National practice patterns of proton versus photon therapy in the treatment of adult patients with primary brain tumors in the United States

Jeffrey M. Ryckman, Vaishnavi Ganesan, Adams Kusi Appiah, Chi Zhang, Vivek Verma

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objectives: To examine patterns of care associated with the administration of proton versus photon therapy for adult patients with primary brain tumors in a large national cohort from the United States. Methods: The National Cancer Database (NCDB) was queried for newly diagnosed primary brain tumors (2004–2014) in adult patients aged 18 and older receiving proton or photon radiotherapy. Clinical features, patient demographics and treatment parameters were extracted. Differences between groups were assessed using multivariable logistic regression analysis. Results: In total, 73,073 patients were analyzed (n = 72,635 [99.4%] photon therapy, n = 438 [0.6%] proton therapy). On multivariable analysis of photon versus proton therapy, several factors predicted for receipt of proton therapy, including younger age (p =.041), highest income quartile (p =.007), treatment at academic institutions (p <.001), in regional facilities outside the Midwest/South (p <.001), diagnosis in more recent years (p =.003), fewer comorbidities (p <.001) and non-glioblastoma histology (p <.001). Conclusions: There are several significant socioeconomic variables that influence receipt of proton therapy for primary brain tumors. Although not implying causation, the socioeconomic findings discovered herein should be taken into account when delivering cancer care to all patients.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalActa Oncologica
Volume58
Issue number1
DOIs
StatePublished - Jan 2 2019

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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