Title: Unplanned Interruption of Radiotherapy in Head and Neck Cancers: report from a Regional Cancer Centre
Authors: Najmi Arshad Manzoor, Shah Saqib Ahmad, Rasool Malik Tariq, Wani Shaq-ul-Qamar, Jan Yasmeen, Wani Shahid Bashir, Lone Mohammad Maqbool, Afroz Fir, Khan Nazir Ahmad
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.90
Abstract
Background and Objectives: Any unplanned interruption in head and neck cancers can affect loco regional control rates. Treatment induced toxicities and radiotherapy equipment breakdown or maintenance are the commonest reasons for treatment interruption. We evaluated occurrence and causes of unplanned interruption of radiotherapy in patients of head and neck cancers receiving radical radiotherapy protocol.
Material and Methods: We conducted a retrospective study of 60 patients enrolled for radical Radiotherapy in our Regional Cancer Centre and recorded all relevant details like; patient characteristics, treatment received as well as details of treatment interruptions.
Observations: Most of the patients were in the age group 55-64 years with males comprising 63.3% of cases. Oral cavity was the commonest subsite involved (33.3%) followed by larynx (23.3%). 60% patients started their radiotherapy within 4 weeks of first visit to our OPD and in only 10% of cases waiting period contributed to delay of more than 4 weeks. The average radiotherapy dose received by patients was 65.4 Gy, and the average fraction number was 32.5. 38 patients (63.3%) received single agent cisplatin based concurrent chemotherapy. The average overall treatment time (OTT), including interruptions, was 50.1 days. Treatment interruption was seen in 46.6% cases, out of which treatment induced toxicity contributed to 71.4% and radiotherapy machine related issues lead to interruption in 28.5% patients. Mucositis was the commonest toxicity observed, in half the patients with interruptions. The treatment breaks were mainly compensated by increasing treatment time for all remaining fractions, as per the departmental protocol and/or by treating them on Saturday of last week also.
Conclusion: All efforts should be made to prevent and minimize the treatment interruptions in patients receiving radiotherapy of head and neck cancers in view of clonogenic repopulation affecting the control rates. At the same time, all interruptions should be properly compensated by a standard departmental protocol.
Keywords: Radiotherapy, Interruption, Head and Neck, Mucositis.
