Socio-economic disparities influence likelihood of post-operative radiation to resection cavities of metastatic brain tumors.

Autor: Haider G; Department of Neurosurgery, Stanford University Medical Center, 453 Quarry Road, Stanford, CA, 94304, USA. ghanih@stanford.edu., Dadey DYA; Department of Neurosurgery, Stanford University Medical Center, 453 Quarry Road, Stanford, CA, 94304, USA., Rodrigues A; School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305, USA., Pollom EL; Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA., Adler JR; Department of Neurosurgery, Stanford University Medical Center, 453 Quarry Road, Stanford, CA, 94304, USA., Veeravagu A; Department of Neurosurgery, Stanford University Medical Center, 453 Quarry Road, Stanford, CA, 94304, USA.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2023 Dec; Vol. 165 (12), pp. 4253-4258. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1007/s00701-023-05826-w
Abstrakt: Purpose: Irradiating the surgical bed of resected brain metastases improves local and distant disease control. Over time, stereotactic radiosurgery (SRS) has replaced whole brain radiotherapy (WBRT) as the treatment standard of care because it minimizes long-term damage to neuro-cognition. Despite this data and growing adoption, socio-economic disparities in clinical access can result in sub-standard care for some patient populations. We aimed to analyze the clinical and socio-economic characteristics of patients who did not receive radiation after surgical resection of brain metastasis.
Methods: Our sample was obtained from Clinformatics® Data Mart Database and included all patients from 2004 to 2021 who did or did not receive radiation treatment within sixty days after resection of tumors metastatic to the brain. Regression analysis was done to identify factors responsible for loss to adjuvant radiation treatment.
Results: Of 8362 patients identified who had undergone craniotomy for resection of metastatic brain tumors, 3430 (41%) patients did not receive any radiation treatment. Compared to patients who did receive some form of radiation treatment (SRS or WBRT), patients who did not get any form of radiation were more likely to be older (p = 0.0189) and non-white (p = 0.008). Patients with Elixhauser Comorbidity Index ≥3 were less likely to receive radiation treatment (p < 0.01). Fewer patients with household income ≥ $75,000 did not receive radiation treatment (p < 0.01).
Conclusion: Age, race, household income, and comorbidity status were associated with differential likelihood to receive post-operative radiation treatment.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
Databáze: MEDLINE
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