Race Disparities in Proton Radiotherapy Use for Cancer Treatment in Patients Enrolled in Children’s Oncology Group Trials

Bitterman DS, Bona K, Laurie F, Kao PC, Terezakis SA, London WB, Haas-Kogan DA. Race Disparities in Proton Radiotherapy Use for Cancer Treatment in Patients Enrolled in Children’s Oncology Group Trials. JAMA Oncol. 2020 Sep 1;6(9):1465-1468. doi: 10.1001/jamaoncol.2020.2259. PubMed PMID: 32910158; PubMed Central PMCID: PMC7411938.

This quality improvement study examines disparities in proton radiotherapy use in patients enrolled in Children’s Oncology Group Trials. Proton radiotherapy is a high-cost, limited resource, for which the most robust evidence-based indications are in pediatric cancers owing to its ability to reduce long-term adverse effects compared with photon therapy.1,2,3 Most proton radiotherapy facilities are located in metropolitan areas or at major academic centers, and therefore require physician referral to the center for treatment. In addition, radiotherapy involves daily treatment for up to 8 weeks, requiring patients to potentially relocate to obtain treatment. Owing to the potential barriers to proton radiotherapy access, we aimed to assess the association of race and socioeconomic factors with proton use in patients with solid malignant diseases enrolled on Children’s Oncology Group (COG) prospective trials.