Causes of interruption of radiotherapy in nasopharyngeal carcinoma patients in Taiwan

Background: Nasopharyngeal cancer (NPC) is now curable with early diagnosis and radiotherapy treatment. In the past several decades, few studies have investigated why some patients fail to complete the recommended full course of radiotherapy. Methods: A total of 3273 nasopharyngeal carcinoma patients were treated at the Radiation Oncology Department of Linkou Chang Gung Memorial Hospital in a span of 18 years from 1979 to 1996. Among these patients, 276 did not co mplete the full course of treatment of radiation therapy. The medical recor ds of these patients were reviewed to determine the factors contributing to treatment interruption. Results: Of the 276 patients whose treatment was interrupted, 120 (43.5%) w ere unable to endure the acute side effects of radiation therapy and were a fraid of the possible complications resulting from the treatment; 57 (20.7% ) had doubts about the diagnosis or had the subjective perception that the treatment offered would be ineffective in view of the severity of their dis ease; 50 (18.1%) resorted to fork prescriptions; 17 (6.2%) were faced with socioeconomic problems; 15 (5.4%) sought treatment at another hospital owin g to transport considerations; 10 (3.6%) stopped radiation therapy and swit ched to chemotherapy for palliative management; seven (2.5%) resorted to pr aying, god worshipping and taking incense powder and magic elixirs because their families were against any established therapy. Conclusions: The acute side effects and complications caused by radiation t herapy were the major factors influencing patients' decisions to discontinu e treatment. This finding suggests that more attention should be paid to pr oviding care with regard to the acute side effects of radiotherapy and to r einforcing pretreatment education.