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Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival
Prostate cancer (PCa) is one of the most common malignancies associated with bone metastases, and palliative radiation therapy (RT) is an effective treatment option. A total of 2641 patients were identified with PCa and bone metastases at diagnosis from 2010 to 2014 in the NCDB. Fractionation scheme...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144149/ https://www.ncbi.nlm.nih.gov/pubmed/30120817 http://dx.doi.org/10.1002/cam4.1655 |
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author | Fischer‐Valuck, Benjamin W. Baumann, Brian C. Apicelli, Anthony Rao, Yuan James Roach, Michael Daly, Mackenzie Dans, Maria C. White, Patrick Contreras, Jessika Henke, Lauren Gay, Hiram Michalski, Jeff M. Abraham, Christopher |
author_facet | Fischer‐Valuck, Benjamin W. Baumann, Brian C. Apicelli, Anthony Rao, Yuan James Roach, Michael Daly, Mackenzie Dans, Maria C. White, Patrick Contreras, Jessika Henke, Lauren Gay, Hiram Michalski, Jeff M. Abraham, Christopher |
author_sort | Fischer‐Valuck, Benjamin W. |
collection | PubMed |
description | Prostate cancer (PCa) is one of the most common malignancies associated with bone metastases, and palliative radiation therapy (RT) is an effective treatment option. A total of 2641 patients were identified with PCa and bone metastases at diagnosis from 2010 to 2014 in the NCDB. Fractionation scheme was designated as short course ([SC‐RT]: 8 Gy in 1 fraction and 20 Gy in 5 fractions) vs long course ([LC‐RT]: 30 Gy in 10 fractions and 37.5 Gy in 15 fractions). Patient characteristics were correlated with fractionation scheme using logistic regression. Overall survival was analyzed using the Kaplan‐Meier method, log‐rank test, Cox proportional hazards models, and propensity score‐matched analyses. A total of 2255 (85.4%) patients were included in the LC‐RT group and 386 (14.6%) patients in the SC‐RT group. SC‐RT was more common in patients over 75 years age (odds ratio [OR]: 1.70, 95% confidence interval [CI] 1.32‐2.20), treatment at an academic center (OR: 1.76, 1.20‐2.57), living greater than 15 miles distance to treatment facility (OR: 1.38, 1.05‐1.83), treatment to the rib (OR: 2.99, 1.36‐6.60), and in 2014 (OR: 1.73, 1.19‐2.51). RT to the spine was more commonly long course (P < .0001). In the propensity‐matched cohort, LC‐RT was associated with improved OS (P < .0001), but no OS difference was observed between 37.5 Gy and either 8 Gy in one fraction or 20 Gy in 5 fractions (P > .5). LC‐RT remains the most common treatment fractionation scheme for palliative bone metastases in PCa patients. Use of palliative SC‐RT is increasing, particularly in more recent years, for older patients, treatment at academic centers, and with increasing distance from a treatment center. |
format | Online Article Text |
id | pubmed-6144149 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-61441492018-09-24 Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival Fischer‐Valuck, Benjamin W. Baumann, Brian C. Apicelli, Anthony Rao, Yuan James Roach, Michael Daly, Mackenzie Dans, Maria C. White, Patrick Contreras, Jessika Henke, Lauren Gay, Hiram Michalski, Jeff M. Abraham, Christopher Cancer Med Clinical Cancer Research Prostate cancer (PCa) is one of the most common malignancies associated with bone metastases, and palliative radiation therapy (RT) is an effective treatment option. A total of 2641 patients were identified with PCa and bone metastases at diagnosis from 2010 to 2014 in the NCDB. Fractionation scheme was designated as short course ([SC‐RT]: 8 Gy in 1 fraction and 20 Gy in 5 fractions) vs long course ([LC‐RT]: 30 Gy in 10 fractions and 37.5 Gy in 15 fractions). Patient characteristics were correlated with fractionation scheme using logistic regression. Overall survival was analyzed using the Kaplan‐Meier method, log‐rank test, Cox proportional hazards models, and propensity score‐matched analyses. A total of 2255 (85.4%) patients were included in the LC‐RT group and 386 (14.6%) patients in the SC‐RT group. SC‐RT was more common in patients over 75 years age (odds ratio [OR]: 1.70, 95% confidence interval [CI] 1.32‐2.20), treatment at an academic center (OR: 1.76, 1.20‐2.57), living greater than 15 miles distance to treatment facility (OR: 1.38, 1.05‐1.83), treatment to the rib (OR: 2.99, 1.36‐6.60), and in 2014 (OR: 1.73, 1.19‐2.51). RT to the spine was more commonly long course (P < .0001). In the propensity‐matched cohort, LC‐RT was associated with improved OS (P < .0001), but no OS difference was observed between 37.5 Gy and either 8 Gy in one fraction or 20 Gy in 5 fractions (P > .5). LC‐RT remains the most common treatment fractionation scheme for palliative bone metastases in PCa patients. Use of palliative SC‐RT is increasing, particularly in more recent years, for older patients, treatment at academic centers, and with increasing distance from a treatment center. John Wiley and Sons Inc. 2018-08-17 /pmc/articles/PMC6144149/ /pubmed/30120817 http://dx.doi.org/10.1002/cam4.1655 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Fischer‐Valuck, Benjamin W. Baumann, Brian C. Apicelli, Anthony Rao, Yuan James Roach, Michael Daly, Mackenzie Dans, Maria C. White, Patrick Contreras, Jessika Henke, Lauren Gay, Hiram Michalski, Jeff M. Abraham, Christopher Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title | Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title_full | Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title_fullStr | Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title_full_unstemmed | Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title_short | Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital‐based analysis of patterns of care, RT fractionation scheme, and overall survival |
title_sort | palliative radiation therapy (rt) for prostate cancer patients with bone metastases at diagnosis: a hospital‐based analysis of patterns of care, rt fractionation scheme, and overall survival |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144149/ https://www.ncbi.nlm.nih.gov/pubmed/30120817 http://dx.doi.org/10.1002/cam4.1655 |
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