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
Abstract 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. Fractionati...
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| Format: | Article |
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Wiley
2018-09-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1655 |
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| author | Benjamin W. Fischer‐Valuck Brian C. Baumann Anthony Apicelli Yuan James Rao Michael Roach Mackenzie Daly Maria C. Dans Patrick White Jessika Contreras Lauren Henke Hiram Gay Jeff M. Michalski Christopher Abraham |
| author_facet | Benjamin W. Fischer‐Valuck Brian C. Baumann Anthony Apicelli Yuan James Rao Michael Roach Mackenzie Daly Maria C. Dans Patrick White Jessika Contreras Lauren Henke Hiram Gay Jeff M. Michalski Christopher Abraham |
| author_sort | Benjamin W. Fischer‐Valuck |
| collection | DOAJ |
| description | Abstract 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 | Article |
| id | doaj-art-5966954b0dbf4d42897656f4d02fa5d2 |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-5966954b0dbf4d42897656f4d02fa5d22025-08-20T03:07:27ZengWileyCancer Medicine2045-76342018-09-01794240425010.1002/cam4.1655Palliative 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 survivalBenjamin W. Fischer‐Valuck0Brian C. Baumann1Anthony Apicelli2Yuan James Rao3Michael Roach4Mackenzie Daly5Maria C. Dans6Patrick White7Jessika Contreras8Lauren Henke9Hiram Gay10Jeff M. Michalski11Christopher Abraham12Department of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADivision of Hospice & Palliative Medicine Department of Hospital Medicine Washington University School of Medicine St. Louis MO USADivision of Hospice & Palliative Medicine Department of Hospital Medicine Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USADepartment of Radiation Oncology Washington University School of Medicine St. Louis MO USAAbstract 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.https://doi.org/10.1002/cam4.1655metastatic prostate cancerNational Cancer Databasepalliative radiation |
| spellingShingle | Benjamin W. Fischer‐Valuck Brian C. Baumann Anthony Apicelli Yuan James Rao Michael Roach Mackenzie Daly Maria C. Dans Patrick White Jessika Contreras Lauren Henke Hiram Gay Jeff M. Michalski Christopher Abraham 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 Cancer Medicine metastatic prostate cancer National Cancer Database palliative radiation |
| 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 | metastatic prostate cancer National Cancer Database palliative radiation |
| url | https://doi.org/10.1002/cam4.1655 |
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