Compliance to National Cancer Grid of India Guidelines for Locally Advanced Cervical Cancer: Results From a Multicentric Observational Cohort in India
8 affiliations
- 1Department of Radiation Oncology, Clinical Research Centre, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, Maharashtra, India
- 2Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- 3Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
- 4MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, India
- 5Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, A Unit of Tata Memorial Centre, New Chandigarh/Sangrur, Punjab, India
- 6Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Mahanama Pandit Madan Mohan Malviya Cancer Centre, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
- 7Valavadi Narayanaswamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
- 8Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
Abstract
PurposeCervical cancer is a major cause of mortality among Indian women. Concurrent chemoradiation and brachytherapy is the standard care for locally advanced cancer. This multi-institutional implementation audit evaluated adherence to National Cancer Grid (NCG)–recommended treatment guidelines.MethodsIn the first phase, seven academic and private cancer centers registered consecutive patients treated with chemoradiotherapy and brachytherapy during a 6-month period (2019-2023). Infrastructure, equipment, staging, and treatment data were collected. Compliance to NCG guideline–defined metrics for external-beam radiation therapy, chemotherapy, brachytherapy, and overall treatment time was assessed using prespecified deviation criteria. Univariate and multivariable logistic regression identified factors associated with deviations.ResultsOf 697 patients, 569 received radical treatment. Stage IIB (International Federation of Gynecology and Obstetrics 2018) was most common. Almost 60% of patients traveled >100 km, 67.7% were nonobese, and 73.1% were younger than 60 years. Over 80% received three-dimensional conformal radiotherapy. For brachytherapy, computer tomography imaging was most frequent (66%). Although intracavitary applicators were used in 83%, hybrid intracavitary-interstitial brachytherapy was limited (6%). Prescription remained point A–based in 69%, although volume-based prescriptions increased through 2019-2022. Cisplatin was the commonest chemotherapy agent (80%). Only 36.6% of chemotherapy-eligible patients completed ≥5 cycles and 47.5% completed treatment <8 weeks. Obesity status, center type, and travel distances were associated with compliance deviations. Multivariable analyses confirmed private centers had lower odds of major/unacceptable overall treatment time–related deviations (odds ratio [OR], 0.39 [95% CI, 0.22 to 0.68]).ConclusionThis audit highlights deviations from guideline-recommended practice, including prolonged treatment times, incomplete chemotherapy delivery, and limited use of advanced techniques. Prospective phase of this study will focus on implementation of quality indicators.
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BibTeX
@article{chopra2026compliance,
title = {{Compliance to National Cancer Grid of India Guidelines for Locally Advanced Cervical Cancer: Results From a Multicentric Observational Cohort in India}},
author = {Supriya Chopra and Varsha Hande and Ankita Gupta and Bhavana Rai and Smita Bansode and Thomas Samuel Ram and Sanjeeva Kumari and Sahil Sood and Abhishek Shinghal and Karthiga Sivaprakasam and Satyajit Pradhan and Prachi Mittal and Jaya Ghosh and Tapas Dora and Sudeep Gupta},
journal = {JCO Global Oncology},
year = {2026},
month = nov,
doi = {10.1200/go-26-00179},
url = {https://doi.org/10.1200/go-26-00179},
note = {CC BY},
}
RIS
TY - JOUR
TI - Compliance to National Cancer Grid of India Guidelines for Locally Advanced Cervical Cancer: Results From a Multicentric Observational Cohort in India
AU - Supriya Chopra
AU - Varsha Hande
AU - Ankita Gupta
AU - Bhavana Rai
AU - Smita Bansode
AU - Thomas Samuel Ram
AU - Sanjeeva Kumari
AU - Sahil Sood
AU - Abhishek Shinghal
AU - Karthiga Sivaprakasam
AU - Satyajit Pradhan
AU - Prachi Mittal
AU - Jaya Ghosh
AU - Tapas Dora
AU - Sudeep Gupta
PY - 2026
DA - 2026/11/12
JO - JCO Global Oncology
DO - 10.1200/go-26-00179
UR - https://doi.org/10.1200/go-26-00179
AB - PurposeCervical cancer is a major cause of mortality among Indian women. Concurrent chemoradiation and brachytherapy is the standard care for locally advanced cancer. This multi-institutional implementation audit evaluated adherence to National Cancer Grid (NCG)–recommended treatment guidelines.MethodsIn the first phase, seven academic and private cancer centers registered consecutive patients treated with chemoradiotherapy and brachytherapy during a 6-month period (2019-2023). Infrastructure, equipment, staging, and treatment data were collected. Compliance to NCG guideline–defined metrics for external-beam radiation therapy, chemotherapy, brachytherapy, and overall treatment time was assessed using prespecified deviation criteria. Univariate and multivariable logistic regression identified factors associated with deviations.ResultsOf 697 patients, 569 received radical treatment. Stage IIB (International Federation of Gynecology and Obstetrics 2018) was most common. Almost 60% of patients traveled >100 km, 67.7% were nonobese, and 73.1% were younger than 60 years. Over 80% received three-dimensional conformal radiotherapy. For brachytherapy, computer tomography imaging was most frequent (66%). Although intracavitary applicators were used in 83%, hybrid intracavitary-interstitial brachytherapy was limited (6%). Prescription remained point A–based in 69%, although volume-based prescriptions increased through 2019-2022. Cisplatin was the commonest chemotherapy agent (80%). Only 36.6% of chemotherapy-eligible patients completed ≥5 cycles and 47.5% completed treatment <8 weeks. Obesity status, center type, and travel distances were associated with compliance deviations. Multivariable analyses confirmed private centers had lower odds of major/unacceptable overall treatment time–related deviations (odds ratio [OR], 0.39 [95% CI, 0.22 to 0.68]).ConclusionThis audit highlights deviations from guideline-recommended practice, including prolonged treatment times, incomplete chemotherapy delivery, and limited use of advanced techniques. Prospective phase of this study will focus on implementation of quality indicators.
SN - 2687-8941
ER -