Radiation therapy at the end of life: a population-based study examining palliative treatment intensity

Radiation Oncology

Arnold L Potosky¹  Andrew Satinsky²  Tania Lobo¹  Huei-Ting Tsai¹  Roxanne E Jensen¹  Marie-Adele Sorel Kress² 

[1] Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven St, NW Suite 4000, Washington 20007, DC, USA;Huron River Radiation Oncology, 5301 E Huron River Dr Ann Arbor, Michigan 48106, USA

关键词: End-of-life care;    Radiation oncology;    Radiotherapy;    Radiation therapy;    SEER-Medicare;    Palliative care;   

Others  :  1149978
DOI  :  10.1186/s13014-014-0305-4

 received in 2014-06-27, accepted in 2014-12-15,  发布年份 2015

【 摘 要 】

Background

To examine factors associated with the use of radiation therapy (RT) at the end of life in patients with breast, prostate, or colorectal cancer.

Methods

Using data from the Surveillance, Epidemiology, and End Results (SEER) – Medicare database, patients were over age 65 and diagnosed between January 1, 2004 and December 31, 2011 with any stage of cancer when the cause of death, as defined by SEER, was cancer; or with stage 4 cancer, who died of any cause. We employed multiple logistic regression models to identify patient and health systems factors associated with palliative radiation use.

Results

50% of patients received RT in the last 6 months of life. RT was used less frequently in older patients and in non-Hispanic white patients. Similar patterns were observed in the last 14 days of life. Chemotherapy use in the last 6 months of life was strongly correlated with receiving RT in the last 6 months (OR 2.72, 95% CI: 2.59-2.88) and last 14 days of life (OR 1.55, 95% CI: 1.40-1.66). Patients receiving RT accrued more emergency department visits, radiographic exams and physician visits (all comparisons p < 0.0001).

Conclusions

Among patients with breast, colorectal, and prostate cancer, palliative RT use was common. End-of-life RT correlated with end-of-life chemotherapy use, including in the last 14 days of life, when treatment may cause increased treatment burden without improved quality of life. Research is needed optimize the role and timing of RT in palliative care.

【 授权许可】

   
2015 Kress et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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