Factors associated with complex oral treatment device usage in patients with head and neck cancer

Clinical and Translational Radiation Oncology

William Perkison¹  Mark S. Chambers²  Stephen Palasi³  Brandon Gunn³  William Morrison³  Jennifer Lagunas³  David I. Rosenthal³  Adam Garden³  Mikaela Bankston³  Joy Godby³  Hannah Burrows³  Eugene J. Koay³  Clifton David Fuller³  Ning Zhang⁴  Sharon Giordano⁴ 

[1] Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, United States;Department of Head and Neck Surgery, Division of Surgery, MD Anderson Cancer Center, Houston, TX, United States;Department of Radiation Oncology, Division of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, United States;Health Service Research Department, Division of Cancer Prevention and Population Science, MD Anderson Cancer Center, Houston, TX, United States;

关键词: Stent;    SEER-Medicare;    Oral mucositis;    Head and neck cancer;    Radiation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC). Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed. Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66–70 (OR = 0.713, 95% CI: 0.528–0.962), male patients (OR = 0.817, 95% CI: 0.710–0.941), non-Hispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582–0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279–0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage. Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.

【 授权许可】

Unknown