ABSTRACT
Noncompliance with therapy is a big obstacle to successful therapy.
We aimed to evaluate the prevalence and risk factors affecting the
compliance of pediatric cancer patients with therapy in a tertiary care
center far away from the capital in a lower-middle income country
(LMIC). A retrospective cohort study of reports of all pediatric cancer
patients who were diagnosed and started treatment between 2006
and 2010 at South Egypt Cancer Institute (SECI) was done. The following
data were collected: Age, sex, diagnosis, compliance with therapy,
and data on potential risk factors that might affect compliance,
including time duration of travel from the patient’s home to SECI,
time lag between the first symptom until the first visit to SECI and
until the start of treatment, results of reevaluation after the initial
course of therapy, and therapy-related severe adverse events.
Noncompliance with therapy was defined as when patients missed
their determined therapy appointment for one week or more or
abandoned therapy. This study included 510 patients. Eighty-three
(16.3%) were non-compliant, as forty patients missed their therapy
appointment (7.8%), and 43 abandoned further therapy (8.4%).
Noncompliance was found to be more prevalent among patients with
solid tumors. Non-compliant patients suffered a significantly higher
relapse rate (47.7% vs. 11.2% in compliant patients, p < .001).
Unfortunately, 75% of the abandoned patients who returned for further
therapy suffered a relapse. Noncompliance with treatment is still
a big problem facing cancer management in LMICs.