Compliance to Multimodality Treatment for Oesophageal Cancer at a High Incidence Region of India

Oesophageal cancer (EC) is extremely aggressive in nature. Despite intensive multimodality treatment, survival is poor at the expense of high treatment-related morbidity. Meghalaya has the highest incidence of EC in India. Outcome of treatment for EC is dismal, and the compliance to the treatment is very low. This study strives to look for the compliance of patients to multimodality treatment at a tertiary hospital in Northeast India. This is an analysis of a prospectively maintained database (Ethics Committee approved) of all patients diagnosed with EC and advised management by the Multidisciplinary Team (MDT) at a tertiary health care centre at North East India between 31st January, 2023 and 31st December, 2024. The socio demographic, clinical, and treatment related details were recorded. The compliance to the treatment plan was assessed, with changes in the final treatment noted. Descriptive and analytical statistics were used. A total of 106 patients with EC were planned for curative (69.8%) and palliative (30.2%) treatment. The commonest ethnic background was Khasi-Jaintia tribe (88.6%%). Only 20.0% (12) of the patients who were advised neoadjuvant chemotherapy-surgery (NACT-Sx) or neoadjuvant chemoradiation-surgery (NACTRT-Sx) were able to complete the planned treatment. It was seen that 41(55.4%) patients receiving curative management were noncompliant. Patients belonging to urban region has higher odds of adherence to NACT-Sx [OR (95% CI): 1.400 (0.342-5.734)], NACTRT-Sx [OR (95% CI): 1.200 (0.304-4.743)], chemoradiation [OR (95% CI): 1.112 (0.983-1.842)], and palliative therapy [OR (95% CI): 1.015 (0.971-1.984)] than rural region. Compliance to multimodality treatment of EC at the study centre is poor. Further studies are recommended to find out the reason of low compliance to multimodality treatment.