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Feyisa JD, Addissie A, Kantelhardt EJ, Zingeta GT, Mideksa HS, GebreLibanos H, Mengesha T, Assefa M. Health-related quality of life assessment among patients with oesophageal cancer at Tikur Anbessa Specialised Tertiary Hospital in Ethiopia: a cross sectional study. Ecancermedicalscience 2024; 18:1656. [PMID: 38425768 PMCID: PMC10901634 DOI: 10.3332/ecancer.2024.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Indexed: 03/02/2024] Open
Abstract
Background In low-income countries, oesophageal cancer often presents at an advanced stage, leaving patients with limited curative treatment options. Furthermore, palliative treatments such as oesophageal stents or brachytherapy are lacking. This has a detrimental effect on their quality of life. In this study, we investigated the health-related quality of life of patients with oesophageal cancer at a tertiary hospital in Ethiopia. Methods This cross-sectional study was conducted at Tikur Anbessa Specialised Tertiary Hospital in Ethiopia. The validated Amharic version of the questionnaire of the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire Cancer 30 (EORTC QLQ C-30) and the oesophageal cancer disease-specific questionnaire QLQ-OES18 were used to assess the quality of life of each patient. Results The overall mean score for the EORTC QLQ C-30 was 35.43 (SD 18.04). The mean scores for the functional scales revealed that cognitive function was the highest, whereas role function was the lowest. The symptom scale results showed the highest score for pain and the lowest for diarrhoea. Dysphagia, choking, role functioning and financial difficulty correlated with the quality of life of patients with oesophageal cancer. Conclusion Dysphagia, choking, role functioning and financial difficulty are important factors that affect the quality of life of patients with oesophageal cancer patients. Increasing the availability of palliative treatments for dysphagia to improve the quality of life in patients with oesophageal cancer is recommended.
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Affiliation(s)
- Jilcha Diribi Feyisa
- Department of Oncology, Saint Paul’s Hospital Millennium Medical College, Addis Ababa 1271, Ethiopia
- Department of Radiation Oncology and Applied Sciences, Dartmouth Cancer Center, Lebanon, NH 03756, USA
- https://orcid.org/0000-0002-5344-5340
| | - Adamu Addissie
- Global Health Working Group, Institute for Medical Epidemiology, Biometrics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 53170, Germany
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa 9086, Ethiopia
| | - Eva Johanna Kantelhardt
- Global Health Working Group, Institute for Medical Epidemiology, Biometrics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 53170, Germany
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 53170, Germany
| | - Girum Tessema Zingeta
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia
- https://orcid.org/0000-0003-0272-8460
| | - Hiwot Saboksa Mideksa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia
| | - Helen GebreLibanos
- Department of Epidemiology, School of Public Health, Debre Birhan University, Debre Birhan 445, Ethiopia
| | - Tariku Mengesha
- Department of Research, Saint Peter’s Specialised Hospital, Addis Ababa 21494, Ethiopia
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia
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Zingeta GT, Worku YT, Awol M, Woldetsadik ES, Assefa M, Chama TZ, Feyisa JD, Bedada HF, Adem MI, Mengesha T, Wong R. Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study. JCO Glob Oncol 2024; 10:e2300253. [PMID: 38181315 DOI: 10.1200/go.23.00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/11/2023] [Accepted: 11/02/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE Head and neck cancers (HNCs) are the third most commonly treated cancer with radiation in Ethiopia. Most patients present with advanced stage and are not candidates for curative treatment. The objective of our study is to assess the outcome of hypofractionated palliative radiotherapy (RT) for advanced HNCs in a resource-limited setting. MATERIALS AND METHODS Patients with histology-proven advanced HNC candidates for hypofractionated palliative RT were enrolled. Three regimens were allowed: 44.4 Gy in 12 fractions, 30 Gy in 10 fractions, and 20 Gy in five fractions. Response to treatment was assessed at baseline and at 4 weeks after treatment completion. The Kaplan-Meier curve was used to measure the survival. RESULTS Between January 2022 and January 2023, 52 patients were enrolled and 25 patients were eligible for outcome assessment. Index symptoms include pain, bleeding, dysphagia, respiratory distress, and others in 25, 13, 10, 6, and 17 patients, respectively. Complete relief of the top three symptoms include pain in 52% of patients, hemostasis in 84% of patients, and dysphagia in 30% of patients. Objectively, 64% of patients attained partial response. For 48% of patients, their quality of life (QoL) improved in one parameter of the physical scores. Moreover, 64% of patients showed improvement in three parameters. The global functional score improved in 80% of patients. One patient had grade 3 xerostomia. At the end of the study period, 44% of patients died. The median survival after radiation was 9 months (95% CI, 7.2 to 10.8). CONCLUSION All palliative hypofractionated regimens used were effective in terms of symptom control, tumor response rate, and QoL, and were well tolerated. This makes it appropriate for our setup because the majority of patients require palliation.
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Affiliation(s)
- Girum Tessema Zingeta
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannes Tesfaye Worku
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Munir Awol
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Edom Seife Woldetsadik
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsion Zebdios Chama
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jilcha Diribi Feyisa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Radiation Oncology and Applied Sciences, Dartmouth Cancer Center, Lebanon, NH
| | - Hawi Furgassa Bedada
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Oncology, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mohammed Ibrahim Adem
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Oncology, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Rebecca Wong
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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Jr JDF, Aseffa M, Zingeta GT, Abegaz KH, Berhane Y. Cervical Cancer Progression in Patients Waiting for Radiotherapy Treatment at A Referral Center in Ethiopia: A Longitudinal Study. Int J Radiat Oncol Biol Phys 2023; 117:e581-e582. [PMID: 37785766 DOI: 10.1016/j.ijrobp.2023.06.1923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Non metastatic cervical cancer is curable and can be treated with radiotherapy. A delay in receiving treatment due to long waiting times results in upstaging of the disease stage and negatively affects the treatment outcomes. However, real world evidence that progression occurs while waiting for treatment is scarce in low-income countries. We evaluated the impact of long waiting times for radiotherapy in patients with cervical cancer at a referral center in Ethiopia. MATERIALS/METHODS A longitudinal study was conducted from January 5, 2019, to May 30, 2020, to address the objectives of this study. Pathologically diagnosed cervical cancer patients with stage IIB to stage IVA were included in the study. We used Kaplan-Meier analysis to assess overall survival with time. Multivariate Cox regression analysis, using the backward LR selection method, was used to fit the final model. RESULTS The median waiting time for radical radiotherapy after diagnosis was 477 days. Waiting for more than 51 days for radiotherapy results in disease progression. Of the 115 patients included in this study, 59 (51.3%) died during the study. A delay in waiting (AHR = 3, 95% CI:1.7-4.9) was significantly associated with disease progression and decreased survival. CONCLUSION Waiting time to receive radiotherapy is very long. Urgent action is required to significantly reduce waiting times and improve the survival of cervical cancer patients.
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Affiliation(s)
- J D Feyisa Jr
- Addis Ababa University School of Medicine Department of Radiotherapy, Addis Ababa, Addis Ababa, Ethiopia
| | - M Aseffa
- Addis Ababa University School of Medicine Department of Radiotherapy, Addis Ababa, Addis Ababa, Ethiopia
| | | | - K H Abegaz
- Madda Walabu University, Ethiopia., Addis Ababa, Ethiopia
| | - Y Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Zingeta GT, Worku YT, Getachew A, Feyisa JD, Furgassa H, Belay W, Mengesha T, Jemal A, Assefa M. Clinical presentation, treatment patterns, and outcomes of colorectal cancer patients at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia: A prospective cohort study. Cancer Rep (Hoboken) 2023; 6:e1869. [PMID: 37452615 PMCID: PMC10480423 DOI: 10.1002/cnr2.1869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/04/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common cause of cancer death in both genders worldwide. AIMS This study aimed to evaluate the outcomes and prognostic factors of CRC patients at Tikur Anbessa Specialized Hospital in Ethiopia. METHODS AND RESULTS A prospective cohort study was conducted on 209 patients from January 2020 to September 2022. Kaplan-Meier curves and bivariate and multivariate Cox regression analyses were used to analyze overall and progression-free survival, with a significance value of P < .05. Results showed an overall mortality rate was 67.46% (95% confidence interval [CI]: 61.0-74.0), while the 1-year overall survival (OS) rate was 63.16% (95% CI: 56.23-69.29), with a median follow-up duration of 20 months. The median OS and progression-free survival times were 17 and 11 months, respectively. Age above 40 years (hazard ratio [HR] = 1.53, 1.02-2.29, p < .040), lower educational level (high school and below) (HR = 2.20, 1.24-3.90, p < .007), poor performance status (HR = 1.60, 1.03-2.48, p < .035), Hgb ≤12.5 g/dL (HR = 1.55, 1.03-2.08, p < .035), T-4 disease (HR = 6.05, 2.28-16.02, p < .000), and metastases at diagnosis (HR = 8.53, 3.77-19.25, p < .000) were all associated with poorer survival. CONCLUSION These findings suggest that poor survival of CRC patients in Ethiopia is largely due to advanced stage of the disease and lack of timely treatment, and highlight the urgent need for improved access to cancer treatment in the region.
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Affiliation(s)
| | - Yohannes T. Worku
- Department of Oncology, School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
| | - Assefa Getachew
- Department of Radiology, School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
| | - Jilcha Diribi Feyisa
- Department of Oncology, School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
- Department of OncologySaint Paul Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Hawi Furgassa
- Department of Oncology, School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
- Department of OncologySaint Paul Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Winini Belay
- Department of Reproductive Health and Health Service Management, School of Public HealthAddis Ababa UniversityAddis AbabaEthiopia
| | - Tariku Mengesha
- Department of EpidemiologySt. Peter Specialized HospitalAddis AbabaEthiopia
| | - Ahmedin Jemal
- Department of Surveillance and Health Services ResearchAmerican Cancer SocietyAtlantaGeorgiaUSA
| | - Mathewos Assefa
- Department of Oncology, School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
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