Congresso Internacional do GRAACC

Dados do Trabalho


Radiation-therapy time intervals in a public tertiary oncology center in a LMIC


Background: Radiation therapy (RT) is an essential part of medulloblastoma (MB) treatment in children above 3-5 years. Time to initiate radiation-therapy (TTR) and radiation-therapy treatment duration (RTD) have been subject of discussion, but no consensus was reached regarding their impact in survival. There is no optimal time specified in medulloblastoma literature concerning what should be the maximal time to start radiation therapy and the optimal duration, with a median of 21-45 days and 42-50 days, respectively, on previsous studies. The goal of this study is to estimate the TTR and RTD, correlating to survival in a low-to-middle income country (LMIC). Methods: Retrospective review of medical records of patients aged 3-18 years-old histopathological proven MB, from January 1997 through December 2016. Relevant clinical and sociodemographic data was retrieved. Results: The medical records of 82 patients were evaluated. The median age at diagnosis was 8 years (IIQ: 6-11), with male predominance (59,8%). The median TTR was 51 days (IIQ: 35-77). Patients submitted to surgery at our institution had a significant shorter TTR when compared to patients submitted to surgery in other hospitals (68 vs. 33 days p < 0.0001). Patients with metastatic disease at presentation also had shorter TTR (p:0.015). The median RTD was 60 days (IIQ: 52-74). Children aged ≤8 years and submitted to 3600 Gy CSI dosis had larger RT duration (p: 0.0009 and p: 0.019, respectively). There was no significant statistical association between sociodemographic factors and overall survival. Conclusions: Median TTR and RTD were longer than reported in literature. Possible explanations for these results are obstacles in post-operative referral to tertiary center and the need for anesthesia during RT for younger children. These specificities reinforce the need for specialized centers in pediatric cancer treatment in LMICs.




Gabriela Oigman, Nathalia Grigorovski, Larissa Uemoto, Denise Magalhaes, Sima Ferman