Cargando…

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

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 be...

Descripción completa

Detalles Bibliográficos
Autores principales: Kress, Marie-Adele Sorel, Jensen, Roxanne E, Tsai, Huei-Ting, Lobo, Tania, Satinsky, Andrew, Potosky, Arnold L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314753/
https://www.ncbi.nlm.nih.gov/pubmed/25582217
http://dx.doi.org/10.1186/s13014-014-0305-4
_version_ 1782355360576700416
author Kress, Marie-Adele Sorel
Jensen, Roxanne E
Tsai, Huei-Ting
Lobo, Tania
Satinsky, Andrew
Potosky, Arnold L
author_facet Kress, Marie-Adele Sorel
Jensen, Roxanne E
Tsai, Huei-Ting
Lobo, Tania
Satinsky, Andrew
Potosky, Arnold L
author_sort Kress, Marie-Adele Sorel
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13014-014-0305-4) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4314753
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-43147532015-02-04 Radiation therapy at the end of life: a population-based study examining palliative treatment intensity Kress, Marie-Adele Sorel Jensen, Roxanne E Tsai, Huei-Ting Lobo, Tania Satinsky, Andrew Potosky, Arnold L Radiat Oncol Research 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13014-014-0305-4) contains supplementary material, which is available to authorized users. BioMed Central 2015-01-13 /pmc/articles/PMC4314753/ /pubmed/25582217 http://dx.doi.org/10.1186/s13014-014-0305-4 Text en © Kress et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kress, Marie-Adele Sorel
Jensen, Roxanne E
Tsai, Huei-Ting
Lobo, Tania
Satinsky, Andrew
Potosky, Arnold L
Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title_full Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title_fullStr Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title_full_unstemmed Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title_short Radiation therapy at the end of life: a population-based study examining palliative treatment intensity
title_sort radiation therapy at the end of life: a population-based study examining palliative treatment intensity
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314753/
https://www.ncbi.nlm.nih.gov/pubmed/25582217
http://dx.doi.org/10.1186/s13014-014-0305-4
work_keys_str_mv AT kressmarieadelesorel radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity
AT jensenroxannee radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity
AT tsaihueiting radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity
AT lobotania radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity
AT satinskyandrew radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity
AT potoskyarnoldl radiationtherapyattheendoflifeapopulationbasedstudyexaminingpalliativetreatmentintensity