Patil Vijay M, Noronha Vanita, Joshi Amit, Muddu Vamshi, Dhumal Sachin, Bhattacharjee Atanu, Prabhash Kumar
Tate Memorial Hospital, Mumbai.
Malabar Cancer Centre, Kerala, India.
J Glob Oncol. 2015 Oct 28;1(2):65-72. doi: 10.1200/JGO.2015.000265. eCollection 2015 Dec.
Approximately 15% to 20% of our patients with head and neck cancer receiving neoadjuvant chemotherapy (NACT) discontinue therapy because of various nonmedical reasons. We sought to analyze the factors associated with treatment default and noncompliance among these patients.
We performed a retrospective analysis of patients with T4 oral cancer treated with NACT between January 2011 and December 2012. We included patients who discontinued treatment for nonmedical reasons before the second cycle of NACT. The factors analyzed were income, education, socioeconomic status, age, sex, place of residence, habits, and payment pattern (government supported or personal capacity). Pearson χ test was used to identify significant factors associated with noncompliance.
Of 486 patients, 91 patients (18.7%) were noncompliant. Percentages of noncompliant patients in the age groups < 30, between 30 and 60, and > 60 years were 25.0%, 17.4%, and 25.5%, respectively ( = .27). Percentages of noncompliance in patients residing within the city, same state, or different state were 20.7%, 20.9%, and 17.1%, respectively ( = .44). Noncompliance rates were 20.3%, 15.7%, 18.1%, and 22.5% in upper middle, lower middle, upper lower, and lower economic strata, respectively ( = .60). Similarly, there was no significant difference in noncompliance according to occupation, education level, payment pattern, sex, or habits.
Our analysis failed to identify any specific significant factor associated with noncompliance with NACT among our patients with T4 oral cancers.
在接受新辅助化疗（NACT）的头颈癌患者中，约15%至20%会因各种非医疗原因中断治疗。我们试图分析这些患者中与治疗违约和不依从相关的因素。
我们对2011年1月至2012年12月期间接受NACT治疗的T4期口腔癌患者进行了回顾性分析。纳入在NACT第二个周期之前因非医疗原因中断治疗的患者。分析的因素包括收入、教育程度、社会经济地位、年龄、性别、居住地点、习惯和支付方式（政府支持或个人支付）。采用Pearson χ检验来确定与不依从相关的显著因素。
486例患者中，91例（18.7%）不依从。年龄<30岁、30至60岁和>60岁组的不依从患者百分比分别为25.0%、17.4%和25.5%（P = .27）。居住在本市、本州或其他州的患者不依从百分比分别为20.7%、20.9%和17.1%（P = .44）。社会经济阶层中上层、中层、中下层和下层的不依从率分别为20.3%、15.7%、18.1%和22.5%（P = .60）。同样，根据职业、教育水平、支付方式、性别或习惯，不依从情况也无显著差异。
我们的分析未能在T4期口腔癌患者中确定任何与NACT不依从相关的特定显著因素。
