Impact of non-adherence to radiotherapy on 1-year survival in cancer patients in Catalonia, Spain

Abstract

Background: This study aims to assess the effects of non-adherence to external beam radiation therapy in cancer patients receiving treatment with a curative. Methods: This retrospective cohort study collected health records data for all cancer patients treated with external beam radiotherapy with curative intent in 2016 in Catalonia, Spain. Adherence was defined as having received at least 90% of the total dose prescribed. A logistic regression model was used to assess factors related to non-adherence, and its association with one-year survival was evaluated using Cox regression. Results: The final sample included 8721 patients (mean age 63.6 years): breast cancer was the most common tumour site (38.1%), followed by prostate and colon/rectum. Treatment interruptions prolonged the total duration of therapy in 70.7% of the patients, and 1.0% were non-adherent. Non-adherence was associated with advanced age, female gender, and some localization of primary tumour (head and neck, urinary bladder, and haematological cancers). The risk of death in non-adherent patients was higher than in adherent patients (hazard ratio [HR] 1.63, 95% confidence interval 0.97-2.74), after adjusting for the potential confounding effect of age, gender, tumour site and comorbidity. Conclusion: Non-adherence to radiotherapy, as measured by the received dose, is very low in our setting, and it may have an impact on one-year survival.

Compliance of Radiotherapy Treatment at a Tertiary Cancer Center in India—A Clinical Audit

“…Despite the large number of patients being offered RT, the noncompliance rate in our department is 2.28%, significantly less than the reported incidence in other institutes, though the definitions of noncompliance vary across studies. 1 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 The distribution of gender (males 112; 56.9%) was reflective of the routine registrations in the year 2019 emphasizing that there is no gender-specific predilection for noncompliance in our study. The same was true for the marital status and age of the patients.…”

“…6 7 8 9 10 11 The studies published globally too mention a wide range of noncompliance across institutions and regions ( Table 5 ). 1 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 The comparison of these results from these studies is challenging as the definition of noncompliance varies. The studies from our country show variable but high noncompliance rate across a spectrum of urban tertiary care centers, academic ones, and centers operating in rural part of the country.…”

Facing problems in radiotherapy for breast cancer patients in Yogyakarta, Indonesia: A cohort retrospective study

“…Our results contrast with findings reported for higher‐income countries, such as the United States and Spain, where radiotherapy completion rate among breast cancer patients were 97% and 99.3%, respectively. 9 , 11 This difference may be explained by the availability of abundant radiotherapy resources and the stricter medical supervision involved in the management of breast cancer treatment in developed countries. 9 , 11 For 261 million Indonesian people in 2017, 261 radiotherapy machines were needed to achieve a 1 MV machine per million population.…”

“… 8 Few researchers have addressed OTT and radiotherapy completion rates among breast cancer patients. 9 , 10 , 11 , 12 , 13 , 14 In this study, we explore problems that breast cancer patients experience with radiotherapy, focusing on OTT and radiotherapy completion rates. We hypothesize that the average OTT of breast cancer patients in Indonesia is longer than standard, and the radiotherapy completion rate is suboptimal.…”

Benefits of Adopting Hypofractionated Radiotherapy as a Standard of Care in Low-and Middle-Income Countries

“…Reports on the incidence of treatment interruptions vary on the basis of the primary site and the treatment setting, but reports range from 20% to 71% while the incidence of treatment discontinuation range from 13% to 61%. 36,[38][39][40][41][42][43][44][45] Compliance with a planned radiotherapy course is crucial as multiple studies have shown that treatment delays and interruptions are associated with worse oncologic outcomes. 34,35 The impacts of treatment interruption or discontinuation also have knock on effects on available resources.…”