumor (ATRT; 6.7%) and nonoptic LGG (9.7%). Urban patients had a higher rate of RT completion (98.3%) compared with rural patients (95.9%; P < .001).
Conclusion:
RT utilization and completion varied significantly by tumor type, reflecting evidence-based treatment protocols and tumor-specific challenges. Geographic disparities in RT completion underscore systemic health care inequities in Egypt. These findings emphasize the need for targeted interventions, including decentralized radiotherapy delivery models and public health strategies, to improve access to and adherence to radiotherapy among underserved populations.
