Pediatric Cancer

PV QA 3 - Poster Viewing Q&A 3

TU_24_3107 - International Pediatric Oncology Patient Access to Treatment in a South Florida Health Network from 2007-2016

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

International Pediatric Oncology Patient Access to Treatment in a South Florida Health Network from 2007-2016
S. Mehta1, D. Asher2, B. Farnia2, N. Logie2, A. M. Markoe2, J. J. Meshman2, and S. Gajjar2; 1University of Miami, School of Medicine, Miami, FL, 2Department of Radiation Oncology, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL

Purpose/Objective(s): Treatment resources for pediatric oncology patients are often not available in many low- and middle-income countries (LMICs). At times, LMIC patients seek care in the USA, however this population has not been well characterized. Located in close proximity to several LMICs, South Florida serves as a unique referral region for many of these patients. As a result, we sought to collect and analyze demographic and treatment information for international pediatric oncology patients referred to our South Florida health network.

Materials/Methods: In an Institutional Review Board (IRB) approved study, the tumor registry covering our health network was queried for international oncology patients, aged 21 years or younger, treated from 2007-2016. Sociodemographic and clinical data was extracted.

Results: From 2007-2016, 141 international pediatric patients were evaluated and 128 received treatment. In this cohort, 41.1% sought initial care at a public hospital and 58.9% at a private hospital with 22% seeking initial care at an emergency department and 78% through scheduled clinic appointments. Demographic characteristics included: average age of presentation of 11.0 years, 52.5% males, 47.5% females, 50.4% from the Caribbean Islands, 34.8% from South America, 11.3% from Central America, 3.5% from the Middle East/Africa, 30.5% from high income countries (ICs), 62.4% from middle ICs, and 7.1% coming from low ICs. Peru was most well represented (18.4%), followed by the Bahamas (11.4%), Dominican Republic (7.8%), and Haiti (7.1%). Patients frequently sought care for leukemia (33.3%), central nervous system tumors (18.4%), lymphoma (9.2%), osteosarcoma (7.8%), and other sarcomas (8.5%). Overall, 49.6% received treatment in their home country and came to South Florida for more specialized care. Treatments received in South Florida during the initial phase of care included chemotherapy alone (19.9%), RT alone (3.6%), surgery alone (10.6%), RT and other treatments (40.4%), or other combinations (15.6%). Of note, 44.0% of patients received RT in their initial cancer management, with 5.6% of these patients receiving RT in the palliative setting. Among this group 95.2% came from countries with fewer than 3 RT machines per million people. Follow up for care in the US occurred in 82.3% of patients with a median follow up of 11.0 months (range, 1-257 months).

Conclusion: About half of the international pediatric oncology patients required RT with a majority coming from countries with limited RT resources. As radiotherapy resources are particularly sparse in select regions of Latin America, fostering international partnerships for pediatric radiotherapy referrals may facilitate improved patient care.

Author Disclosure: S. Mehta: None. B. Farnia: None. A.M. Markoe: None. J.J. Meshman: None.

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