RESUMO
Background: In India, cervical cancer is the second‑leading cause of cancer incidence among women. Socioeconomic factors play a vital role in cervical cancer survival. Objectives: This study assessed the role of education and income on disparities in time‑to‑treatment initiation (TTI) and its impact on cervical cancer survival. Materials and Methods: This was a retrospective facility‑based record study conducted among newly treated cervical cancer patients registered in a tertiary medical care center in Mumbai between 2014 and 2016. Adjusted hazard ratio with a 95% confidence interval was reported. Results: In total, 1947 cervical cancer patients with a mean age of 52.89 (±10.55) years were included. The average number of days for TTI among highly educated patients was 27 versus 35 days for patients with no formal education. An increasing trend in survival was observed as education levels shift from no formal to higher education category (75.54%, 77.30%, and 85.10%, P = 0.01). All cause mortality was lower in cervical cancer patients with secondary education and above than illiterates (hazard ratio [HR] = 0.63, P < 0.01), among those with higher income (HR = 0.78, P = 0.04) than lower income and among who started on treatment within 30 days (HR = 0.90, P = 0.29) than patients who started treated after 30 days. Conclusions: Inferior survival is found for cervical cancer patients with lower education and income and who initiated treatment after 30 days. Hence, it is important to improve awareness and screening activities, especially among the lower socioeconomic groups, for early diagnosis and better treatment outcomes.
RESUMO
Background: Sparse data from India are available regarding the outcome of prostate cancer treatment. We report our experience in treating prostate cancer with radiotherapy (RT). Materials and Methods: This study included 159 men with locally advanced cancer treated with RT with or without hormone therapy between 1984 and 2004. The median RT dose was 70 Gy over 35 fractions. Eighty-five patients received whole pelvic RT and prostate boost, and 74 patients were treated with 3-dimensional conformal radiotherapy (3DCRT) to prostate and seminal vesicles alone. Results: The median follow-up was 25 months and the freedom from biochemical failure for all the patients at 5 years was 76%, disease-free survival (DFS) 59.1%, and overall survival (OAS) was 70.1%. The risk stratification (91% vs 52%, P < 0.03) and RT dose (72.8% for dose > 66 Gy vs 43.5% for dose < 66 Gy; P = 0.01) affected the DFS. DFS at 5 years was better in the group receiving 3DCRT to prostate and seminal vesicles (78% vs 51.5%; P = 0.001) and was reflected in OAS as well (P = 0.01). Conclusion: CRT technique with dose escalation results in significant benefit in DFS and OAS in locally advanced prostate cancer.