Resum
Background: Treatment interruption is the failure to execute approved treatment plan of a patient. This adversely affects treatment outcomeif not properly managed.This retrospective study causes and management of radiation treatment interruptions during High Dose Rate Brachytherapy(HDRB) for carcinoma of the cervix in a teaching hospital in Nigeria.
Methods: Five hundred patients with cervical carcinoma, who received HDRB, post external beam radiotherapy, between August, 2008 and July, 2013 were assessed. They were grouped into(A): those who experienced treatment interruption and(B): those who did not. Each patient was scheduled to receive three fractions of HDRB over 3 weeks. Those in groups A were assessed for the exact treatment fraction missed, the cause and duration of treatment interruption and the actions taken to compensate for non-execution of treatment.
Results: A total of 90 patients fall into group A and most (41) of them experienced interruptions in the third fraction of their treatment. The most frequent(44%) causes of treatment interruptions observed among them were patientrelated.Record of compensation for treatment interruption was not found in patients’treatment folders. This action may be due to lack of functional procedures for managing treatment interruptions and insufficient follow-up of patients, who never came back for consideration for compensation.
Conclusion: This study showed that radiation oncology centres need to review their policies for managing treatment interruptions and documentation. Also, the mechanism for patients’ follow-up should be strengthened to a reasonable extent to achieve better radiotherapy care.
Keywords: Treatment interruption, cervical carcinoma, treatment audit, treatment documentation, duration of interruption.
Résumé
Contexte: L’interruption du traitement est la faillite a exécute le plan de traitement approuvé au patient. Ceci affecte négativement le résultât du traitement si pas correctement man géré. Cette étude rétrospective examine les causes et la gestion des interruptions de traitement de radiation pendant la curiethérapie en haut débit de dose (HDRB) pour le carcinome du col de l’utérus dans un hôpital d’enseignement au Nigeria.
Méthodes: Cinq cents patients avec le carcinome cervical, qui ont reçu HDRB, post radiothérapie de rayon externe, entre Août 2008 et Juillet 2013 ont été évalués. Ils ont été regroupés en (A): ceux qui ont vécu l’interruption du traitement et (B): ceux qui n’ont pas. Chaque patient devrait recevoir trois fractions d’HDRB pour trois semaines. Ceux dans le groupe A ont été évalués pour la fraction exacte de traitement manquée, la cause et la durée d’interruption du traitement et les mesures prises pour compenser la non-exécution du traitement.
Résultats: Un total de 90 patients tombent dans le groupe A et la plupart d’eux (41) ont eu des interruptions dans la troisième fraction de leur traitement. Les causes les plus fréquentes (44%) d’interruptions de traitements observés étaient liées aux patients. Le registre de compensation pour l’interruption du traitement n’a pas été trouvé dans les dossiers de traitement des patients. Cette action peut être due à l’absence de procédures fonctionnelles pour la gestion des interruptions de traitement et suivi insuffisant des patients, qui ne sont jamais revenus pour la considération de compensation.
Conclusion: Cette étude a montré que les centres de radio-oncologie doivent revoir leurs politiques de gestion des interruptions de traitement et de documentation. En outre, le mécanisme de suivi des patients doit être renforcé dans une mesure raisonnable pour atteindre de meilleurs soins de radiothérapie.
Mots-clés: Interruption du traitement, carcinome cervical, audit de traitement, documentation de traitement, durée de l’interruption.
Correspondence: Dr. Bidemi I. Akinlade, Department of Radiotherapy, College of Medicine, University of Ibadan, Nigeria. E-mail: bidy2012@yahoo.com; bakinlade@comui.edu.ng
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