Abstract
The objective was to analyze the radiotherapy (RT) practice at the cancer centre of a tertiary academic medical institution in Delhi. This audit from an Indian public institution covered patient care processes related to cancer diagnosis, integration of RT with other anti-cancer modalities, waiting time, overall treatment time, and compliance with RT. Over a period of one year, all consecutively registered patients in radiotherapy were analyzed for the audit cycle. Analysis of 1,030 patients showed median age of 49.6 years, with presentation as stage I and II in 14.2%, stage III and IV in 71.2% and unknown stage in 14.6%. A total of 974 (95%) were advised for RT appointment; 669 (68.6%) for curative intent and 31.4% for palliation. Mean times for diagnostic workup and from registration at cancer centre to radiotherapy referral were 33 and 31 days respectively. Median waiting time to start of RT course was 41 days. Overall RT compliance was 75% and overall duration for a curative RT course ranged from 50 days to 61 days. Non-completion and interruption of RT course were observed in 12% and 13% respectively. Radiotherapy machine burden in a public cancer hospital in India increases the waiting time and 25% of advised patients do not comply with the prescribed treatment. Infrastructure, machine and manpower constraints lead to more patients being treated on cobalt (74%) and by two-dimensional (78%) techniques.
Highlights
In our present state of cancer care globally, around half of the approximately 28 million cancer survivors worldwide underwent radiotherapy (RT) at some point in their treatment (Global Cancer Facts and Figures, 2011)
The objective was to analyze the radiotherapy (RT) practice at the cancer centre of a tertiary academic medical institution in Delhi. This audit from an Indian public institution covered patient care processes related to cancer diagnosis, integration of RT with other anti-cancer modalities, waiting time, overall treatment time, and compliance with RT
Radiotherapy machine burden in a public cancer hospital in India increases the waiting time and 25% of advised patients do not comply with the prescribed treatment
Summary
In our present state of cancer care globally, around half of the approximately 28 million cancer survivors worldwide underwent radiotherapy (RT) at some point in their treatment (Global Cancer Facts and Figures, 2011). The WHO expert group, in 1990s, estimated the need for radiotherapy in more than 50% of all cancer patients as part of their treatment and approximately 40% of the cures in cancer can be attributed directly to the benefits of radiotherapy (Porter et al, 1999). By collecting data from various international sources, Delaney et al (2005) showed that the optimal radiotherapy utilization rate for all cancers should be 52.3%. At least 50% to 60% of cancer patients in the developing world can benefit from radiotherapy (Pal and Mittal, 2004).As well as being effective, radiation therapy is less expensive than both surgery and chemotherapy.
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