Review of radiation oncology emergencies in Lagos University Teaching Hospital, Nigeria

• Published in: SA journal of oncology Vol. 3; no. 7; pp. e1 - e8
• Main Authors: Adegboyega, Bolanle C, Sowunmi, Anthonia C, Alabi, Adewunmi O, Ojifinni, Oludoyinmola O, Adenipekun, Adeniyi A
• Format: Journal Article
• Language: English
• Published: Cape Town African Online Scientific Information Systems (Pty) Ltd t/a AOSIS 01.01.2019; AOSIS (Pty) Ltd; AOSIS
• Subjects: Age; Cancer; Cancer metastasis; Cancer therapies; Care and treatment; Chemotherapy; Compression; Demography; emergencies; Emergency medical care; Geopolitics; Hemorrhage; Medical emergencies; Metastases; Metastasis; Nigeria; Oncology; outcome; Pain; Patient outcomes; Patients; pattern; radiation; Radiation (Physics); Radiation therapy; Radiotherapy; Spinal cord; Spinal cord compression; Teachers; Teaching hospitals; Tranexamic acid; Tumors; University colleges; Nigeria
• ISSN: 2518-8704; 2518-8704
• DOI: 10.4102/sajo.v3i0.66

Background Radiation oncology emergencies (ROEs) are common in metastatic or locally advanced cancer accounting for a large proportion of radiotherapy indications in poor resource settings. Aim To review pattern, presentation and outcome of ROEs in Lagos University Teaching Hospital (LUTH) and compare with an earlier study in the northern part of the country for possible geographical variation. Setting A retrospective review of ROE record from 2008 to 2016 in LUTH. Method Demographic data, clinical presentation, treatment and outcomes were analysed using charts and frequency tables. Results Total of 458 cases of oncologic emergencies were reviewed. The mean age was 52.3 years with a male-to-female ratio of 1:2.2. The majority (85%) of the patients presented in stage IV, 10% stage III and 5% stage II diseases. Spinal cord compression was the commonest presentation seen in 53.9% of cases, brain metastases in 22.1% of patients and tumour haemorrhage in 22.5% of patients. Time from the onset of symptoms to treatment was between 24 and 48 h in 16.4%, > 48 h to 1 week in 64.4% and above 1 week in 19.2%. There was a complete or significant response in signs and symptoms in 77%, no improvement in 11% and 1.1% had disease progression. Conclusion This study showed a varied pattern of presentation in ROEs from what was obtained in northern Nigeria, with spinal cord compression being the commonest in south west Nigeria. Despite a delayed onset in treatment, radiation therapy is vital in oncology emergencies management. There is a need for accessible functional radiotherapy centres in Nigeria to combat the delays in commencing treatment.