Format

Send to:

Choose Destination
See comment in PubMed Commons below
Int J Radiat Oncol Biol Phys. 2014 Aug 1;89(5):1092-9. doi: 10.1016/j.ijrobp.2014.04.048. Epub 2014 Jul 8.

Use of single- versus multiple-fraction palliative radiation therapy for bone metastases: population-based analysis of 16,898 courses in a Canadian province.

Author information

  • 1BC Cancer Agency Centre for the North, Prince George, British Columbia, Canada; University of Northern British Columbia, Prince George, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: rolson2@bccancer.bc.ca.
  • 2BC Cancer Agency Centre for the North, Prince George, British Columbia, Canada; University of Northern British Columbia, Prince George, British Columbia, Canada.
  • 3BC Cancer Agency Centre for the North, Prince George, British Columbia, Canada.
  • 4BC Cancer Agency Centre for the North, Prince George, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada.
  • 5University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer Agency Centre for the Southern Interior, Kelowna, British Columbia, Canada.
  • 6University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer Agency Vancouver Centre, Victoria, British Columbia, Canada.

Abstract

PURPOSE:

There is abundant evidence that a single fraction (SF) of palliative radiation therapy (RT) for bone metastases is equivalent to more protracted and costly multiple fraction courses. Despite this, there is low utilization of SFRT internationally. We sought to determine the utilization of SFRT in a population-based, publicly funded health care system.

METHODS AND MATERIALS:

All consecutive patients with bone metastases treated with RT during 2007 to 2011 in British Columbia (BC) were identified. Associations between utilization of SFRT and patient and provider characteristics were investigated.

RESULTS:

A total of 16,898 courses of RT were delivered to 8601 patients. SFRT was prescribed 49% of the time. There were positive relationships among SFRT utilization and primary tumor group (P<.001; most commonly in prostate cancer), worse prognosis (P<.001), increasing physician experience (P<.001), site of metastases (P<.001; least for spine metastases), and area of training (P<.001; most commonly for oncologists trained in the United Kingdom). There was wide variation in the prescription of SFRT across 5 regional cancer centers, ranging from 25.5% to 73.4%, which persisted after controlling for other, potentially confounding factors (P<.001).

CONCLUSIONS:

The large variability in SFRT utilization across BC Cancer Agency (BCCA) cancer centers suggests there is a strong cultural effect, where physicians' use of SFRT is influenced by their colleagues' practice. SFRT use in BC was similar to that in other Canadian and western European reports but strikingly higher than in the United States. Further work is needed to standardize SFRT prescribing practices internationally for this common indication for RT, with the potential for huge health system cost savings and substantial improvements in patients' quality of life.

Copyright © 2014 Elsevier Inc. All rights reserved.

PMID:
25035213
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk