Hazarika Munlima, Mishra Rakesh, Saikia Bhargab Jyoti, Bhuyan Chidananda, Nyuthe C W, Sarma Anupam, Kumar Gaurav, Sutnaga Cliffton, Kalita Manoj, Roy Partha
Department of Medical Oncology, Dr.B Borooah Cancer Institute, Gopinath Nagar, Guwahati, Assam, India. Email:
Department of Pathology, Dr. B Borooah Cancer Institute, Gopinath Nagar, Guwahati, Assam, India.
Asian Pac J Cancer Prev. 2019 Apr 29;20(4):1133-1137. doi: 10.31557/APJCP.2019.20.4.1133.
Introduction: Refusal and abandonment of treatment is often considered as an important reason for poor survival of pediatric cancer patients in developing and underdeveloped countries. In this study we analyze the factors responsible for treatment abandonment and refusal in a Regional Cancer Centre (RCC) in North East India. Material and Methods: All histopathologically or cytologically confirmed cases of childhood cancer from below 15 years of age registered from 1st April, 2010 to 31st March, 2017 were included in this study. Parents or caregivers were interviewed thoroughly and a questionnaire was filled up for analysis of demographic and socio-economic factors. Modified Kuppuswamy scale was used to measure socioeconomic status. Results: Of 592 patients 161 (27.1%) abandoned therapy and 23 (3.9%) refused treatment. Factors associated with abandonment of treatment included: lower risk if residing in urban areas (Odds ratio [OR] = 0.8333, 95% CI 0.565-1.228; P=0.36) and higher risk with maternal education less than secondary school (OR = 1.357; 95%CI: 0.553-3.326; P=0.505). Low socioeconomic status and age >5yrs were also associated with abandonment of treatment. In a binary logistic regression analysis, male sex [Odds Ratio (OR) = 0.701; 95% CI 0.48-1.01; P=0.062] have lowest risk of abandoning treatment with trend to statistical significance. Conclusion: There is a need for proper definition of the problem of childhood cancer patients so that appropriate policy can be introduced to improve survival by improving treatment compliance.
在发展中国家和不发达国家，拒绝和放弃治疗常被视为儿童癌症患者生存率低的重要原因。在本研究中，我们分析了印度东北部一家区域癌症中心（RCC）治疗放弃和拒绝的相关因素。材料与方法：纳入2010年4月1日至2017年3月31日登记的所有15岁以下经组织病理学或细胞学确诊的儿童癌症病例。对家长或照顾者进行了全面访谈，并填写了一份问卷以分析人口统计学和社会经济因素。采用改良的库普苏瓦米量表来衡量社会经济地位。结果：592例患者中，161例（27.1%）放弃治疗，23例（3.9%）拒绝治疗。与放弃治疗相关的因素包括：居住在城市地区风险较低（比值比[OR]=0.8333，95%可信区间0.565 - 1.228；P=0.36），母亲教育程度低于中学风险较高（OR = 1.357；95%可信区间：0.553 - 3.326；P=0.505）。社会经济地位低和年龄>5岁也与放弃治疗有关。在二元逻辑回归分析中，男性[比值比（OR）=0.701；95%可信区间0.48 - 1.01；P=0.062]放弃治疗的风险最低，有统计学意义的趋势。结论：需要对儿童癌症患者的问题进行恰当定义，以便出台适当政策，通过提高治疗依从性来提高生存率。
