Article

Radiation Therapy: Predictors of Nonadherence to Treatment Schedules Among Patients With Head and Neck Cancer

Jennifer Miller

Laura A. Szalacha

Susan R. Hartranft

Carmen Rodriguez

head and neck cancer, radiation therapy, chemotherapy, adherence, depression
CJON 2021, 25(3), 305-313. DOI: 10.1188/21.CJON.305-313

Background: Patients with head and neck cancer (HNC) often undergo a demanding treatment schedule, including radiation therapy (RT). Nonadherence to RT schedules is a documented problem among patients with HNC and can negatively affect patient outcomes.

Objectives: This retrospective, descriptive study aimed to examine whether demographic or clinical characteristics or physical and psychological symptoms were associated with nonadherence to RT among patients with HNC.

Methods: Electronic health records of 262 patients with HNC who received treatment at a cancer center in the southeastern United States were reviewed to determine whether nonadherence was related to symptom scores and other patient- and clinical-related factors.

Findings: Patients at highest risk for nonadherence included women, those admitted as inpatients during treatment, and those who received outpatient IV fluids during treatment. Nonadherent patients reported higher mean scores on 9 of 12 symptoms measured during treatment, indicating a higher symptom burden. Patients with tongue tumors, greater spiritual well-being, and less constipation were less likely to be nonadherent.

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