Black Children with Cancer Are Far Less Likely to Receive Proton Radiotherapy, Study Finds

A new study finds that Black children with cancer are far less likely to receive proton radiotherapy compared to white children. The study appeared in JAMA Oncology.

Proton radiotherapy is a high-cost, limited resource, but may augment quality of life for pediatric cancer patients compared to standard photon therapy.  Cancer centers that offer proton radiotherapy are often located in metropolitan areas that may require travel or even relocation for families seeking therapy for their sick child.

“We were motivated to carry out this investigation based on our anecdotal experiences in clinic that children who receive proton therapy are predominantly white,” said corresponding author Daphne Haas-Kogan, MD, chair of the Department of Radiation Oncology at the Brigham via a press release. “The strongest evidence for proton therapy is in childhood cancer, and we were concerned that imbalances in who receives this treatment could translate to long-term health disparities in our patients. This question was particularly urgent to us because of the rapidly growing number of proton centers in the country, which could potentiate any existing disparities if there is imbalanced distribution and use of these expensive technologies.”

In this study, researchers assessed data from over 1,200 children enrolled in the Children’s Oncology Group prospective trials between 2010 and 2018. According to the results, approximately 85% of pediatric cancer patients received photon therapy and 15% received proton therapy. Researchers observed that Black pediatric patients were tree times less likely to receive proton therapy than non-Hispanic white patients.

“We found that even when we think we are treating patients in as standard a way as possible, we may not be offering the same access to advancements in treatment,” said lead author Danielle Bitterman, MD, a resident in the Department of Radiation Oncology at the Brigham. “These results call for introspection and to proactively address barriers to access to make sure patients who most need proton therapy are prioritized based on medical need so that these treatments are distributed equitably and fairly.”