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A Preliminary Study On Patient Noncompliance for Cervical Cancer Radiotherapy

R Meerschaert

R Meerschaert*, S Miller , L Zhuang , Wayne State University School of Medicine, Detroit, MI


SU-I-GPD-T-93 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: Patient noncompliance extends overall cancer treatment time and therefore negatively affects treatment outcomes. This study investigated the effect of various demographic, clinical, and treatment factors on patient noncompliance in cervical cancer radiotherapy.

Methods: This study included 53 cervical cancer patients (stage IB-IVB) who underwent external beam radiotherapy (EBRT) and/or brachytherapy (BT) between 2012-2015 at an urban academic center. Treatment duration over 56 days was deemed as prolonged treatment based on American Brachytherapy Society (ABS) guideline. Patient noncompliance was categorized by number of missed appointments as: compliant (0-2), moderately noncompliant (3-5) and completely noncompliant (>5). Factors including race, religion, age, marital status, cancer stage, treatment start season (summer/winter), travel distance, genitourinary (GU)/gastrointestinal (GI) toxicity, and treatment fractionation were investigated for their effect on level of noncompliance by multinomial logistic regression or ROC analysis. Additionally, noncompliance was categorized into patient-initiated noncompliance and physician-initiated noncompliance to investigate causes for patient noncompliance.

Results: Based on ABS guidelines, 32 patients had prolonged treatment. Overall, 16 patients were complaint, 10 were moderately noncompliant, and 27 were completely noncompliant. Treatment start season (p=0.012), cancer stage (p=0.019), travel distance (p=0.009), and treatment fractionation (p=0.001) were statistically significant in affecting level of noncompliance. Race (p=0.009), marital status (p=0.022), religion (p=0.008), cancer stage (p=0.019), GI toxicity (p=0.008), and treatment fractionation (p=0.000) were statistically significant in affecting treatment prolongation. Among all noncompliance causes, 64.2% were initiated by the patient and 35.8% were initiated by the physician.

Conclusion: Patient compliance to radiotherapy schedule is crucial for successful treatment. Various factors were found in this study to identify patients at high risk for radiotherapy noncompliance which may be used to develop strategies to improve both patient and physician adherence to prescribed therapy.

Funding Support, Disclosures, and Conflict of Interest: Funding Support: AAPM Graduate Fellowship

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