Age disparity in palliative radiation therapy among patients with advanced cancer
| Autor: | Loren K. Mell, Maria Elena Martinez, Eric Roeland, James D. Murphy, Quynh-Thu Le, Heidi N. Yeung, Beibei Xu, Jonathan Wong |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Cancer Research Medical surveillance Aging Palliative care Lung Neoplasms Palliative Radiation Therapy Colorectal cancer medicine.medical_treatment Quality of life Epidemiology 80 and over Cancer Aged 80 and over Radiation Brain Neoplasms Palliative Care Age Factors Confounding Factors Epidemiologic Patient Preference Other Physical Sciences Oncology Regression Analysis Female Colorectal Neoplasms medicine.medical_specialty Clinical Sciences Oncology and Carcinogenesis Longevity Bone Neoplasms Breast Neoplasms Medicare Article Age Distribution Internal medicine 7.2 End of life care medicine Humans Radiology Nuclear Medicine and imaging Oncology & Carcinogenesis Intensive care medicine Aged Epidemiologic Radiotherapy business.industry Prostatic Neoplasms medicine.disease Confounding Factors United States Radiation therapy Quality of Life business SEER Program |
| Zdroj: | International journal of radiation oncology, biology, physics, vol 90, iss 1 Wong, J; Xu, B; Yeung, HN; Roeland, EJ; Martinez, ME; Le, QT; et al.(2014). Age disparity in palliative radiation therapy among patients with advanced cancer. International Journal of Radiation Oncology Biology Physics, 90(1), 224-230. doi: 10.1016/j.ijrobp.2014.03.050. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/9j92240z |
| ISSN: | 1879-355X |
| DOI: | 10.1016/j.ijrobp.2014.03.050. |
| Popis: | Purpose/Objective Palliative radiation therapy represents an important treatment option among patients with advanced cancer, although research shows decreased use among older patients. This study evaluated age-related patterns of palliative radiation use among an elderly Medicare population. Methods and Materials We identified 63,221 patients with metastatic lung, breast, prostate, or colorectal cancer diagnosed between 2000 and 2007 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Receipt of palliative radiation therapy was extracted from Medicare claims. Multivariate Poisson regression analysis determined residual age-related disparity in the receipt of palliative radiation therapy after controlling for confounding covariates including age-related differences in patient and demographic covariates, length of life, and patient preferences for aggressive cancer therapy. Results The use of radiation decreased steadily with increasing patient age. Forty-two percent of patients aged 66 to 69 received palliative radiation therapy. Rates of palliative radiation decreased to 38%, 32%, 24%, and 14% among patients aged 70 to 74, 75 to 79, 80 to 84, and over 85, respectively. Multivariate analysis found that confounding covariates attenuated these findings, although the decreased relative rate of palliative radiation therapy among the elderly remained clinically and statistically significant. On multivariate analysis, compared to patients 66 to 69 years old, those aged 70 to 74, 75 to 79, 80 to 84, and over 85 had a 7%, 15%, 25%, and 44% decreased rate of receiving palliative radiation, respectively (all P |
| Databáze: | OpenAIRE |
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