Clinical Audit in Radiation Oncology: Results from One Academic Centre in Delhi, India

Kaur, Jaspreet; Mohanti, Bidhu Kalyan; Muzumder, Sandeep

doi:10.7314/apjcp.2013.14.5.2829

“…47 For example, a study in New Delhi reported a median of 41 days from registration to radiation therapy initiation; 25% of patients did not complete therapy. 48 Many African countries, including Cameroon, Rwanda, and South Africa, have reported an interval of up to 7 months between request for care as a result of symptoms and treatment of cancer. 41,49,50 Although more than half of the population in less-developed countries reside in rural areas, 51 oncology services tend to exist in urban areas.…”

Section: Resources Currently Available In Lower-resource Settingsmentioning

confidence: 99%

Barriers and Challenges to Treatment Alternatives for Early-Stage Cervical Cancer in Lower-Resource Settings

Wu

¹

,

Jerónimo

²

,

Feldman

³

2017

JGO

View full text Add to dashboard Cite

Cervical cancer is one of the most common cancers among women worldwide, and approximately 85% of new diagnoses occur in less-developed regions of the world. Global efforts in cervical cancer to date have focused on primary and secondary prevention strategies of human papillomavirus vaccination and cervical cancer screening. Cervical cancer screening is effective to reduce the incidence of cervical cancer and can result in diagnosis at earlier stages, but it will take time to realize its full impact. With expansion of screening programs, there is now a greater imperative to increase access to treatment for women who have cervical cancer, particularly in earlier stages of disease, when it is still curable. Resources for multimodality treatment can be limited—or even absent—in many less-developed regions of the world and may be associated with geographic, social, and financial barriers for the patient. However, there is evidence that, in many cases, less-invasive and less–resource-intensive treatment options are still effective. To this end, the National Comprehensive Cancer Network and American Society of Clinical Oncology have published guideline adaptations for specific resource constraints, and research about more conservative approaches to the treatment of cervical cancer continues. This review focuses on potential barriers and challenges to provision of safe and effective treatment of early-stage cervical cancer in lower-resource settings, and it suggests future directions for expansion of access to cervical cancer treatment around the world.

show abstract

“…Head-and-neck cancer (HNC) is the most common malignancy in India, and 83% of patients present with Stage III and IV HNC. [ 1 ] Radiation therapy (RT) is the most commonly used and effective cancer-directed therapy for advanced HNC. In modern oncology practice, combined modality therapy (CMT) is the mainstay of cancer management.…”

Section: Introductionmentioning

confidence: 99%

Burden of acute toxicities in head-and-neck radiation therapy: A single-institutional experience

Muzumder

¹

,

Srikantia

²

,

Udayashankar

³

et al. 2019

South Asian J Cancer

Self Cite

View full text Add to dashboard Cite

Introduction: Combined modality therapy is the standard of care in locally advanced head-and-neck cancer (HNC). The incidence of acute toxicities increases with additional therapy. The present study investigated the incidence and patterns of mucositis, dysphagia, aspiration, feeding tube use, admission for supportive care, and treatment compliance in patients with HNC treated curatively with radiation therapy (RT) with or without chemotherapy. Methods and Material: A retrospective review of 164 consecutive HNC patients treated with RT at St. John's Medical College Hospital, Bengaluru, from January 2013 to June 2017 was done. Results: A total of 148 HNC patients were treated with a curative intent and 122 (82.4%) were locally advanced HNC. Combined Modality treatment was received by 119 (80.4%) patients. Eighty-four (56.7%) patients were treated by concurrent chemo-radiation. IMRT technique was used in 125 (84.5%) patients. The incidence of grade 3-4 mucositis, dysphagia and aspiration was 25%, 46%, and 10%, respectively. Nasogastric tube feeding was necessitated in 18.9% (n=28) and 27% (n = 40) required inpatient admission for supportive care. Twenty-nine (19.6%) patients did not complete planned RT dose and 46 (31%) patients had unscheduled RT break (>2days). Fifty-six (66.7%) patients did not receive planned chemotherapy. Conclusions: Acute toxicity due to RT in HNC remains a challenge despite using modern techniques. A significant proportion of patients require supportive therapy for more than 12 weeks and did not complete the scheduled treatment.

show abstract

“…Some of the key factors that are assessed include compliance to RT, waiting time for RT, intention of treatment, effect on overall treatment time and the integration with allied cancer modalities. 11 Thus, an audit has the potential to improve overall RT practice, specifically in developing countries such as India with an aim to improve treatment outcomes. 11 There are several reasons for unwanted interruptions in planned RT.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing non-adherence to radiotherapy: a retrospective audit of 1,548 patients from a tertiary cancer centre

Palwe

¹

,

Patil

²

,

Pandit

³

et al. 2019

View full text Add to dashboard Cite

Purpose: To determine the frequency, factors and reasons of patient non-adherence to radiotherapy (RT) in a tertiary cancer centre. Background: Inadvertent treatment interruptions often lead to prolongation of planned treatment time. In the case of RT with a curative intent, prolongation of planned treatment has been associated with inferior clinical outcomes. Delay or prolongation of treatment is associated with a relative risk of local recurrence by up to 2% per day for specific malignancies. Thus, it is critical to understand key factors that influence non-adherence to RT. Methods and Materials: A retrospective observation audit was conducted comprising patients treated with radical, adjuvant or palliative RT at our centre from January 2018 to December 2018. Non-adherence was defined as premature permanent termination of planned treatment by the patient without recommendation or consultation from the treating clinician. All data were collected and analysed (retrospectively) with the help of Statistical Package for the Social Sciences (SPSS) version 22. Results: A total of 1,548 patients were included in the study of which 105 (6·7%) were non-adherent to planned RT. Of the total 105 patients, 44 (42%) were elderly (60 years and above). Treatment non-adherence was predominant in males (male:female = 1·85:1). More than 90% of non-adherent patients had stage III and IV cancer. A total of 77 patients (74%) out of 105 were more than 50 km away from our centre. A total of 66 (63%) out of 105 patients had completed more than 2 weeks of radiation (40% of planned RT) and then defaulted for radiation due to acute toxicities. Conclusion: Treatment adherence is a major factor in determining successful outcomes among cancer patients treated with RT. This study reveals several factors that contribute to non-adherence to treatment.

show abstract

Clinical Audit in Radiation Oncology: Results from One Academic Centre in Delhi, India

Cited by 11 publications

References 29 publications

Barriers and Challenges to Treatment Alternatives for Early-Stage Cervical Cancer in Lower-Resource Settings

Barriers and Challenges to Treatment Alternatives for Early-Stage Cervical Cancer in Lower-Resource Settings

Burden of acute toxicities in head-and-neck radiation therapy: A single-institutional experience

Factors influencing non-adherence to radiotherapy: a retrospective audit of 1,548 patients from a tertiary cancer centre

Contact Info

Product

Resources

About