medwireNews: While the overall rate of radiotherapy (RT) use among patients with metastatic cancer in their last year of life was stable between 2000 and 2007, the use of advanced techniques increased during the period, show US study results.
The findings may help to explain the observed increasing costs associated with radiation oncology care over the past decade, suggest the researchers in Cancer.
Several non-clinical factors, including race, marital status, and neighborhood income, also significantly affected the receipt of RT in this population of metastatic breast, colorectal, lung, pancreas, and prostate cancer patients.
"The overall rates of advanced radiation technology use were relatively low; however, the steepness of the slopes of their rise may have significant future cost implications for radiation oncology in advanced cancer care," write Beverley Ashleigh Guadagnolo (MD Anderson Cancer Center, Houston, Texas) and co-workers.
The study population included 64,525 patients aged at least 65 years and older, whose details were identified in the Surveillance, Epidemiology, and End Results database. A third (29.7%) of all patients received some form of RT after their metastatic cancer diagnosis.
Multivariate analysis showed that RT was more likely to be received by non-Hispanic White, Hispanic, and non-Hispanic other ethnicity patients compared with non-Hispanic Black patients; married compared with single patients; and in patients from higher compared with lower income neighborhoods.
Of the 18,718 patients who received RT and had the RT type documented, there was a significant increase in the rate of intensity-modulated (IM) RT between 2000 and 2007, from 0.0% to 4.93%. The proportion of patients who received stereotactic radiosurgery (SRS) - a RT therapy commonly used for the specific treatment of metastases - increased significantly from 0.13% to 3.72%.
Overall, use of 2D-RT decreased during the period studied, while use of 3D-RT increased, report the researchers, although this is in part due to improved imaging capabilities for planning, they remark.
"The advantage of IMRT arises in higher conformality of the area targeted for full radiotherapy dose," say Guadagnolo et al.
Meanwhile, "SRS techniques are often delivered in fewer treatment days than conventional radiotherapy techniques, and therefore offer a more convenient treatment course for eligible patients," the team concludes.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
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