ANALYSIS OF CAUSES OF INTERRUPTION OF RADIOTHERAPY TREATMENT IN A CANCER CENTER

Many prognostic factors may directly or indirectly affect local cancer control, including discontinuation of radiotherapy treatment, which is an independent and significant factor primarily in the management of lung and head and neck cancer. Interruptions are always consequences of unwanted incidents that may compromise the likelihood of tumor control, are caused by predictable reasons such as preventive maintenance, treatment or unpredictable schedules such as toxicity, clinical complications, and corrective maintenance. This study aimed to analyze the frequency and causes of treatment discontinuation in patients undergoing radiotherapy and it was conducted in the radiotherapy department of the AC Camargo Cancer Center, data were collected through a report extracted from the radiotherapy information system (Aria) and consultation in electronic health record. This study has included patients who were underwent outpatient radiotherapy treatment from January to December 2018, totaling 235 patients. The main reason for discontinuation of treatment it was lack of clinical conditions of the patient, 85% of treatment interruptions were due to toxicity, clinical deterioration or infection-related, 4% had pause related to scheduling brachytherapy sessions, 1% due to planning-related factors, 01% awaiting the result of additional tests, 02% for other reasons and 4% died during treatment, 50% of patients who had their treatment permanently suspended due to lack of clinical conditions died on average 23 days after discontinuation. 58% of the patients had curative therapeutic purpose and may have had the treatment schedule altered upon discontinuation. The causes of interruption are not widely discussed as their impact on prognosis. Identifying the different causes of interruption has brought us a clear vision to act preventively ensuring safety and quality in the course of radiotherapy. This project has shown us that it is possible to improve the process in several aspects, from interruption prevention to root cause management with the implementation of quality indicators. For more effective analysis it is necessary to evaluate the patient‘s absenteeism, as it appears as a recurrent but it was not addressed in this study.