DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20200064

Patterns of radiation treatment default and its evaluation in a cancer center in the Southern part of Odisha: a retrospective study

Jitendra Patra, Bishnu Prasad Das

Abstract


Background: The incidence of cancer in India is alarming. However, many patients discontinued their treatment protocols resulting in higher mortality rate. This study aims to find out different patterns of treatment defaults in cancer patients receiving external beam radiation in the radiotherapy department of a cancer center in the southern part of Odisha state.

Methods: It is a retrospective epidemiological study carried out in cancer patients receiving external beam radiotherapy for their cancer treatment but had not completed the full course of treatment during the study period from January 2018 to May 2019. Patterns of failure in relation to various demographic and socio-economic statuses were analyzed.

Results: One hundred seven defaulter patients were included in this study. The mean age of the patients was 50.93±14.3 years (range 12 to 90 years) and 66(61.7%) were being females. Out of 107 patients, 53.2% patients were receiving treatment in curative intent, 28.0% patients were treated in adjuvant intent and 18.2% in palliative intent. Forty-two (39.2%) patients were from a distance >50 km from the study center, 74.7% of patients belong to low socio-economic status and 60.7% patients were illiterate. Only 33.3% of patients completed more than 15 fractions of radiation excluding the palliative cases. The comparison of various factors such as distance from study center (p=0.759), education (p=0.2428), socio-economic status (p=0.6628) and acute radiation toxicity (p=0.9359) among the groups of patients receiving more or less than 15 fractions of radiation did not showed any statistical significant differences.

Conclusions: Radiation induced acute toxicity, distance from study center, education and socio-economic status might be responsible for the treatment discontinuation. There is no particular association of age, disease site and intent of treatment with default among patients.


Keywords


Cancer, Curative intent, Defaulter, Radiotherapy

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References


Barrow TM, Michels KB. Epigenetic epidemiology of cancer. Biochem Biophys Res Commun. 2014 Dec 5;455(1-2):70-83.

Gulland A. Global cancer prevalence is growing at alarming pace, says WHO. BMJ Clin Res Ed. 2014;348:1338.

Badwe RA, Dikshit R, Laversanne M, Bray F. Cancer incidence trends in India. Japanese J Clin Oncol. 2014 Apr 21;44(5):401-7.

Trufelli DC, Miranda VD, Santos MB, Fraile NM, Pecoroni PG, Gonzaga SD, et al. Analysis of delays in diagnosis and treatment of breast cancer patients at a public hospital. Revista Associação Méd Brasil. 2008 Feb;54(1):72-6.

Dinshaw KA, Rao DN, Ganesh B. Tata memorial hospital cancer registry annual report. Mumbai, India;1999.

Murthy NS, Chaudhry K, Rath GK. Burden of cancer and projections for 2016, Indian scenario: gaps in the availability of radiotherapy treatment facilities. Asian Pac J Cancer Prev. 2008 Jan 1;9(4):671-7.

Konski A, Berkey BA, Kian Ang K, Fu KK. Effect of education level on outcome of patients treated on Radiation Therapy Oncology Group Protocol 90‐03. Cancer: Interdisciplinary Inter J Am Cancer Society. 2003 Oct 1;98(7):1497-503.

Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981 Feb 1:127-40.

Pujari L, Padhi S, Meher P, Tripathy A. An audit and analysis of different causes of defaults in patients receiving radiation for head and neck cancers: A tertiary regional cancer center experience. Ind J Cancer. 2017 Jan 1;54(1):31.

Price AJ, Ndom P, Atenguena E, Mambou Nouemssi JP, Ryder RW. Cancer care challenges in developing countries. Cancer. 2012 Jul 15;118(14):3627-35.