OP049: Feasibility of organ preservation strategies in head and neck cancer in developing countries

Abstract

Purpose Chemoradiotherapy is an established strategy for organ-preservation in head–neck cancer. These protocols are associated with added toxicity and need support infrastructure. Practice setup and availability of resources vary at community level in developing-countries. Our aim is to evaluate feasibility of organ preservation strategies in different settings in developing-countries. Materials and methods In a questionnaire-based study, questions were directed to clinicians with varied practice setup to gather information regarding infrastructure, finance, feasibility of organ-preservation protocols and their current practice trends. Results Responses from 100 clinicians with focused practice in head-neck oncology were analyzed. 61% clinicians were practicing organ preservation for advanced head-neck cancers in their practice. However 65% centers lacked sufficient infrastructure to support organ-preservation protocols. 40% patients were treated on cobalt-radiotherapy machine. 59% of clinicians suggested less than third of their patients were fit to undergo chemoradiation and 67% believed adherence to treatment protocol was observed in less than 2/3rd of cases. Based of their experience 82% clinicians felt only 1/3rd patients requiring salvage would actually undergo treatment. Majority of patients (68%) used personal funds for treatment and less than 1/3rd of patients could afford complete treatment. Conclusions Infrastructure needed to support organ preservation protocols vary significantly between centers in developing countries. It may not be feasible to perform organ preservation strategies in certain centers and feasibility guidelines should be made for its judicious use in developing countries.