Outcome of Combined Modality Treatment Employing Modern Chemotherapy with Cobalt Based Radiotherapy in Curaçao

Background

Many cancers are currently treated with the combination of radiotherapy and chemotherapy as a radiosensitizer (combined modality treatment, CMT). In Curaçao, radiotherapy is delivered employing a cobalt radiation machine (Theratronics (1981) and Plato treatment planning system (2002)). For most indications randomized controlled trials are lacking between linear accelerator based radiotherapy and cobalt based radiation. With the exception of specific cases, structurally referring patients to centers employing linear accelerator based radiotherapy, is not economically feasible. All patients in Curaçao eligible for CMT are treated at the Department of Hematology/Medical Oncology and Radiotherapy in the Saint Elisabeth Hospital. As a measure of quality of the care delivered, we want to assess outcome of CMT in Curaçao and compare this to published trial data as well as published ‘real world data’ in both low, middle and high income countries.

Study questions and methods

A retrospective analysis of all patients treated with CMT for the cancers stated below during the period 2010-2014 will be performed in order to answer the following questions:

1. What are the characteristics of the patients treated with CMT on Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer.
2. What is the progression free survival (PFS) of patients treated with CMT in Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer?
3. What are patterns of treatment failure in patients treated with CMT in Curaçao for rectal cancer, head and neck cancer, cervical cancer, lung cancer, esophageal cancer and anal cancer?
4. What are the determinants of PFS in these patients?
5. What are the rates of grade 3 and 4 toxicity during and after treatment?
6. How does our outcome compare to the literature, specifically to:

• Clinical trial data?
• Real world data in high income countries?
• Real world data in low- and middle income countries?

Study period

June – December 2016

Investigators

R van der Horst, medical student

Schnog, internist-hematologist/medical oncologist

Samson, radiation oncologist

Andrea, radiation oncologist

Coronel, pathologist

For more information contact:

Dr. John – John Schnog
Head of the department of Oncology
Address: Pater Eeuwensweg 36
Willemstad, Curaçao
Tel: +5999 788 9903
Email: j.schnog@cbhri.com