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المؤلفون: Bethann Scarborough, Vishal Gupta, R. Sheu, Batya Reckson, Brett A. Miles, Stanislav Lazarev, Zahra Ghiassi-Nejad, Krzysztof Misiukiewicz, Richard L. Bakst
المصدر: Advances in Radiation Oncology
Advances in Radiation Oncology, Vol 3, Iss 1, Pp 62-69 (2018)مصطلحات موضوعية: lcsh:Medical physics. Medical radiology. Nuclear medicine, 0301 basic medicine, medicine.medical_specialty, lcsh:R895-920, medicine.medical_treatment, Improved survival, Disease, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Head and neck, business.industry, Medical comorbidity, Head and neck irradiation, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Head and Neck Cancer, Surgery, Discontinuation, Radiation therapy, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, business, Patient education
الوصف: Purpose: Factors related to premature discontinuation of curative radiation therapy (PDCRT) are understudied. This study aimed to examine causes and clinical outcomes of PDCRT at our institution by investigating the most common anatomical site associated with PDCRT. Methods and materials: Among the 161 patients with PDCRT of various anatomic sites at our institution between 2010 and 2017, 36% received radiation to the head and neck region. Pertinent demographic, clinical, and treatment-related data on these 58 patients were collected. Survival was examined using the life-table method and log-rank test. Results: The majority of patients were male (81%), white (67%), ≥60 years old (59%), living ≥10 miles away from the hospital (60%), single (57%), with Eastern Cooperative Oncology Group score ≥1 (86%), experiencing significant pain issues (67%), and had treatment interruptions in radiation therapy (RT; 66%). The most common reasons for PDCRT were discontinuation against medical advice (33%), medical comorbidity (24%), and RT toxicity (17%). Of the comorbidities leading to PDCRT, 50% was acute cardiopulmonary issues and 43% was infection. The mean follow-up time was 15.9 months, and the 2-year overall survival and disease-specific survival rates were 61% and 78%, respectively. Patients with illicit substance abuse, cardiovascular disease, and Eastern Cooperative Oncology Group score ≥2 had worse survival. A trend toward improved survival with total completed dose ≥50 Gy versus 50 Gy appears to confer a relative therapeutic benefit.