title: Delivery of radiation therapy in resource-limited settings: A pilot quality assessment study.
abstract: Progress has been made in resource-limited countries in treating acute lymphoblastic leukemia, but advances in solid malignancies have been slower. Multidisciplinary care coordination is challenging, assessing adherence to guidelines through quality improvement initiatives is essential. We characterized deviations from guidelines in the delivery of radiation in a middle-income country program as a pilot for evaluating adequacy of local control and as surrogate for integration of multidisciplinary care. One-third of patients for whom it was indicated did not receive radiation. Of the patients who received radiation, 95% had a deviation. This study underscores the importance of quality assessment in resource-limited settings.
authors.affiliation: Harvard Medical School.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Power-Hays
authors.affiliation: Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Paola
authors.initials: P
authors.lastname: Friedrich
authors.affiliation: Pediatric Hematology-Oncology Unit, Dr. Arturo Grullón Regional Children's Hospital, Santiago, Dominican Republic.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Fernandez
authors.affiliation: "El Cibao" Radiation Therapy Center, Santiago, Dominican Republic.
authors.forename: Naly A
authors.initials: NA
authors.lastname: Cruz
authors.affiliation: Division of Radiation Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.
authors.forename: Karen
authors.initials: K
authors.lastname: Marcus
authors.affiliation: Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.affiliation: Pediatric Hematology-Oncology Unit, Dr. Arturo Grullón Regional Children's Hospital, Santiago, Dominican Republic.
authors.forename: Luisa
authors.initials: L
authors.lastname: Collado
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D003906:Developing Countries; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D010865:Pilot Projects; D011785:Quality Assurance, Health Care; D011878:Radiotherapy; D012189:Retrospective Studies
keywords: childhood cancer; low/middle-income countries (LMIC); radiation therapy