Loise Wairiri, MD
Nominated From: University of Washington
Research Site: Kenyatta National Hospital
Research Area: Cancer, HIV
Primary Mentor: Dr. McKenna Eastment
Research Project
Evaluation of Treatment-related Outcomes and Implementation of Supportive Management Tools for People Living with HIV and General Patient Population Undergoing Definitive Management for Locally Advanced Cervical Cancer in a Resource-Limited Setting
Treatment and overall survival outcomes for locally advanced cervical cancer in resource-limited settings are poor. Factors contributing to these outcomes include a lack of treatment completion, often due to treatment-related toxicities, and late-stage presentation of the disease. Newer prospective series suggest that completion of radiation treatment in People Living with HIV (PLWH) yields comparable outcomes to the general population without HIV. Treatment completion and duration in treatment are consistently demonstrated in the literature as independent favorable indicators for overall survival in locally advanced cervical cancer. The research project’s main hypothesis is that implementing strategies to enhance supportive management for radiation therapy within the existing clinical workflow can increase treatment completion rates and improve post-treatment surveillance for both PLWH and the general patient population, consequently improving treatment outcomes. Proposed tools and strategies to be implemented include pre-treatment educational materials, on-treatment questionnaires, on treatment radiation contouring software, and post-treatment educational materials to guide in surveillance. All implementation tools will be developed with the aid of the on-site clinical team to reflect provider team recommendations and guidelines. The primary objective of the study is to evaluate the current treatment outcomes for locally advanced cervical cancer for PLWH and the general population at Kenyatta National Hospital (KNH) in the era of modern radiation treatment techniques. We will first collect retrospective data to assess the current landscape of treatment outcomes for locally advanced cervical cancer. Afterwards collect prospectively and analyze treatment completion data and variables on the implementation of the tools. The project aims to improve treatment outcomes, lower barriers to care, and enhance post-treatment surveillance rates for locally advanced cervical cancer in KNH, with the goal that this can be implemented in other cancer clinics in Kenya.
Research Significance
There are significantly poor outcomes from locally advanced cervical cancer in LMICs as compared to other populations in the world. This research aims to interrogate, quantify, and analyze contributing factors to these poor outcomes in an LMIC. The proposal also seeks to implement low cost supportive tools that can be easily integrated to the clinic and potentially can be applied widely to other LMICs, with the aim of improving locally advanced cervical cancer outcomes in both HIV and general patient populations.
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