Abstract 4814: Pediatric radiation treatment adherence in LMIC
Authors: Joseph Adedayo , Akinsete Adeseye , Fakile Ugonna , Agbakwuru Chidiebere , Keno Lensa , Adisa Omolola O. , Oladipo Aishat , Fagbemide Oluwafunmilayo , Habeebu Muhammad , Ngwa Wilfred 
Published: March 2024

Abstract
Background: Radiation therapy plays a significant role in the treatment of pediatric cancer. However, there have been documented challenges and difficulties encountered by patients while accessing care for cancer and it has been postulated that travel distance contributes to treatment breaks and abandonment.
Objectives: The objective of this study was to determine the prevalence of treatment breaks, assess the travel burden of patients receiving radiotherapy for pediatric cancers at a high-volume center in Nigeria and to determine the impact of travel burden on treatment breaks and treatment completion.
Materials and Methods: A retrospective cross-sectional study design was utilized. Data was extracted from the electronic medical records of all pediatric patients referred to the center for radiation therapy between June 2019 and June 2023. Data was analyzed using Microsoft Excel and the results were presented in descriptive statistics. Association between data were analyzed using chi-square test with the level of significance (p) set at &lt;0.05. Results: A total of 210 pediatric cancer patients were enrolled with an average age of 10.9 years. Children aged 0-14 years accounted for 69.05% while 30.95% were between the age of 15 and 19 years. Brain tumors were the most predominant diagnosis, representing 28.10% of cases. Treatment intent was predominantly radical or curative (81.69%). 61.43% (129) of the patient population came from the within the state with an average travel distance of 19.3 km. Of all the 210 patients, 44.29% of patients did not commence RT. The reasons for this were mostly financial constraints but were not explored in this study. Of those who did commence RT, 54.70% had breaks, and 45.30% did not have breaks. Also, 75.21% of patients completed their treatment; however, 24.79% were unable to complete their treatment. Travel distances varied, with the average distance to the treatment center being 165.3 km and the median at 28.5 km. The study categorized travel distance into quartiles: short (0-16 km), medium (&gt;16 km to 28.5 km), long (&gt;28.5 km to 302 km), and very long (&gt;302 km to 1387 km). Chi-square test did not reveal a significant association between travel distance and treatment completion (p=0.57), nor between travel distance and treatment breaks (p=0.20).
Conclusion: These findings highlight the complex interplay of demographic factors, disease profiles, and socioeconomic barriers affecting treatment continuity and completion among pediatric oncology patients in a resource-limited setting. These findings suggest that in this low - resource context, other variables such as socioeconomic status and financial barriers may play a more pivotal role than travel distance in treatment commencement, adherence and completion. As such, more detailed investigation of the obstacles through a comprehensive and targeted strategy could lead to more favorable outcomes in pediatric cancer radiation therapy adherence.
Citation Format: Adedayo Joseph, Adeseye Akinsete, Ugonna Fakile, Chidiebere Agbakwuru, Lensa Keno, Omolola O. Adisa, Aishat Oladipo, Oluwafunmilayo Fagbemide, Muhammad Habeebu, Wilfred Ngwa. Pediatric radiation treatment adherence in LMIC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4814.