Socioeconomic factors affect the selection of proton radiation therapy for children

Shen, Colette J.; Hu, Chen; Ladra, Matthew M.; Narang, Amol; Pollack, Craig Evan; Terezakis, Stephanie A.

doi:10.1002/cncr.30849

Cited by 55 publications

(64 citation statements)

References 35 publications

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“…For instance, it has been shown that access to private insurance compared to Medicaid or no insurance positively affects the prognosis of adult glioblastoma patients leading to better overall survival 4 . While less studied in the pediatric population, data exist demonstrating disparities of care and survival in pediatric oncology patients based on socioeconomic and racial/ethnic factors [5][6][7] . In the U.S., malignant neoplasms are the leading cause of death by disease in children past infancy.…”

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confidence: 99%

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Fineberg

Zahedi

Eguchi

et al. 2020

Sci Rep

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Previous studies have demonstrated effects of racial and socioeconomic factors on survival of adults with cancer. While less studied in the pediatric population, data exist demonstrating disparities of care and survival in pediatric oncology patients based on socioeconomic and racial/ethnic factors. Brain cancers recently overtook leukemia as the number one cause of childhood cancer fatalities, but demographic and socioeconomic disparities in these tumors have not been adequately studied. We obtained data from the SeeR program of the national cancer institute (nci). We selected patients under 19 years of age with central nervous system (CNS) cancers diagnosed between 2000 and 2015. We included patient demographics, tumor characteristics, treatment, and socioeconomic characteristics as covariates in the analysis. We measured overall survival and extent of disease at diagnosis. We saw that Black and Hispanic patients overall had a higher risk of death than non-Hispanic White patients on multivariable analysis. On stratified analysis, Black and Hispanic patients with both metastatic and localized disease at diagnosis had a higher risk of death compared to White, non-Hispanic patients, although the difference in Black patients was not significant after adjusting for mediating factors. However, our findings on extent of disease at diagnosis demonstrated that neither Black race nor Hispanic ethnicity increased the chance of metastatic disease at presentation when controlling for mediating variables. In summary, racial and ethnic disparities in childhood CNS tumor survival appear to have their roots at least partially in post-diagnosis factors, potentially due to the lack of access to high quality care, leading to poorer overall outcomes.

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confidence: 99%

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Fineberg

Zahedi

Eguchi

et al. 2020

Sci Rep

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“…8 However, previous research has also identified differences in treatment utilization across racial-ethnic and socioeconomics groups. [11][12][13] This may be compounded when therapies are novel, intensive, or expensive.…”

Section: Discussionmentioning

confidence: 99%

Disparities in the use of antineoplastic immunotherapy in pediatric malignant adrenal tumors

Shoag

Podda

Kobetz

2020

Pediatric Blood & Cancer

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Dinutuximab is a costly life‐prolonging immunotherapy for high‐risk neuroblastoma. We used a large pediatric inpatient database to analyze the use of antineoplastic immunotherapy in patients with malignant adrenal tumors 1 year after Food and Drug Administration approval of dinutuximab for high‐risk neuroblastoma. On multivariate modeling, children of Black race (odds ratio [OR] 0.62, P = .04; referent non‐Black) and the lowest ZIP code income quartile (OR 0.74, P = .03; referent wealthier 3 quartiles) were significantly less like to receive antineoplastic immunotherapy. These results suggest substantial disparities in the distribution of a vital therapy in children with advanced cancer.

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“…In China, it was estimated that intensity‐modulated photon therapy costs two times than 125 I IBT. Shen et al analyzed 12 101 children in the National Cancer Data Base who had been diagnosed with a solid malignancy and had received photon‐ or proton‐based radiotherapy, and they found that a higher median household income and educational attainment were associated with increased proton use . More than half of this cohort were from rural China; they are struggling to be economically stable due to the children's disease.…”

Section: Discussionmentioning

confidence: 99%

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

Chen

et al. 2019

Pediatric Blood & Cancer

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Background The purpose of this study was to present our preliminary assessment of the safety and efficacy of 125I interstitial brachytherapy (IBT) in the management of pediatric skull base tumors. Methods Thirty pediatric patients with skull base tumors treated with 125I IBT from April 2007 to May 2017 were included in this study. The probabilities of local control (LC) and overall survival (OS) were calculated by the Kaplan–Meier method. Results The one‐ and two‐year LC rates were 96.7% and 74.8%, respectively. The one‐ and two‐year OS rates were 93.3% and 72.2%, respectively. No severe acute toxicity was observed. Severe late toxicities were observed in one (3.33%) of 30 patients. Conclusion 125I IBT is effective and safe in the management of pediatric skull base tumors, with satisfactory cosmetic and functional outcomes.

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Socioeconomic factors affect the selection of proton radiation therapy for children

Cited by 55 publications

References 35 publications

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Disparities in the use of antineoplastic immunotherapy in pediatric malignant adrenal tumors

¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors

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Socioeconomic factors affect the selection of proton radiation therapy for children

Cited by 55 publications

References 35 publications

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Population-Based Analysis of Demographic and Socioeconomic Disparities in Pediatric CNS Cancer Survival in the United States

Disparities in the use of antineoplastic immunotherapy in pediatric malignant adrenal tumors

125I interstitial brachytherapy in management of pediatric skull base tumors

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Product

Resources

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¹²⁵I interstitial brachytherapy in management of pediatric skull base tumors