Radiotherapy for breast cancer patients in Indonesia: evaluation of adherence, health outcomes, and financial barriers to support bridging of treatment gaps
Radiotherapy for breast cancer patients in Indonesia: evaluation of adherence, health outcomes, and financial barriers to support bridging of treatment gaps
Breast cancer is the most diagnosed cancer in Indonesia, with high incidence and mortality rates. Radiotherapy is one of the most crucial treatments to reduce breast cancer recurrence and mortality. However, the availability of radiotherapy services is still limited in Indonesia, resulting in long waiting times, with about 60% of patients having unmet radiotherapy demands. Because these gaps affect patients’ quality of life and survival, Indonesia needs to improve breast cancer management.
This thesis of Ayu Suryanegara investigates the obstacles to implementing radiotherapy services in Indonesia to help bridge treatment gaps. The results show that radiotherapy services in Indonesia have low completion rates and a high number of treatment interruption days. Additionally, non-adherence was potentially associated with poorer clinical outcomes and lower health-related quality of life. Furthermore, National Health Insurance tariffs for radiotherapy services in Indonesia were insufficient to cover the actual costs of outpatient radiotherapy.
The findings suggest that enhancing radiotherapy service infrastructure, implementing hypofractionation radiotherapy, and revising tariffs or the reimbursement system may enhance adherence, health-related quality of life, and clinical outcomes for breast cancer patients.