Radiotherapy Interruption in Cancer Patients: Rates and Causes at Ahvaz Golestan Hospital

Razmjoo, Sasan; Haghi, Negar; Birgani, Mohammad Javad Tahmasebi; Arvandi, Shole; Hosseini, Seyed Mohammad; Shahbazian, H B; Reza, Javan, Mohammad

doi:10.31557/apjcc.2020.5.1.33-36

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Moreover, the treatment delay, especially during radiotherapy, could be critical, as any gap during treatment could lead to accelerated repopulation of cancer cells (González Ferreira et al, 2015;Nagar and Formenti, 2020). The delay during radiation treatment was a major concern even during the pre-pandemic time (Razmjoo et al, 2020).…”

Section: Treatment Delay During Radiotherapy Of Cancer Patients Due T...mentioning

confidence: 99%

Treatment Delay during Radiotherapy of Cancer Patients due to COVID-19 Pandemic

Mitra

Simson²,

Khurana³

et al. 2022

Asian Pac J Cancer Prev

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Purpose:To analyze the impact of treatment delay caused by COVID-19 infection on patients scheduled for radiotherapy treatment. Methods and Materials: In this descriptive study, we analyzed all patients who were COVID-19 positive during the scheduled radiotherapy course, those who had an infection while on neoadjuvant treatment period, or during surgery before the start of radiation. The study period was from June 2020 to May 2021. A treatment delay was defined as a delay in starting the radiation treatment, a gap during their scheduled radiation treatment, or treatment discontinuation. All patients who had a treatment delay were followed-up till November 2021. Results: The median follow-up time of the study was 13 months. Ninety-four patients were selected for the study who met the inclusion criteria. Seventy-seven patients had a mild COVID-19 infection, while 17 had a moderate to severe illness. Of the entire cohort, 83 patients had a treatment delay. The median treatment delay (MTD) in days was 18 (6 to 47). Amongst those who had a treatment delay, 66 patients were treated with curative intent, of which 51 patients are on follow-up -34 patients are disease-free (MTD -18.5, 10 to 43), seven had either a residual disease or locoregional recurrence (MTD -22, 10 to 32), seven had distant metastasis (MTD -18, 15 to 47), and three patients died (MTD -20, 8 to 27). Of three patients who died, only one died of COVID-19-related causes. Conclusions: Even though the mortality due to COVID-19 infection among those who underwent radiotherapy was low, a treatment delay might have caused adverse treatment outcomes. Longer follow-up of these patients is required to further establish this. It will remain debatable whether it was worth delaying radiotherapy for mild to moderate COVID-19 infection for a significant time to cause a potential cancer treatment failure.

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Section: Treatment Delay During Radiotherapy Of Cancer Patients Due T...mentioning

confidence: 99%

Treatment Delay during Radiotherapy of Cancer Patients due to COVID-19 Pandemic

Mitra

Simson²,

Khurana³

et al. 2022

Asian Pac J Cancer Prev

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Influence of radiotherapy interruption on esophageal cancer with intensity-modulated radiotherapy: a retrospective study

Mou,

Liang,

Cheng

et al. 2024

BMC Cancer

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Background Radiotherapy interruption (RTI) prolongs the overall total treatment time and leads to local control loss in many cancers, but it is unclear in esophageal cancer. We aimed to evaluate the influence of RTI on the overall survival (OS), progression-free survival (PFS), and local-regional recurrence-free survival (LRFS) of patients with esophageal cancer undergoing chemoradiotherapy. Methods A total of 299 patients with esophageal squamous cell carcinoma from 2017 to 2019 were retrospectively analyzed to investigate the effect of RTI on OS, PFS, and LRFS. The delayed time of radiotherapy interruption was calculated as the actual radiation treatment time minus the scheduled time. The univariate and multivariate analyses were performed by the COX proportional hazards regression models, and the survival analysis was performed through the Kaplan‒Meier method, and compared with the log-rank test. Results The 3-year OS, PFS, and LRFS rates were 53.0%, 42.0%, and 48.0%, respectively. The univariate and multivariate analyses showed that the delayed time > 3 days was an independent adverse prognostic factor for OS (HR = 1.68, 95% CI 1.10–2.55, p = 0.016), and LRFS (HR = 1.74, 95% CI 1.18–2.57, p = 0.006). The patient with a delayed time of > 3 days had poorer survival rates of OS, and LRFS than patients with a delayed time of ≤ 3 days (OS, p = 0.047; LRFS, p = 0.013), and the survival outcomes of patients with shorter delayed time (1–3 days) were slightly different from the patients without interruptions. The impact of delay time on PFS is not statistically significant, but the survival outcomes of the two groups were slightly different. Conclusion There was a significant correlation between delayed time and local control of esophageal cancer. The delayed time for more than 3 days might decrease the survival outcome, and increase the local recurrence risk.

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Radiation treatment dropouts-Pitfalls and solutions: A retrospective observational study

Patro

Avinash

Bhattacharyya

et al. 2023

Cancer Research, Statistics, and Treatment

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JOURNAL/crsat/04.03/02201859-202306020-00008/figure1/v/2023-08-03T140821Z/r/image-tiff JOURNAL/crsat/04.03/02201859-202306020-00008/figure2/v/2023-08-03T140821Z/r/image-tiff Background: Interruptions in radiation treatment are known to have a deleterious effect on oncologic outcomes,specifically, an increase in tumor recurrence and decrease in cancer cure rate. Objectives: Our primary aim was to determine the factors influencing radiotherapy interruptions and provide solutions to decrease these dropouts. Materials and Methods: This was a retrospective observational study conducted between May 2009 and July 2010 at Mahatma Gandhi Cancer Hospital and Research Institute, a tertiary cancer center in Vishakhapatnam, Andhra Pradesh, India, on patients with histopathologically proven cancer, who were receiving radiation, either as definitive concurrent chemoradiation or in the adjuvant or palliative setting. Before the start and during treatment, patients were counseled by radiation oncologists, radiation coordinators, and radiation therapy technologists. During radiotherapy, an interruption of more than five consecutive days was considered a treatment interruption. Following a treatment interruption, patients were called on the telephone, counseling was done, and the cause of the treatment interruption was recorded and attempts were made to resolve the problem. Results: We enrolled 1200 patients in the study. There were more male (n = 724 [60.4%]) than female (n = 476 [39.6%]) patients. The cohort included 379 patients (31.6%) with carcinoma of the head-and-neck and 301 patients (25.1%) with gynecological malignancies. There were 100 (8.3%) treatment interruptions recorded during the study period. The common causes of radiation interruption were radiation-induced toxicity (n = 20 [20%]), patient death (n = 15 [15%]), financial (n = 15 [15%]), and social (n = 12 [12%]) issues. After counseling over the telephone, treatment could be restarted in 25 (25%) of the 100 patients who had interrupted and stopped radiotherapy. Conclusion: Treatment interruption is relatively common in our patients receiving radiotherapy. To prevent such dropouts and increase compliance to treatment, adequate and frequent counseling before and during radiation treatment is needed.

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Radiotherapy Interruption in Cancer Patients: Rates and Causes at Ahvaz Golestan Hospital

Cited by 3 publications

References 7 publications

Treatment Delay during Radiotherapy of Cancer Patients due to COVID-19 Pandemic

Treatment Delay during Radiotherapy of Cancer Patients due to COVID-19 Pandemic

Influence of radiotherapy interruption on esophageal cancer with intensity-modulated radiotherapy: a retrospective study

Radiation treatment dropouts-Pitfalls and solutions: A retrospective observational study

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