title: Feasibility of organ-preservation strategies in head and neck cancer in developing countries.
abstract: BACKGROUND
  Chemoradiotherapy is an established strategy for organ preservation in head-neck cancer. These protocols are associated with added toxicity and need support infrastructure. Practice setup and availability of resources vary at the community level in developing countries.
  
  
  OBJECTIVE
  To evaluate the feasibility of organ-preservation strategies in different settings in developing countries.
  
  
  METHODS
  Survey.
  
  
  METHODS
  In a questionnaire-based study, questions were directed to clinicians with varied practice setups to gather information regarding infrastructure, finance, and feasibility of organ-preservation protocols and their current practice trends.
  
  
  METHODS
  Descriptive.
  
  
  RESULTS
  Responses from 100 clinicians with focused practice in head-neck oncology were analyzed. Sixty-one percent clinicians were practicing organ preservation for advanced head-neck cancers in their practice. However, 65% centers lacked sufficient infrastructure to support organ-preservation protocols. Forty percent patients were treated on cobalt-radiotherapy machine. Fifty-nine percent of clinicians suggested that less than third of their patients were fit to undergo chemoradiation and 67% believed that adherence to treatment protocol was observed in less than two-thirds of cases. Based on their experience 82% clinicians felt that only one-third patients requiring salvage would actually undergo treatment. The majority of the patients (68%) used personal funds for treatment and less than one-third of the patients could afford complete treatment.
  
  
  CONCLUSIONS
  The infrastructure needed to support organ-preservation protocols varies significantly between centers in developing countries. It may not be feasible to perform organ-preservation strategies in certain centers and feasibility guidelines should be made for their judicious use in developing countries.
authors: Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Bangalore, India.
authors: N P
authors: NP
authors: Trivedi
authors: V D
authors: VD
authors: Kekatpure
authors: N N
authors: NN
authors: Trivedi
authors: M A
authors: MA
authors: Kuriakose
authors: G
authors: G
authors: Shetkar
authors: B V
authors: BV
authors: Manjula
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003906:Developing Countries; D005472:Fluorouracil / Q000008:administration & dosage; D017408:Guidelines as Topic; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000601:surgery / Q000628:therapy; D006295:Health Resources; D006801:Humans; D007194:India / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil