Ghiassi-Nejad Zahra, Sindhu Kunal K, Moshier Erin, Zubizarreta Nicole, Mazumdar Madhu, Goldstein Nathan E, Dharmarajan Kavita V
Department of Radiation Oncology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA.
Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue (Box 1077), New York, NY 10029, USA.
J Geriatr Oncol. 2020 Sep;11(7):1096-1102. doi: 10.1016/j.jgo.2020.03.010. Epub 2020 Mar 31.
Whole brain radiation therapy (WBRT) is widely used to treat patients with brain metastases. However, there is debate regarding its utility in patients with poor prognoses. In this study, we sought to characterize the use of WBRT in the United States, especially in adults aged 55 and above.
Patients with brain metastases were identified using the National Cancer Database between 2010 and 2013. The receipt and completion of WBRT with various patient factors were correlated using multivariable logistic regression.
28,422 patients with brain metastases were identified, 23,362 of whom were aged 55 or above. 14,845 patients received WBRT and 12,310 patients completed treatment. Among adults aged 55 and above, 11,945 patients received WBRT, and 9812 patients completed treatment. Patients aged 60 and above were less likely to receive WBRT, while those aged 65 and above were less likely to complete WBRT.
These results suggest that WBRT may be over-utilized in the United States, especially among older adults. Better interventions to improve pre-WBRT decision-making in this population are needed to select patients who might derive benefit.
