Presentation (CTI)

OBJECTIVES: Cervical cancer patients in rural India frequently experience poor dietary and socioeconomic situations, which can impede adherence to the routine concurrent chemoradiation treatment advised by the 1999 NCI alert. Hematologic and gastrointestinal problems frequently cause therapy pauses and inadequate dosage. This study assesses treatment compliance and related toxicities in a rural community to identify context-specific recommendations for better care delivery.
METHODS: A retrospective observational study was planned on 1672 cervical cancer patients attending the Department of Radiation Oncology between 2012-2014. Patients were treated on Cobalt and Linac machines. The patients were taxed for haematological and gastroenteritis toxicity using Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria.
RESULTS: Mean age of cervical cancer patients was found to be 53 years. Most of the patients included (88.95%) in our study are from rural backgrounds. Of the total patients, 52.01% were IIB and 33.98 %were stage IIIB. About 85% of the cases were of Squamous cell carcinoma. Grade 3 enteritis was seen in 38.97% and 5.99% had grade 3 or higher haemoglobin toxicity, TLC toxicity was found to be 38.97%. Only 24.17% of patients treated on cobalt machine and 37.15% of patients treated on Linear accelerator could complete the planned chemotherapy cycles of cisplatin 40 mg/m² weekly. Only 38.95% of patients could complete the treatment in the stipulated time of ≤ 8 weeks.
CONCLUSIONS: Adherence to concurrent chemoradiation guidelines in rural cervical cancer patient is often compromised due to high acute toxicity and poor nutritional status with limited means for supportive therapy attributes to non-adherence to chemoradiation. Further studies are needed to evaluate compliance and develop personalized, population-specific treatment strategies with targeted supportive care to improve outcomes in this vulnerable group.