Context: Strict adherence and timely completion of the external beam radiation therapy (EBRT) schedule is an important prognostic factor in the survival of head and neck cancer patients. However, many patients are unable to complete the radiation treatment due to various reasons resulting in a poor outcome.
Aims: This study aims to study the pattern and various possible causes of defaults for possible intervention.
Settings And Design: A retrospective epidemiological analysis.
Subjects And Methods: Patients receiving EBRT for head and neck cancers with curative intent from January 2015 to December 2015 but did not complete the prescribed treatment were included. Unplanned treatment breaks in the treatment was not taken into consideration.
Statistical Analysis Used: SPSS version 21.
Results: Out of 458, 92 (20.08%) patients did not complete the EBRT (P = 0.06). Fifty-six out of total 92 patients (60.9%) who defaulted stopped taking treatment within halfway of the treatment (15 fraction) and 12 out of total 92 patients (13%) just at the 22nd/23rd fraction. Defaulter rates in patients from different places are in the range of 12.8% to 33.0% but was statistically not significant (P = 0.224). There was no particular age (P = 0.966), disease site (P = 0.354) preponderance among defaulters. Use of concurrent chemo-radiation in radical or adjuvant settings was also not related to defaults (P = 0.406).
Conclusions: Radiation-induced acute toxicity, socioeconomic status and distance plays minimal role as a cause of patients who stop taking EBRT. There is no particular relation between age, disease site, treatment received before radiotherapy, intent of treatment, and concurrent chemoradiation-induced acute reactions with defaults among patients. Loss of income and work in the poor population during the treatment may be an important possible cause of defaults.
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http://dx.doi.org/10.4103/ijc.IJC_114_17 | DOI Listing |
Oper Neurosurg (Hagerstown)
November 2024
Department of Neurological Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA.
Science
January 2025
Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.
Cochlear inner hair cells (IHCs) and outer hair cells (OHCs) require different transcription factors for their cell fate stabilization and survival, suggesting separate mechanisms are involved. Here, we found that the transcription factor Casz1 was crucial for early IHC fate consolidation and for OHC survival during mouse development. Loss of Casz1 resulted in transdifferentiation of IHCs into OHCs, without affecting OHC production.
View Article and Find Full Text PDFPLoS One
January 2025
Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany.
Introduction: Despite its importance in voice training, comprehensive research into sustained vowel phonation with constant pitch and increasing and decreasing loudness, the so-called Messa di Voce, is lacking. The study examines the laryngeal behavior during Messa di Voce, regarding the impact of the speed of execution on voice stability parameters.
Materials And Methods: Nine untrained, healthy subjects (5 female, 4 male) were asked to perform Messa di Voce exercises on the vowel [i:], involving a gradual increase and decrease of volume.
PLoS One
January 2025
Department of Radiation Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Radiotherapy is the main treatment for patients with head and neck cancer (HNC) and is associated with an increased risk of ischemic cerebrovascular events (ICVE). The purpose of this cross-sectional study was to determine the incidence of ICVE and carotid artery stenosis (CAS) in patients with HNC who receive radiotherapy and the risk factors for CAS. We enrolled 907 patients with HNC who underwent radiotherapy between February 2011 and June 2022 and obtained information on their clinical and tumor characteristics and their treatment from the clinical records.
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