Publication:

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

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.