International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Incidence and Clinical Utilization of Radiotherapy of Childhood Tumors in South Korea Using National Health Insurance Sharing Service Data","authors":"J. Chung ,&nbsp;H. Lim ,&nbsp;J. Kim","doi":"10.1016/j.ijrobp.2024.11.044","DOIUrl":"10.1016/j.ijrobp.2024.11.044","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the clinical utilization of radiotherapy for childhood tumors in South Korea using National Health Insurance Sharing Service (NHISS) data.</div></div><div><h3>Methods</h3><div>Children aged 19 or younger diagnosed with childhood tumors from 2003 to 2020 were identified in the NHISS data using the International Classification of Disease 10 (ICD-10) codes C and D. Data from 2003 and 2004 were excluded to adjust for the washout period.</div></div><div><h3>Results</h3><div>Between 2005 and 2020, 36,152 patients were diagnosed with childhood tumors. The distribution over four-year intervals was as follows: 13,716 (0.11% of total population) in the first quadrennial period (2005-2008), 8,846 (0.08%) in the second (2009-2012), 6,893 (0.07%) in the third (2013-2016), and 6,697 (0.07%) in the fourth (2017-2020). Regarding radiotherapy, of the total patients aged 19 or younger, 5.6% underwent treatment in the first period, 10.0% in the second, 11.7% in the third, and 11.7% in the fourth. Among those treated with radiotherapy, 2-dimensional (2D), 3D-conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT) and proton therapy were used in 110 (14.3%), 608 (79.1%), 34 (4.4%) and 8 (1.0%) cases in the first quadrennial period, 50 (5.7%), 604 (68.3%), 170 (19.2%) and 53 (6.0%) cases in the second, 18 (2.2%), 310 (38.4%), 364 (45.0%) and 116 (14.4%) cases in the third, and 4 (0.6%), 83 (12.7%), 405 (61.8%) and 162 (24.7%) cases in the fourth, respectively. The most common tumors treated with radiotherapy, in order of prevalence, were brain (C71; e.g., ependymoma, n=986), benign neoplasm of central nervous system (D33, D43; e.g., craniopharyngioma, n=764), primary bone and cartilage (C40-41; e.g., osteosarcoma, n=286), non-Hodgkin's lymphoma (C83.7 and C85; e.g., b-cell lymphoma, n=200), soft tissue (C46 and C49.9; e.g., rhabdomyosarcoma, n=186), endocrine (C74-75; e.g., adrenal gland tumor, n=164), Hodgkin lymphoma (C81, n=123), and nasopharyngeal cancer (C11.9, n=92).</div></div><div><h3>Conclusions</h3><div>Despite the declining birth rate, the overall incidence rate of childhood tumors remains steady at approximately 0.07% of the total population. Radiotherapy utilization rate showed an increasing trend according to the more recent quadrennial period. This trend may be associated with the introduction of more advanced radiotherapy techniques with extended national health insurance coverage. This tendency was repeatedly manifested in the subset of patients with CNS tumors.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e12"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Survival Among Infantile, Pediatric and Adult Intracranial Medulloblastoma: A SEER Analysis","authors":"V. Chua ,&nbsp;M. Dumago ,&nbsp;J. Jacinto ,&nbsp;C. Villar ,&nbsp;D. Tsang ,&nbsp;J. Co","doi":"10.1016/j.ijrobp.2024.11.027","DOIUrl":"10.1016/j.ijrobp.2024.11.027","url":null,"abstract":"<div><h3>Objective</h3><div>Survival differences in infantile, paediatric, and adult medulloblastoma are unclear. This study aims to determine the difference in the overall survival among infant, pediatric and adult intracranial medulloblastomas and its associated factors</div></div><div><h3>Methods</h3><div>The National Cancer Institute-Surveillance, Epidemiology and End Results (SEER) database was queried for medulloblastoma from 2000 to 2020 using International Classification of Disease(ICD) for Oncology, with morphology codes 9470-9477/3. Age groups were divided into infantile (&lt;3years old), paediatric (3-18years old) and adult (&gt;18 years old). Rates of dying among infantile and adult medulloblastoma were compared to the rate among pediatric medulloblastomas. Chi-squared test was used for categorical variable. Cox-proportional analysis was used, Kaplan-Meier survival curves were generated for the three cohorts and log rank test was performed.</div></div><div><h3>Results</h3><div>1,991 patients were included: infantile(372,18.68%), paediatric(1,026,51.53%) and adult(593,29.78%) medulloblastoma. The 3-year overall survival (OS) were 69.81%, 84.62%, 83.45%; the 5-year OS were 66.65%, 79.46%,76.45%; and the 10-year OS were 63.67%, 72.38% and 66.89% respectively for infantile, pediatric and adult medulloblastoma. Regional and distant disease, large cell medulloblastoma, less than complete surgery, non-receipt of radiotherapy and chemotherapy were associated with higher rate of dying. 297 patients were treated with chemotherapy but not radiotherapy, with majority (220, 74.07%) being infantile medulloblastoma. 216 (36%) of the adult medulloblastoma did not receive any chemotherapy. Less than 5% had molecular classification reported.</div><div>Crude hazard ratio(HR) of infantile compared to paediatric medulloblastoma is 1.65 (95%CI:1.33-2.04). After adjusting for gender, histology/molecular subtyping and receipt of radiotherapy, the HR decreased to 1.29(95%CI:1.01-1.66). Crude HR of adult compared to pediatric medulloblastoma is 1.24(95%CI:1.02-1.51). After adjusting for gender, histology/molecular subtyping and receipt of chemotherapy, the HR decreased to 1.10(95%CI:0.89-1.37).</div></div><div><h3>Conclusion</h3><div>There is a survival difference among infantile, paediatric and adult medulloblastoma. The difference appeared to decrease when adjusted for the treatment and biology.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages e6-e7"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations About the risk of Neurovascular Late Effects in Pediatric Radiotherapy","authors":"L. Toussaint ,&nbsp;L. Tram Henriksen ,&nbsp;K. Van Beek ,&nbsp;S. Bolle ,&nbsp;C. Demoor-Goldschmidt ,&nbsp;J. Gains ,&nbsp;M. Høyer ,&nbsp;S. Isebaert ,&nbsp;G. Janssens ,&nbsp;R. Kortmann ,&nbsp;C. Martins Pedro ,&nbsp;K. Scheinemann ,&nbsp;B. Timmermann ,&nbsp;Y. Lassen-Ramshad","doi":"10.1016/j.ijrobp.2024.11.028","DOIUrl":"10.1016/j.ijrobp.2024.11.028","url":null,"abstract":"<div><h3>Objectives</h3><div>Survivors of pediatric brain tumors are at an increased risk of developing neurovascular disease, with radiotherapy being a major determinant. The aim of this project was to map how the risk of neurovascular late effects is considered when treating pediatric patients with a brain or skull base tumor with radiotherapy.</div></div><div><h3>Methods</h3><div>A web-based survey, prepared in the frame of the HARMONIC project (harmonicproject.eu) together with the SIOPE radiotherapy working group (ROWG) was distributed to ROWG members throughout Europe. The survey included 33 questions about neurovascular structures at risk, screening and information of the patients, recommendations, and follow-up programs.</div></div><div><h3>Results</h3><div>47 participants from 18 European countries completed the survey, with 87% of them treating patients with photon therapy. 39 of the respondents (83%) never delineated specific structures for large vessel disease, mainly because no dose constraints exist (31/39, 79%) and neurovascular structures are not traditionally integrated into pediatric radiotherapy protocols (28/39, 71%). 35 of the respondents (74%) did not screen patients for risk factors of neurovascular disease before radiotherapy. Of the respondents, 22 (47%) informed all patients with a brain or skull base tumor of the risk of large vessel disease after radiotherapy, and 24 (55%) informed all patients of the risk of small vessel disease. 26 (55%) didn't have a follow-up imaging program for neurovascular disease after radiotherapy in pediatric patients, and 32 (68%) didn't have a follow-up program with blood sampling for seromarkers of risks of neurovascular disease. Of note, 94% of the respondents expressed interest in participating in a follow-up workshop on neurovascular disease after radiotherapy in pediatric patients.</div></div><div><h3>Conclusion</h3><div>Despite a general agreement on the importance of this topic, neurovascular late effects are currently not well included in the clinical practice of European radiotherapy centers.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e7"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperparathyroidism in Adult Childhood Cancer Survivors Treated with Radiotherapy: Data from a Tertiary Oncology Centre","authors":"G. Aljawi,&nbsp;X. Wang,&nbsp;S. Wiseman,&nbsp;K. Goddard","doi":"10.1016/j.ijrobp.2024.11.029","DOIUrl":"10.1016/j.ijrobp.2024.11.029","url":null,"abstract":"<div><h3>Objectives</h3><div>Adult Childhood Cancer Survivors (ACCS) who receive radiotherapy (RT) to the neck are at ongoing risk of hyperparathyroidism (HPT). This study explores HPT risk factors and potential screening recommendations.</div></div><div><h3>Methods</h3><div>The clinical records of 12 ACCS diagnosed with HPT aged between 15 and 39 and followed at BC Cancer were reviewed. Patients were treated with RT between 1971 and 2001. Previous cancer treatment, HPT and associated thyroid disease details were collected.</div></div><div><h3>Results</h3><div>Twelve ACCS were identified; 58.33 % females and 41.66% males. Median age at diagnosis for the original cancer was 2.5 years. ACCS received RT for different childhood malignancies; leukemia 25% (3/12), rhabdomyosarcoma 25% (3/12), Wilms tumor 16.66 % (2/12), neuroblastoma 16.66 % (2/12), Hodgkin lymphoma 8.33% (1/12) and ependymoma 8.33% (1/12). Patients received RT to the brain 25% (3/12), craniospinal axis 8.33% (1/12), head and neck 16.66 % (2/12), chest (1/12), whole lungs 16.66 % (2/12) and total body RT 25% (3/12). The median latency period to develop HPT was 37.60 years from time of RT. HPT in almost all patients was diagnosed with routine blood work showing elevated serum calcium (median 2.68 mmol/l) which prompted PTH levels which were elevated (median 14.52 pmol/l). Patients were further investigated and all had parathyroid adenomas. Out of 12 ACCS; 25% developed renal stones (3/12) and 50% had osteoporosis (6/12) as complications of HPT. Patients were evaluated by surgeons and 66.66% (8/12) underwent surgical resection. ACCS with HPT also had hypothyroidisim 50% (6/12), thyroid nodules 66.66% (8/12) and 2 patients had pathology proven papillary thyroid cancer.</div></div><div><h3>Conclusion</h3><div>HPT is a very late complication of RT to the neck. Serum calcium levels should be checked in ACCS in long-term follow-up as HPT is associated with morbidities (renal stones and osteoporosis).</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e7"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Radiation Oncology Society Congress","authors":"","doi":"10.1016/j.ijrobp.2024.11.005","DOIUrl":"10.1016/j.ijrobp.2024.11.005","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e1"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curative Proton Therapy for Infants: At What Cost?","authors":"D. Indelicato ,&nbsp;J. Bradley ,&nbsp;D. Klawinski ,&nbsp;P. Aldana ,&nbsp;E. Sandler ,&nbsp;C. Morris ,&nbsp;R. Mailhot","doi":"10.1016/j.ijrobp.2024.11.017","DOIUrl":"10.1016/j.ijrobp.2024.11.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Infants (age 12 months and younger) are the most difficult population of cancer patients to treat. Historically, radiation would be excluded from treatment options and this view remains prevalent worldwide. New radiation technology may shift this perspective. The purpose of this study is to report the outcomes of infants undergoing treatment with curative-intent proton therapy.</div></div><div><h3>Methods</h3><div>Between 2006-2023, 15 infants with a median age of 11 months (range, 7-12 months) were irradiated at the University of Florida, constituting 0.75% of all pediatric patients treated with curative intent during this period. Eight patients were male and none had metastatic disease. The diagnoses included rhabdomyosarcoma (7), Ewing sarcoma (2), ATRT (1), ependymoma (1), and pineoblastoma (1). All patients were treated with standard radiation doses for their disease and the mean was 50.4 GyRBE (range, 41.1-54). 14/15 patients received disease-specific multi-agent chemotherapy. Cumulative incidence method was used to estimate overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and local control (LC).</div></div><div><h3>Results</h3><div>With a median followup of 3.5 years (range, 01.-11.2 years), the 5 year OS, CSS, PFS, and LC was 58%, 65%, 58%, and 72%, respectively. Two and 5 patients had leptomeningeal and local recurrence, respectively. One patient died from a 1 metachronous rhabdoid tumor in lungs and kidneys. No patients were lost to follow-up. Four of 7 surviving patients experienced serious toxicity including blindness, deafness, vasculopathy and cataracts requiring surgery, global developmental delay, panhypopituitarism, hemorrhagic cystitis, and severe dentofacial and musculoskeletal problems.</div></div><div><h3>Conclusion</h3><div>When proton therapy is utilized as part of a multimodality treatment plan in infants with sarcoma and brain tumors, survival is possible but often comes at the cost of major toxicity. Improvements in patient selection may take us farther than improvements in technology.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e3"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteosarcoma Stereotactic Body Radiotherapy: Factors Associated with Local Failure","authors":"J. Kocsis ,&nbsp;S. Campbell ,&nbsp;L. Angelov ,&nbsp;J. Scott ,&nbsp;M. Trucco ,&nbsp;S. Johnson ,&nbsp;P. Qi ,&nbsp;A. Magnelli ,&nbsp;P. Anderson ,&nbsp;S. Zahler ,&nbsp;S. Thomas ,&nbsp;E. Murphy","doi":"10.1016/j.ijrobp.2024.11.021","DOIUrl":"10.1016/j.ijrobp.2024.11.021","url":null,"abstract":"<div><h3>Objectives</h3><div>Stereotactic body radiotherapy (SBRT) is a noninvasive ablative radiotherapy tool that can be beneficial for sarcoma. Outcomes of SBRT for metastatic or recurrent osteosarcoma are not well known. We sought to understand factors associated with local failure.</div></div><div><h3>Methods</h3><div>Patient, tumor, and treatment factors were collected from an IRB-approved sarcoma SBRT registry and assessed for impact on local failure. Dosimetric analysis was performed to determine patterns of failure. Definition of recurrences: In-field: &gt;80% of recurrent volume within the 95% isodose line, marginal: 20% to 80% of recurrent volume within 95% isodose line, out of field: &lt;20% of recurrent volume within 95% isodose line. Estimates of local failure were determined using the Kaplan-Meier method. Local failure was determined on a per-lesion basis.</div></div><div><h3>Results</h3><div>A total of 24 patients with metastatic osteosarcoma received SBRT to a total of 71 lesions. Median age was 18 and KPS 90. Median number of lesions treated per patient was 4 (R:1-14). Median dose used was 40Gy over 5 fractions, BED₄ was 120Gy. Median imaging follow up was 9.5 months. Targets included: 47 bone (extremity: 12, spine: 24, other: 11), 11 lung, 12 soft tissue, and 1 liver. Median PTV was 36 cc (R: 3-623 cc). Concurrent therapy was given for 57 lesions (75%). Eleven of 71 lesions (15.5%) failed locally. 6- and 12-month local failure was 10.3% and 13.6%, respectively. Type of local failure included in-field in 4, marginal in 3, and out of field in 4. Median SBRT dose for lesions that failed was 35Gy over 5 fractions. Spine targets and PTV size were significantly associated with local failure on both UVA and MVA.</div></div><div><h3>Conclusion</h3><div>SBRT for metastatic osteosarcoma results in durable control. Larger PTV size and spine location are associated with local failure in our series. Further study is warranted.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Pages e4-e5"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Aggressive Approach for Mucinous Prostate Cancer","authors":"Shalini Moningi MD,&nbsp;Peter F. Orio III DO, MS","doi":"10.1016/j.ijrobp.2024.11.008","DOIUrl":"10.1016/j.ijrobp.2024.11.008","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page 584"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ripple: Introducing Routine Patient-Reported Quality of Life Assessment into South Australian Pediatric Oncology Practice","authors":"M. Doig ,&nbsp;S. Jessop ,&nbsp;J. Hansford ,&nbsp;H. Le ,&nbsp;P. Gorayski ,&nbsp;A. Cunningham ,&nbsp;A. Hutchinson ,&nbsp;M. O'Connor ,&nbsp;V. Bedford ,&nbsp;E. Bezak ,&nbsp;N. Parange ,&nbsp;K. Skelton ,&nbsp;T. Price ,&nbsp;M. Short","doi":"10.1016/j.ijrobp.2024.11.014","DOIUrl":"10.1016/j.ijrobp.2024.11.014","url":null,"abstract":"<div><h3>Objectives</h3><div>Health-Related Quality of Life (HRQoL) assessment of children with cancer is not routinely performed in South Australia. Our goal was to co-design and evaluate a digital platform ‘Ripple’ for HRQoL collection and real-time clinical actioning in young patients.</div></div><div><h3>Methods</h3><div>Study 1 involved platform co-design with children, parents, and multi-disciplinary health professionals. The Ripple platform hosts validated PedsQL Generic Core score patient-reported outcome measures (PROMs) in child self-report and parent-proxy versions for children aged 5-12 years. Study 2 involved a 12-month multi-site hybrid implementation-effectiveness study to test the digital platform's feasibility in South Australian paediatric oncology and radiation oncology services. Children aged 5-12 years receiving treatment or follow-up care, a parent and their healthcare team were invited. Children and parents completed PROMs remotely or in clinic to align with clinical milestones. Clinicians were instantaneously notified of results. Preliminary results from Study 2 are presented.</div></div><div><h3>Results</h3><div>Study 1 included 20 participants (seven children, four parents and nine clinicians). In Study 2, 65 participants were recruited, including 28 children, 27 parents and 10 healthcare professionals. 54% of children were female and the median age at recruitment was 7 years. Children were diagnosed with a haematological malignancy (n=19), extracranial solid tumour (n=6) or central nervous system tumour (n=3). Compliance of children and parents completing the scheduled PROMs was 100% and 86%, respectively. Seven of nine clinicians had engaged with the PROM results. Of note, six patients required clinical follow-up based on a PROM entry due to emotional functioning responses (n=6), very low total score (n=2) or a significant decline from previous entry (n=2).</div></div><div><h3>Conclusion</h3><div>Early results show that patient-reported HRQoL assessment using a child-friendly digital platform is feasible in paediatric oncology clinical practice. Further research is needed to investigate whether PedsQL can support psychosocial assessment in this cohort.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e2"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Claims and Hospitalizations for Pediatric Cancer Survivors after Receiving Proton Radiotherapy Compared to Photon Radiotherapy: Real-World Data from 2010-2022","authors":"N. Logie,&nbsp;M. Mahsin,&nbsp;M. Fidler-Benaoudia,&nbsp;A. Harper,&nbsp;D. Bru,&nbsp;R. Nordal,&nbsp;S. Patel,&nbsp;S. Chafe","doi":"10.1016/j.ijrobp.2024.11.015","DOIUrl":"10.1016/j.ijrobp.2024.11.015","url":null,"abstract":"<div><h3>Objectives</h3><div>Proton radiotherapy (PRT) is predicted to have fewer late-effects compared to photon radiotherapy (PHT) in survivors of childhood cancers. While PRT is more costly upfront, the reduction in long-term morbidity is expected to result health-systems savings. In this study, we use real-world data (RWD) to compare physician claims and discharge abstract database (DAD) data in a cohort of pediatric patients receiving PRT/PHT.</div></div><div><h3>Methods</h3><div>Using the Alberta Health Services (AHS) pediatric database; we identified those receiving radiotherapy (RT) between 2010-2022 who met AHS guidelines for PRT. Data from the Alberta Pediatric Cancer Survivors cohort was abstracted including physician claims and DAD data (after completion of RT). Univariate analysis was performed using t-test (sig. p&lt;0.05).</div></div><div><h3>Results</h3><div>Records for 182 patients were reviewed: 28 patients (15.4%) received PRT. Median follow-up (FU) from RT was not different between PRT (8.5yrs, SD=2.7yrs) and PHT (9.1yrs, SD=3.1 yrs)(p=0.053). The average number of outpatient visits was lower for PRT (M= 114.0, SD=94.5) vs PHT (M=179.0, SD=201.5) (p=0.005). Regarding inpatient hospitalizations, the length of stay (LOS) was lower for PRT (PRT M=30.7, SD=30.2) vs PHT (M=52.0, SD=56.9, p=0.017). To compare patients with similar anticipated treatment-related morbidity, we reviewed patients with CNS primaries (PRT=25, PHT=63). Health-care practitioner claims for CNS patients was lower for PRT (M= 78.1[4-250]) vs PHT (mean=149.1 [1-119])(p=0.024). We reviewed LOS data for CNS patients and quantified days of admission per year of FU. Patients receiving PRT had a lower LOS per year of FU (mean= 0.41/yr [0/yr-5.14/yr]) vs PHT (mean= 2.11/yr [0/yr-44.03/yr]). With an estimated cost of $2000/day for hospital admission, the mean cost of admission over the entire length of FU per patient was almost 5 times higher for PHT (PRT=$8080 vs PHT=$38370).</div></div><div><h3>Conclusions</h3><div>RWD shows that PRT is associated with reduced outpatient physician visits and LOS after completion of RT compared to PHT. With reductions of LOS, there is potential cost savings of approximately $30,650 over a median FU of 8.5 years per patient.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e2"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}