TY - JOUR
T1 - National practice patterns of proton versus photon therapy in the treatment of adult patients with primary brain tumors in the United States
AU - Ryckman, Jeffrey M.
AU - Ganesan, Vaishnavi
AU - Kusi Appiah, Adams
AU - Zhang, Chi
AU - Verma, Vivek
PY - 2019/1/2
Y1 - 2019/1/2
N2 - 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.
AB - 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.
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U2 - 10.1080/0284186X.2018.1512755
DO - 10.1080/0284186X.2018.1512755
M3 - Article
C2 - 30280620
AN - SCOPUS:85054362484
VL - 58
SP - 66
EP - 73
JO - Acta Oncologica
JF - Acta Oncologica
SN - 0284-186X
IS - 1
ER -