Assessment of non-adherence to external radiotherapy treatment in cancer patients in Catalonia,Spain

Purpose or Objective: Non-adherence to external radiotherapy is an aspect of treatment which has not been fully explored. The objective of this study is to analyse the relevance of this problem and its impact on 1-year surviva

Impact of non-adherence to radiotherapy on 1-year survival in cancer patients in Catalonia, Spain

Background: This study aims to assess the effects of non-adherence to external beam radiation therapy in cancer patients receiving treatment with a curative. Methods: This retrospective cohort study collected health records data for all cancer patients treated with external beam radiotherapy with curative intent in 2016 in Catalonia, Spain. Adherence was defined as having received at least 90% of the total dose prescribed. A logistic regression model was used to assess factors related to non-adherence, and its association with one-year survival was evaluated using Cox regression. Results: The final sample included 8721 patients (mean age 63.6 years): breast cancer was the most common tumour site (38.1%), followed by prostate and colon/rectum. Treatment interruptions prolonged the total duration of therapy in 70.7% of the patients, and 1.0% were non-adherent. Non-adherence was associated with advanced age, female gender, and some localization of primary tumour (head and neck, urinary bladder, and haematological cancers). The risk of death in non-adherent patients was higher than in adherent patients (hazard ratio [HR] 1.63, 95% confidence interval 0.97-2.74), after adjusting for the potential confounding effect of age, gender, tumour site and comorbidity. Conclusion: Non-adherence to radiotherapy, as measured by the received dose, is very low in our setting, and it may have an impact on one-year survival

Understanding variations in the use of hypofractionated radiotherapy and its specific indications for breast cancer: A mixed-methods study

Background and purpose: Radiation oncology guidelines favour hypofractionated whole-breast radiotherapy (HWBRT) over more conventional schemes in the conservative treatment of breast cancer, but its adoption still varies in clinical practice. This study assessed the patterns of HWBRT adoption in Catalonia (Spain). Material and methods: We used a mixed-methods approach based on an explanatory sequential design, first collecting and analysing quantitative data on HWBRT use (>2.5 Gy per fraction) in 11 public radiotherapy centres (2005-2015) and then performing 25 semi-structured interviews with all department heads and reference radiation oncologist/s. Results: Of the 34,859 patients fulfiling the study criteria over the study period, just 12% were hypofractionated, reaching a percentage of 29% in 2015 (p < 0.001). Our analysis showed a narrowing age gap between patients receiving conventional fractionation and hypofractionation in centres leading adoption. However, there were important differences in clinicians' interpretation of evidence (e.g. regarding the perceived risk of long-term toxicity) and selection of patients for specific indications, both within and between departments. Conclusions: Differences observed in the rate of adoption of HWBRT could not be tackled only using a rational, evidence-based approach. Factors related to the management of radiotherapy departments play a major role in the diffusion of therapeutic strategies

La camelina Guarro (s. XIX-XX)

La Camelina Guarro fou un preparat farmacèutic molt popular a la Barcelona de la darreria del segle XIX i primer terç del XX. La seva provada eficàcia per a prevenir la caiguda del cabell i estimular-ne el creixement va ser fruit dels minuciosos estudis farmacològics d'un montblanquí, Joan Guarro i Robusté, i del qual en aquest capítol n'oferim un esbós biogràfic, així com la informació més rellevant de la loció que va popularitzar.Camelina Guarro has a pharmaceutical preparation very popular in Barcelona in the late nineteenth century and the first third of the twentieth century. Hit had been proved to prevent hair loss and stimulate its growth as the result of detailed pharmacological studies by Joan Guarro Robusté in Montblanc. In this chapter you will find a biographical sketch and most relevant information about this popular lotion.La Camelina Guarro fue un preparado farmacéutico muy popular en la Barcelona de finales del siglo XIX y el primer tercio del XX. Su contrastada eficacia en la prevención de la caída del cabello y la estimulación de su crecimiento fueron los resultados de minuciosos estudios farmacológicos de un montblanquense, Joan Guarro i Robusté, del cual en este artículo ofrecemos una síntesi biográfica, así como la información más relevante de la loción que popularizó