DOI: 10.4103/jhnps.jhnps_14_26 ISSN: 2347-8128

Factors Associated with Noncompliance to Radiotherapy in Head and Neck Cancer Patients: An Experience from a Tertiary Care Center of North-western India

Devender Baisoya, Arti Kumawat, Dhiraj Daga, Unnati Batra, Jayant Kumar Jain, Narender Singh Shah

Context:

Head and neck cancers (HNC) represent a significant health burden in India, particularly in the northern region, with radiotherapy (RT) serving as a cornerstone treatment modality.

Aims:

This study aimed to investigate the determinants of noncompliance to curative-intent RT among HNC patients at a tertiary care center in Northwestern India.

Settings and Design:

This retrospective analysis evaluated 297 HNC patients who underwent curative-intent RT between January 2020 and December 2024 at our center.

Subjects and Methods:

Patient-initiated premature discontinuation without clinical authorization was classified as noncompliance. Socioeconomic, disease, and treatment parameters were assessed through medical records, with telephone interviews conducted to ascertain reasons for discontinuation.

Statistical Analysis Used:

Data were compiled and analyzed using Microsoft Excel. Proportions were compared using appropriate statistical tests, with P ≤ 0.05 considered statistically significant.

Results:

The overall noncompliance rate was 40.07% (119/297 patients). Statistically significant predictors included age (highest in 41–60 years, 46.41%, P = 0.049), occupation (highest in retired, 60.0%, and unemployed, 53.42%, P = 0.037), distance from hospital (52.0% for >100 km vs. 32.92% for < 50 km, P = 0.019), and concurrent chemotherapy (43.42% vs. 28.99%, P = 0.032). RT-related toxicities (31.93%) and lack of belief in RT efficacy (19.33%) were the primary reported reasons for discontinuation.

Conclusion:

Noncompliance with RT remains a significant challenge in managing HNCs. Early identification of high-risk patients based on socioeconomic and treatment-related factors, alongside proactive toxicity management and comprehensive patient education, may improve treatment completion rates and outcomes.

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