Impact of patient nationality on the severity of early side effects after radiotherapy

J Cancer Res Clin Oncol. 2023 Aug;149(9):5573-5582. doi: 10.1007/s00432-022-04505-0. Epub 2022 Dec 10.

Abstract

Background: Major demographical changes in Germany commenced in the 1960s. Ongoing humanitarian crises in the Ukraine with subsequent immigration will have also long-range effects on national provision of cancer treatment. Ensuring the best possible outcomes for each cancer patient undergoing radiotherapy requires the prediction and prevention of unfavorable side effects. Given that recent research has primarily focused on clinical outcome indicators solely, less is known regarding sociodemographic predictors of therapeutic outcomes, such as patient nationality. Here, we investigated whether the severity of early side effects after radiotherapy are associated with patient nationality and other sociodemographic and clinical characteristics.

Methods: Out of 9187 patients treated at a German university medical center between 2017 and 2021, 178 German and 178 non-German patients were selected for matched-pair analysis based on diagnostic and demographic criteria. For all 356 patients, data on side effects from follow-up care after radiotherapy were collected.

Results: Non-German patients were more likely to have severe side effects than German patients. Side effect severity was also associated with tumor entity, concomitant therapy, body mass index, and age.

Conclusion: Foreign cancer patients are at higher risk of experiencing severe side effects of radiotherapy, suggesting a need to develop and implement targeted preventive measures for these patients. Further research investigating factors predicting the occurrence of radiotherapy side effects, including other sociodemographic characteristics, is needed to better personalize therapy regimens for cancer.

Keywords: Immigration; Personalize therapy; Preventive medicine; Radiation therapy; Side effects.

MeSH terms

  • Drug-Related Side Effects and Adverse Reactions* / etiology
  • Ethnicity
  • Germany / epidemiology
  • Humans
  • Neoplasms* / etiology
  • Neoplasms* / radiotherapy
  • Patients
  • Radiotherapy / adverse effects