1439O_PR - Paediatric radiation therapy across Europe – a European questionnaire survey supported by the SIOPe, ESTRO, PROS and several national paediatric he...

Date 11 September 2017
Event ESMO 2017 Congress
Session Public health policy and health economics
Topics Bioethics, Legal, and Economic Issues
Surgery and/or Radiotherapy of Cancer
Presenter charlotte demoor-goldschmidt
Citation Annals of Oncology (2017) 28 (suppl_5): v605-v649. 10.1093/annonc/mdx440
Authors C. demoor-goldschmidt1, C. Carrie2, G. Whitfield3, P. Meijinders4, K. Dieckmann5, B. Timmermann6, L. Zaletel7, P. Banovic8, M. Solak Mekic9, Y. Lassen10, K. Alexopoulou11, J. Giralt12, J. Vizkeleti13, L. Jarusevicius14, B. Ondrova15, P. Daly16, P. Brandal17, G. Janssens18, U. Ricardi19, R. Dieter-Kortmann20
  • 1Cancer And Radiation, Inserm U 1018 cancer and radiation team, 94805 - Villejuif/FR
  • 2Radiotherapy, centre leon berard, lyon/FR
  • 3Radiotherapy, the Christie, manchester/GB
  • 4Radiotherapy, Iridium Cancer Network Antwerp-GZA- University of Antwerp, antwerp/BE
  • 5Radiotherapy, Vienna General Hospital (AKH) - Medizinische Universität Wien, 1090 - Vienna/AT
  • 6Radiotherapy, Clinic for Particle Therapy, West German Proton Center Essen, University Hospital Essen, essen/DE
  • 7Radiotherapy, institute of oncology, ljublajna/SI
  • 8Radiotherapy, IMC Banja Luka - Member of the Affidea Group, banja luka/BA
  • 9Radiotherapy, Clinical Hospital Center “Sestre milosrdnice”-University Hospital for Tumors, University Hospital Center Sestre Milosrdnice, 10000 - Zagreb/HR
  • 10Radiotherapy, Aarhus University Hospital, radiotherapy, aarhus/DK
  • 11Radiotherapy, Athens General Hospital for Children & Adolescents, athens/GR
  • 12Radiotherapy, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 13Radiotherapy, national institute of oncology, budapest/HU
  • 14Radiotherapy, Hospital of Lithuanian University of Health Sciences, 50009 - Kaunas/LT
  • 15Radiotherapy, Proton therapy center Czech, prague/CZ
  • 16Radiotherapy, St Lukes Radiation Oncology centre, dublin/IE
  • 17Radiotherapy, Norwegian Radium Hospital, oslo/NO
  • 18Radiotherapy, University Medical Center Utrecht – Princess Maxima Center for Pediatric Oncology, utrecht/NL
  • 19Radiation Oncology, A.O.U. Citta della Salute e della Scienza di Torino, Turin/IT
  • 20Radiotherapy, univeristy of Leipzig, leipzig/DE

Abstract

Background

Increased focus has been made to improve the quality of care and access to European trials in paediatric oncology. Information about paediatric radiotherapy (Ped-RT) throughout Europe is not widely available. The aim of this study was to provide an overview of resources and organization for Ped-RT.

Methods

Experts in Ped-RT oncology were invited by email to complete a 21-point questionnaire.

Results

Sixty-nine answers from 24 countries (7 centres with proton) were collected and 16 centres were visited. A minority of radiation oncologists (11.74%) treat only children, which is in contrast with paediatric oncologists (93.44%) or surgeons (71.67%) who are more often dedicated. In 5 countries, ped-RT is centralized in one centre. Access to ped-RT formations is unequal throughout Europe even if everyone agrees with the fact that specific knowledges are needed. Regarding the techniques, 12% use sometimes, meaning for some patients, 2D- conventional radiotherapy, 4% still use Cobalt and 15% never or rarely use IMRT (Intensity Modulated Radiotherapy), 64% use hypofractionated treatments, defined as at least 3Gy per fraction and 32% when considering 5 Gy or more. Eighty-four percent have access to paediatric devices for personalized immobilization. Radiation treatments can be easily delivered under anaesthesia in 75% of the centres if necessary, or under hypnosis in 9% of centres (2 countries). The environment is mostly adapted to children, with dedicated waiting area (47%), patient information (83%), gifts (98%), the possibility to listen to music or songs (93%) or watch cartoons (12%).

Conclusions

This survey provides quantitative data demonstrating the current healthcare inequalities for children and adolescents who need radiotherapy in Europe. Nevertheless, an effort to guarantee a treatment of quality with the local environment has been pointed out.

Clinical trial identification

not applicable

Legal entity responsible for the study

C. Demoor-Goldschmidt

Funding

None

Disclosure

All authors have declared no conflicts of interest.