Clinicopathology and Treatment Patterns of Head and Neck Cancers in Ethiopia

Abstract

PURPOSE Head and neck cancers are the third most common cancers treated with radiation in Ethiopia. There is, however, a lack of published data on clinical and pathological characteristics and treatment patterns of head and neck cancers in the country. The objective of the study was to assess clinical and pathological characteristics and treatment patterns of head and neck cancers at Tikur Anbessa Specialized Hospital, which housed the only radiotherapy facility in Ethiopia during the study period. MATERIALS AND METHODS A retrospective cross-sectional study design with a simple random sampling of histologically confirmed head and neck cancers treated from 2014 to 2017 with analysis of descriptive data. RESULTS Three hundred twenty-one patient charts were analyzed in this study from a total population of 1,377 from the department cancer registry. The male to female ratio was 2:1. The median age was 45 years (interquartile range, 26-59). The most common primary site of head and neck cancers was nasopharynx (128 of 321, 40%), and the major histologic type was squamous cell carcinoma (285 of 321, 89%). Majority of the cases had advanced disease (stage III-IVC, 221 of 251, 88%), but 92% had potentially curable disease (231 of 321). Cobalt radiotherapy was used for 67% of all patients receiving treatment (184 of 273). Induction chemotherapy followed by radiotherapy was frequently used for curative intent patients (75 of 231, 32%). There was long duration between diagnosis and initiation of treatment, with 56% (148 of 264) waiting longer than 3 months. CONCLUSION Majority of patients with head and neck cancers seen in Ethiopia presented at advanced stage of disease, received cobalt radiotherapy, and had protracted treatment initiation. These findings underscore the need for additional investments to improve research capacity and increase the availability of high-quality radiotherapy and supportive services to deliver optimal care for patients with head and neck cancer and other cancer patients in the country.

Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study

“… 7 In Ethiopia, most patients present at an advanced stage where curative treatment strategies are not amenable. 8 …”

“…7 In Ethiopia, most patients present at an advanced stage where curative treatment strategies are not amenable. 8 In general, there is a paucity of research on palliative care, with significant gaps in the literature relating to dose and fractionation, identifying patients who are suited for palliation, the degree or duration of symptom reduction, and treatment-related toxicities. Furthermore, because of resource constraints, a long RT waiting list, and the poor socioeconomic status of patients in Ethiopia, shorter palliative RT regimens are an ideal choice for our setup if found feasible.…”