Compliance to Therapy—Elderly Head and Neck Carcinoma Patients

Abstract

BackgroundTreatment compliance of elderly patients to intensive multi-modality cancer therapy can be challenging and has not been adequately addressed in developing countries. The present study evaluated compliance of elderly head and neck carcinomas patients to cancer-directed therapy.MethodsForty-seven elderly HNSCC patients were evaluated in the present study. Patients were assessed as per stage and site of disease, general condition, performance status, and any pre-existing co-morbidities. Compliance was defined as patients who were able to complete cancer therapy as intended at primary clinic. Non-compliance to therapy was stratified as early, mid- and late-course non-compliance. Statistical analysis was done using STATA 9.1 software, chi-square/Fischer’s exact test to see strength of association between two categorical variables that could possibly affect compliance in elderly patients.ResultsSixty-eight per cent of elderly patients were subjected to radical treatment, majority (42/47) presented in loco-regionally advanced stage (III–IV), most common site of malignancy was oropharynx (21/47). Sixty-two per cent of elderly HNSCC patients were compliance to cancer therapy. Median overall treatment time for patients subjected to radical radiation therapy was 52 (range 47–99) days, and for radical surgery and adjuvant radiotherapy was 109 (95–190) days. Compliance to therapy for elderly HNSCC patients was not significantly associated with advanced stage, poor general condition, intent of treatment or presence of co-morbidity. As regards to non-compliance, majority (14/18) of elderly patients showed mid-course treatment non-compliance.ConclusionsNearly two-thirds of elderly head and neck carcinoma patients were compliant to cancer-directed therapy.

Multiple symptoms in people with head and neck neoplasia: a descriptive study

“…A xerostomia é o nome dado a essa sensação, sendo uma das principais complicações orais associadas à radioterapia em pessoas com CCP. A perda da função salivar também pode levar a outras consequências adversas, incluindo alteração/ redução na função do paladar e dificuldade com a mastigação e deglutição (3,6) .…”

“…Os procedimentos cirúrgicos mais complexos frequentemente são necessários, com ressecção de partes moles, ossos da face e algumas vezes da pele, precisando de fechamento com retalhos. Estes podem levar a complicações como broncoaspiração, dificuldade de mastigação, disfagia, disfonia, afasia e outras alterações da fala, além de alterações estéticas que podem levar a problemas psicológicos e sociais (5)(6) . A radioterapia para CCP, por sua vez, tem como efeitos adversos a mucosite, a xerostomia, a cárie de radiação, a disgeusia, a dermatite e a osteorradionecrose (5) .…”

“…A radioterapia para CCP, por sua vez, tem como efeitos adversos a mucosite, a xerostomia, a cárie de radiação, a disgeusia, a dermatite e a osteorradionecrose (5) . Já na quimioterapia, a maioria das drogas induz à depressão da medula óssea, sendo frequentes a alopécia, a mucosite, a disgeusia, acarretando a baixa ingestão alimentar e consequente perda de peso (6)(7) .…”

Regression Analysis of Non-iatrogenic Factors That Determine Adherence to Radiation Therapy

“…Inclusion criteria were (1) indications for radiotherapy, age of more than 18 years, and termination radiation therapy between the second day after the initiation and the day before the scheduled end of the therapy and (2) termination of radiation therapy being a true wish of patients and their families, with doctors' persuasion failed. Exclusion criteria were (1) previous radiation therapy, (2) cognitive disorders, such as due to tumor brain metastases, (3) iatrogenic termination of radiation therapy, (4) termination of radiation therapy due to mechanical failures, maintenance, holidays or other objective reasons, and (5) death during radiation therapy.…”

“…Radiation therapy lasts longer than chemotherapy, surgery, or other treatments. Some patients show poor compliance to or even withdraw from radiation therapy [2,3], which affects the effectiveness of the treatment. Such patient-initiated termination differs from the so-called iatrogenic termination of radiotherapy, which is termination due to treatment effects that cannot be tolerated by patients or due to occurrence of complications.…”