Factors influencing the use of palliative external beam radiotherapy for advanced breast cancer patients in the University College Hospital, Ibadan

Abstract

Background: PRT (palliative RT [PRT]) has been proven as an effective treatment modality for symptom relief in advanced breast cancer patients; however, access to this treatment in Nigeria is determined by some demographic factors. Materials and Methods: We retrospectively collected data from records of patients treated with PRT for advanced breast cancer between January 1, 2005, and December 31, 2009, at the University College Hospital Ibadan, Nigeria. Patients' Socio-demographic factors, tumor characteristics and RT treatment received were evaluated. Data obtained were analyzed using Statistical Package for Social Sciences version 20.0 (Chicago, IL, USA) statistical software. National population data on 2006 census were used to determine age-corrected values for metastatic sites and socioeconomic status (SES) of the patients. Results: Five hundred and eighty-four patients' data between 2005 and 2009 were considered eligible and reviewed. Their ages ranged between 20 and 89 years, with a mean age of 45 years, with only 0.7% being male patients. The commonly affected age groups demanding for PRT were between 40 and 59 years, which accounted for 7.6 persons/100,000 populations. Breast cancer predominantly metastasizes to the bone, affecting 11.4 persons/100,000 populations, within the age range of 50–79 years. Pain associated with other symptoms accounted for more than half (66.6%) of the presenting complaints that demand the use of PRT for effective relief. Majority of the patients referred for PRT were from low SES and fell within the age range of 30–49 years, with 7.02 persons/100,000 populations. Conclusion: Age is a predictive factor of pattern of breast cancer metastasis and rate of PRT utilization. Majority of the affected age groups (40–59 years) demanding for PRT were of low- and middle-SES. Therefore, there is a need for more RT machines in the country with effective national health insurance coverage on cancer patients to aid affordability.