Purpose/Objective(s):
Radiotherapy (RT) is a cornerstone of cancer treatment, contributing to improved local control and survival in various malignancies. However, not all patients who are planned for RT can ultimately receive the planned RT protocol. Completing the planned RT protocol as intended is important in achieving a good outcome. Treatment terminations, whether due to medical, logistical, or patient-related factors, represent a significant challenge and may negatively impact patient outcomes. Understanding the reasons for RT terminations is crucial for optimizing cancer care delivery and minimizing its potential consequences. In this study, we aimed to explore the factors leading to RT terminations, their impact on patient outcomes, and possible strategies to mitigate these challenges. Materials/Methods:
All patients who planned RT in our department because of cancer were analyzed retrospectively from January 2020 to December 2024. The RT termination was defined as the termination of radiotherapy at any point following consent and CT simulation. Patients <18 years of age were excluded. The RT termination reasons were categorized as COVID-19 infection, death from any cause, patient request, treatment (RT or ChT or both) related side effects, deterioration in performance status, and change in treatment decision.
Results:
297 (2.96%) patients did not continue the planned radiation therapy, among 10039 patients who underwent radiation therapy between September 01, 2020, and December 31, 2024. The most 3 reasons for termination were deterioration of performance status (143 patients [48.1%]), death for any reason (56 patients [18.9%]), and patient requests (39 patients [13.1%]). In 170 of the 297 patients (57.2%) who discontinued radiation therapy, the initial intent was palliative. Death within or at first months after radiation therapy discontinuation occurred in 21 of 127 patients who discontinued curative radiation therapy (16.5%) and in 35 of 170 patients who discontinued palliative radiation therapy (20.6%). Most primary diagnosis was lung cancer (96, 32.3%), gastrointestinal system cancers (65, 21.9%), primary brain cancer (33, 11.1%), urinary system cancers (31, 10.4%) and gynecological cancers (23, 7.7%). Brain (92, 31%), bone (59, 19.8%), thorax (58, 19.5), lower abdomen (52, 17.5%), and upper abdomen (27, 9.1%) were the most radiation-applied body areas.
Conclusion:
Psychological, social, and nutritional support is important before and during the period of RT administration. For successful implementation of cancer treatment, radiation oncologists, attending physicians of various disciplines, and other healthcare providers must work as a team to understand the patient’s general condition. The team members should share information about adverse events and other relevant issues.
