Heidi N Yeung1, William M Mitchell1, Eric J Roeland1, Beibei Xu2, Loren K Mell2, Quynh-Thu Le3, James D Murphy4. 1. Division of Palliative Medicine, Department of Internal Medicine, University of California, San Diego, La Jolla, USA. 2. Department of Radiation Medicine and Applied Sciences, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, USA. 3. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California, USA. 4. Department of Radiation Medicine and Applied Sciences, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, USA. Electronic address: j2murphy@ucsd.edu.
Abstract
CONTEXT: Randomized data support shorter radiotherapy courses for management of cancer-related symptoms in the palliative setting. OBJECTIVES: The purpose of this study was to evaluate the length of palliative radiotherapy before hospice enrollment among the elderly U.S. population, with a further focus on factors that influence the duration of radiation and the length of survival on hospice, including whether the duration of radiation was associated with length of survival on hospice. METHODS: A total of 6982 patients with breast, prostate, lung, or colorectal cancer who received a course ofradiotherapy within 30 days before hospice enrollment were identified within the Surveillance, Epidemiology, and End Results-Medicare linked database. The primary end points included the duration of palliative radiotherapy and the time from hospice enrollment through death (hospice duration). Multivariate linear regression and multivariate Cox models evaluated factors associated with the length of radiotherapy course and hospice duration. RESULTS: The median length of palliative radiotherapy was 14 days, and the median hospice duration was 13 days. The course of palliative radiotherapy was longer than hospice duration in 48% of the patients. Breast and lung cancer were associated with longer courses of radiotherapy and shorter stays on hospice. Patients treated in freestanding radiation centers had longer courses of radiotherapy. For these groups, a longer radiotherapy course was not associated with longer hospice duration. CONCLUSION: This study found relatively long courses of radiotherapy before short lengths of survival on hospice. Future research is needed to identify barriers to shorter radiotherapy courses.
RCT Entities:
CONTEXT: Randomized data support shorter radiotherapy courses for management of cancer-related symptoms in the palliative setting. OBJECTIVES: The purpose of this study was to evaluate the length of palliative radiotherapy before hospice enrollment among the elderly U.S. population, with a further focus on factors that influence the duration of radiation and the length of survival on hospice, including whether the duration of radiation was associated with length of survival on hospice. METHODS: A total of 6982 patients with breast, prostate, lung, or colorectal cancer who received a course of radiotherapy within 30 days before hospice enrollment were identified within the Surveillance, Epidemiology, and End Results-Medicare linked database. The primary end points included the duration of palliative radiotherapy and the time from hospice enrollment through death (hospice duration). Multivariate linear regression and multivariate Cox models evaluated factors associated with the length of radiotherapy course and hospice duration. RESULTS: The median length of palliative radiotherapy was 14 days, and the median hospice duration was 13 days. The course of palliative radiotherapy was longer than hospice duration in 48% of the patients. Breast and lung cancer were associated with longer courses of radiotherapy and shorter stays on hospice. Patients treated in freestanding radiation centers had longer courses of radiotherapy. For these groups, a longer radiotherapy course was not associated with longer hospice duration. CONCLUSION: This study found relatively long courses of radiotherapy before short lengths of survival on hospice. Future research is needed to identify barriers to shorter radiotherapy courses.
Authors: Roberta I Jordan; Matthew J Allsop; Yousuf ElMokhallalati; Catriona E Jackson; Helen L Edwards; Emma J Chapman; Luc Deliens; Michael I Bennett Journal: BMC Med Date: 2020-11-26 Impact factor: 8.775