Analyzing Patterns of Treatment Gaps and Its Causes to Improve Integrated Care in Pediatric Cancer Patients Undergoing Radiation Therapy at a Tertiary Care University Hospital

Introduction: Objective is to analyze the pattern of treatment gaps and its causes in pediatric cancer patients during radiation therapy (RT) to improve collaborative treatment and streamline the service at a tertiary care university hospital. Methodology: The hospital database was retrospectively reviewed from January 2022-December 2024 and data was collected for patients 8 days (n=21,12%). The delay reasons were need for admission and optimization (n=54,31%), suspicion of disease progression and need for plan re-evaluation (n=2,1.12%), prolonged chemotherapy at primary center (n=2,1.12%) and welfare issues (n=1,0.5%). The most common reason for admission was neutropenic fever (n=16,9%) followed by chest congestion and transfusion because of decreased cell count, equally (n=2,1.1%). Conclusion: Our study shows that almost half of the patients experienced no interruptions, gaps were observed in 55% of cases, with admission due to neutropenic fever being the most common cause. Addressing modifiable factors such as improved pre-treatment optimization and enhancing coordination with referring centers can further streamline RT services and improve outcomes for the patients.