ABSTRACT
Background: Prevalence of cancer is increasing worldwide. Early diagnosis with appropriate therapeutic interventions is essential for better treatment outcome. Identification and necessary modifications of factors responsible for delayed presentation might increase the life expectancy or quality of living. This study aims to identify the factors responsible for delayed presentation of cancer patients to radiotherapy department.Methods: This is a quantitative descriptive study, done with in a period from August 2018 to October 2019, among 120 cancer patients of different stages presenting to OPD of Radiotherapy department of M.K.C.G Medical College. Data were collected by using pretested semi-structured questionnaires, entered into Microsoft Excel and analyzed by using SPSS version 20.0.Results: A total of 120 cancer patients, 60 from each early and late stage had participated in the study. The mean age of presentation was 53.19 years. The number of male patients were 54 and female were 66. Maximum patients had addiction of chewing tobacco. When the time interval from appearance of symptoms to diagnosis were compared, 1 – 3 months were taken by 45% of early stage and 28.3% of late stage patients. Similarly, <1week time was taken from diagnosis to start of treatment in 25% and 13.3% in respective groups. Comparison of educational status (p=0.001), difference between primary and secondary delay (p<0.05), and socio-economic status (p=0.008) between both the groups were found to be statistically significant.Conclusions: Factors responsible for delayed presentation are related both to patient and system. Educating common people regarding early sign symptoms, emphasizing early detection at grass root level, proper referral and by upgrading existing oncology facilities, we can avoid adverse treatment outcome.
ABSTRACT
Background: Radiotherapy is one of the primary modalities of cancer treatment but may associated with short and long-term toxicities. Oral mucositis is frequently encountered in head and neck cancer resulting in unplanned treatment breaks. Few studies emphasized that use of oral glutamine may significantly reduce oral mucositis and other acute toxicities. This study aims to assess the effects of glutamine on oral mucositis in head and neck cancer patients receiving chemo-radiation.Methods: It is a prospective study carried out in sixty-four head and neck cancer patients attending radiotherapy department for chemo-radiation from January 2018 to May 2019. Patients were randomly assigned into two arms containing 32 subjects in each. All the patients in arm-A were taking oral glutamine supplement of 15 mg once daily, two hours prior to radiation and arm-B serve as the control group. Dose of radiation fixed at 66 Gy in 33 fractions over a period of 7 weeks along with an infusion of weekly cisplatin (40 mg/m2). Patients were evaluated regarding onset, severity and the recovery period of mucositis.Results: Oral mucositis appeared at around 5th week in arm-A and 3rd week in arm-B (p<0.0001). Number of patients with mucositis is significantly less in arm-A (75%, 24 out of 32) as compared to arm-B (96.8%) (p=0.0310). The time required for healing of mucositis is significantly less than 1 week in arm-A compared to ~2 weeks in the arm-B (p<0.0001).Conclusions: Oral glutamine when given prior to radiation results in delayed onset of oral mucositis with decreased severity and an early healing period.
ABSTRACT
Background: The incidence of cancer in India is alarming. However, many patients discontinued their treatment protocols resulting in higher mortality rate. This study aims to find out different patterns of treatment defaults in cancer patients receiving external beam radiation in the radiotherapy department of a cancer center in the southern part of Odisha state.Methods: It is a retrospective epidemiological study carried out in cancer patients receiving external beam radiotherapy for their cancer treatment but had not completed the full course of treatment during the study period from January 2018 to May 2019. Patterns of failure in relation to various demographic and socio-economic statuses were analyzed.Results: One hundred seven defaulter patients were included in this study. The mean age of the patients was 50.93±14.3 years (range 12 to 90 years) and 66(61.7%) were being females. Out of 107 patients, 53.2% patients were receiving treatment in curative intent, 28.0% patients were treated in adjuvant intent and 18.2% in palliative intent. Forty-two (39.2%) patients were from a distance >50 km from the study center, 74.7% of patients belong to low socio-economic status and 60.7% patients were illiterate. Only 33.3% of patients completed more than 15 fractions of radiation excluding the palliative cases. The comparison of various factors such as distance from study center (p=0.759), education (p=0.2428), socio-economic status (p=0.6628) and acute radiation toxicity (p=0.9359) among the groups of patients receiving more or less than 15 fractions of radiation did not showed any statistical significant differences.Conclusions: Radiation induced acute toxicity, distance from study center, education and socio-economic status might be responsible for the treatment discontinuation. There is no particular association of age, disease site and intent of treatment with default among patients.