Psychosocial and quality of life assessment in cancer patients: a pilot study in Indian set up

Background: Routine screening for distress is internationally recommended as a standard of care among cancer patients. This study was conducted to assess the level of stress and determine the association between quality of life (QOL) with demographic, socio-economic status, treatment phase, cancer stage, etc.Methods: An observational study, performed in the department of Clinical Oncology, Nayati Multi Super Speciality Hospital, Mathura, India. Data of 62 histopathologically proven cancer patients between Nov 2016 and July 2018, were analyzed. This pilot study was conducted to assess the QOL and stress levels of cancer patients by using scales of WHOQOL-BREF, QSC-R23 and Hamilton scale. Results: Among 62 cancer patients, high distress along with poor QOL was seen maximum in males, 40-60 year age group and educated. In majority of domains, high distress was found in middle class, whereas poor QOL was found in Lower class in Environmental domain (p<0.01). We found higher distress in nuclear families (p<0.05). High distress was seen in cancer patients who were aware of illness and was found to statistically significant. Poor QOL in stage 4 was found to be statistically significant in Psychological domain of WHOQOL-BREF. High distress was found in patients undergoing treatment in all patients as compared to Pre-treatment phase and Post-treatment phase (p<0.05).Conclusion: To assess psychological stress in cancer patients using all three scales we could not obtain a conclusive result covering all dimensions of QOL. So, in our next study authors plan to develop one indigenous new scale.

Retrospective analysis of random and systematic errors in radiation therapy of head and neck cancer patients and its clinical predictive implications with VMAT treatment

Background: The accuracy of radiotherapy is based on the matching of 2D portal/CBCT image with a reference image. The aim of this study is to determine the random and systematic setup errors (in cm) in radiotherapy of head and neck cancer patients and to derive the setup margin and its clinical implications.Methods: Author retrospectively reviewed the records of 25 head and neck cancer (HNC) patients treated with radiotherapy between Dec 2017 and July 2018. After immobilization, setup accuracy was assessed by registration of XVI image with planning reference image using Elekta XVI image guidance system and the isocenter correction was applied. For each patient 10 CBCT image sets were taken. The translational errors in X, Y and Z directions were used to estimate systematic (Σ) and random (σ) errors and to derive the final setup margin by using van Herk’s formula (2.5Σ + 0.7σ).Results: The mean translational errors ranges from -0.23 cm to 0.32 cm in Lateral (X), -0.15 to 0.16 cm in Longitudinal (Y) and -0.11 to 0.17 cm in vertical (Z) directions. The Mean and SD for systematic errors 0.21±0.13, 0.11±0.18, 0.14±0.11 and random error (in cm) are -0.03±0.33, 0.00±0.21 and 0.05±0.30 in X, Y and Z axis respectively. The final total margin for CTV to PTV including setup margin in the X, Y and Z directions (in cm) were 0.56, 0.61, and 0.47 respectively.Conclusion: Thus, the precise immobilization techniques are very important to reduce the setup margins, and the number of CBCTs during head and neck radiotherapy treatment.