Barriers to radiotherapy completion in breast cancer patients: A retrospective analysis from a tertiary hospital in Indonesia

Abstract

Introduction

Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality in Indonesia. Radiotherapy is a crucial treatment modality to improve local control, reduce recurrence, and enhance survival rates. However, access to radiotherapy remains limited, leading to prolonged waiting times and potential treatment incompletion. This study aims to identify key predictors influencing radiotherapy completion and analyze waiting times in a resource-limited setting

Methods

A retrospective study was conducted on breast cancer patients who underwent radiotherapy between January 2018 and December 2019 at Hasan Sadikin General Hospital, Indonesia. Data were obtained from the Hospital-Based Cancer Registry (HBCR). Statistical analyses were performed using chi-square and Mann-Whitney U tests to assess factors influencing radiotherapy completion and waiting time.

Results

279 Breast cancer patients were included. 77.8 % (n = 217) completed their prescribed radiotherapy. Significant predictors of completion include age, those older than 65 years old tend to do not complete their radiation treatment (p = 0.035). Those receiving treated using Linac radiotherapy had higher completion rates than those treated with Co-60. However, waiting time was not significantly associated with treatment completion (p = 0.427). The median radiotherapy waiting time was 8 weeks (0–40 weeks). Patients with metastatic disease (p < 0.001) and those receiving palliative intent radiotherapy (p < 0.001) experienced significantly shorter waiting times.

Conclusion

Radiotherapy completion rates among breast cancer patients in Indonesia remain suboptimal, with access disparities affecting treatment adherence. Addressing logistical and systemic barriers could improve outcomes and enhance cancer care delivery in resource-limited settings.

Plain language summary

Breast cancer is the most common cancer among women in Indonesia. Many patients require radiotherapy to prevent the disease from coming back and to improve survival. However, some patients do not complete their treatment due to long waiting times and other challenges. This study looks at how long patients wait for radiotherapy and what factors influence whether they complete treatment. We analyzed the medical records of 279 breast cancer patients who received radiotherapy at Hasan Sadikin General Hospital between 2018 and 2019. We examined their age, radiation therapy tools, waiting time, and whether they completed radiotherapy. We used statistical methods to find patterns and associations between these factors. Our findings suggest that certain groups of patients, especially older individuals and those undergoing curative treatment, may need additional support to complete their radiotherapy.