ESTRO meets Asia 2024 - Abstract Book
S240
Interdisciplinary – Paediatric tumours
ESTRO meets Asia 2024
198
Digital Poster
Radiotherapy Practices in Paediatric Malignancies: A Single-Center Experience.
Sadeka Sultana Ahmed, Sharif Ahmed, Mostafa Aziz Sumon, A F M Kamal Uddin, MD Rashid Un Nabi
Oncology, United Hospital Ltd., Dhaka, Bangladesh
Purpose/Objective:
Incidences of pediatric malignancies are increasing in Bangladesh as well as worldwide. Radiotherapy has a pivotal role in management of various childhood malignancies like hematological and Solid (Especially bone and soft tissue) tumors. However, the complexities associated with Radiation planning and treatment delivery pose challenges for clinicians, while it’s time to deal with Paediatric Radiation. Till date there is no dedicated Paediatric Radiation Oncology department in Bangladesh. This study aims to investigate and understand the prevailing radiotherapy practices & challenges within our institution.
Material/Methods:
A retrospective analysis was conducted on case records of pediatric malignancy patients undergoing radiation treatment over a one-year period (January 2023 to December 2023). Demographic information, Radiation details, and toxicities were meticulously examined.
Results:
The study included 10 pediatric malignancy cases receiving Radiotherapy. The median age of all included patients was 5.2 years and a majority being females (80%). Common malignancies treated with Radiation, included bone and soft tissue sarcomas (40%), brain tumors (30%), and Wilms tumors (30%). Radiotherapy was given as a part of radical intent treatment in adjuvant setting in all patients. Radiation techniques, such as 3D-Conformal Radiotherapy (3DCRT), Intensity-Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT), were employed. Proper counseling to parents or guardian of the patient, regarding daily anaesthesia, patient setup, treatment delivery and acute & long term toxicities is a big challenge. A notable percentage (70%) of cases required anaesthesia during Radiation Treatment delivery, which is challenging. A number of patients experienced treatment breaks, commonly attributed to neutropenia and respiratory tract infections . Grade 3 or 4 neutropenia were observed in 10% of patient, which is most frequent . Managing hematological toxicity in paediatric patients, being the most challenging as they are, more frequently associated with infection.
Conclusion:
Treating paediatric patients is a real challenge in terms of counseling, Patient setup, Treatment delivery and managing toxicities. So paediatric patients requiring Radiation, need a multimodality treatment approach. Anaesthesia services proved essential for Radiation Treatment delivery in most of pediatric cases. The occurrence of acute Grade 3 or more toxicities and treatment breaks underscores the importance of coordinated supportive care during the treatment of pediatric malignancies. For the proper management of paediatric patient requiring radiation need comprehensive setup and dedicated unit.
Keywords: Paediatric Malignancies, challenge, Anaesthesia
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