Estimation of the optimal radiotherapy utilization rate for childhood neuroblastoma

Azumi Fukushima, nternational Atomic Energy Agency,,Austria
Varsha Hande, nternational Atomic Energy Agency,,Austria
Katherinec Wakeham, nternational Atomic Energy Agency,,Austria
Michael B. Barton, nternational Atomic Energy Agency,,Austria
Mohamed S. Zaghlou, nternational Atomic Energy Agency,,Austria
Daniel C. Moreira, Children's Research Hospital,USA
Nickhill Bhakta, Children's Research Hospital,USA
Kathy Pritchard Jones, University College London
Michael Sullivan, University College London
Bilal Mazhar Qureshi, Aga Khan University

Voloume,issue and pagination is not provided by author/publisher


Background and purpose: The optimal utilization rate of radiotherapy (oRUR) serves as a benchmark for assessing service demand and improving access to cancer care. While it is estimated that approximately 50 % of adult cancer patients require external beam radiotherapy during their treatment, there is a scarcity of data regarding the optimal use of radiotherapy in pediatric cancer. In this study, we adopted an established method and developed a model to estimate the oRUR in childhood neuroblastoma.
Materials and methods: We developed a decision tree model to calculate the oRUR using indications for radiotherapy and corresponding epidemiological data collected through systematic review and meta-analysis. Sensitivity analyses were performed to evaluate the impact of variations in radiotherapy indications between treatment protocols and variables in the model. We calculated and compared the oRUR for global, high-income, and low- and middle-income settings.
Results: The oRUR for pediatric neuroblastoma was 64 % (95 % CI: 58 %-71 %) in the global setting, 50 % in high-income countries, and 68 % in low- and middle-income countries. The impact of variation in radiotherapy indications between major international treatment protocols was negligible.
Conclusion: The knowledge of oRUR is crucial for evaluating current practices, identifying gaps in access, and planning future radiotherapy services for treating childhood cancer. Based on our results, 64 % of children with neuroblastoma have an indication for radiotherapy. Patients in low- and middle-income countries have more indications for radiotherapy than those in high-income countries, due to a more adverse tumour stage distribution caused by limited access to healthcare resources