Radiotherapy Utilization and Treatment Continuity of Pediatric Patients With Brain Tumor in Egypt: A Decade of Data.

Abstract

We assessed radiotherapy (RT) utilization and completion among pediatric patients with brain tumor treated at Children's Cancer Hospital Egypt (CCHE). A retrospective analysis was conducted among pediatric patients with brain tumor treated at CCHE between 2009 and 2020. Patients were categorized on the basis of demographics, tumor types, RT utilization status (prescribed, not prescribed, and did not complete), and geographic place of residence (urban <i>v</i> rural). RT utilization was stratified by tumor type and geographic region and compared using chi-square tests. Among 3,977 pediatric patients with brain tumor, 2,327 (58.5%) were prescribed RT. The highest RT utilization was observed among patients with diffuse intrinsic pontine glioma (DIPG; 98.2%) and germinoma (98.0%), while nonoptic low-grade glioma (LGG; 11.2%) and optic pathway glioma (OPG; 2.0%) had the lowest among patients prescribed RT, 2,264 (97.2%) completed treatment. The highest noncompletion was observed in patients with atypical teratoid rhabdoid tumor (ATRT; 6.7%) and nonoptic LGG (9.7%). Urban patients had a higher rate of RT completion (98.3%) compared with rural patients (95.9%; <i>P</i> < .001). RT utilization and completion varied significantly by tumor type, reflecting evidence-based treatment protocols and tumor-specific challenges. Geographic disparities in RT completion underscore systemic health care inequities in Egypt. These findings emphasize the need for targeted interventions, including decentralized radiotherapy delivery models and public health strategies, to improve access to and adherence to radiotherapy among underserved populations.