Jooya Alborz, Qureshi Daniel, Phillips William J, Leigh Jennifer, Webber Colleen, Aggarwal Ajay, Tanuseputro Peter, Morgan Scott, Macrae Robert, Ong Michael, Bourque Jean-Marc
Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network (UHN), Toronto, CAN.
Department of Public Health, London School of Hygiene and Tropical Medicine, London, GBR.
Cureus. 2024 Feb 20;16(2):e54582. doi: 10.7759/cureus.54582. eCollection 2024 Feb.
As a result of improvements in cancer therapies, patients with metastatic malignancies are living longer, and the role of palliative radiotherapy has become increasingly recognized. However, access to adequate palliative radiotherapy may continue to be a challenge, as is evident from the high proportion of patients dying of prostate cancer who never receive palliative radiotherapy. The main objective of this investigation is to identify and describe the factors associated with the receipt of palliative radiation treatment in a decedent cohort of prostate cancer patients in Ontario.
Population-based administrative databases from Ontario, Canada, were used to identify prostate cancer decedents, 65 years or older who received androgen deprivation therapy between January 1, 2013, and December 31, 2018. Baseline and treatment characteristics were analyzed using univariate and multivariate logistic regression models for association with receipt of radiotherapy in a two-year observation period before death.
We identified 3,788 prostate cancer decedents between 2013 and 2018; among these, 49.9% received radiotherapy in the two years preceding death. There were statistically significant positive associations between receipt of radiotherapy and younger age at diagnosis (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.3); higher stage at diagnosis (OR 1.3, 95% CI 1.1-1.7); receipt of care at a regional cancer center (OR 1.8, 95% CI 1.3-2.4); and involvement of radiation oncologists (OR 155.1, 95% CI 83.3-288.7) or medical oncologists (OR 1.4, 95% CI 1.1-1.8). However, there were no associations between receipt of radiotherapy and income, distance to the nearest cancer center, involvement of urologists in cancer care, healthcare administrative region, home-care involvement, or number of hospitalizations in the observation period.
We found the utilization of palliative radiotherapy for prostate cancer patients in Ontario varies depending on age, stage at diagnosis, number of comorbidities, registration at regional cancer centers, and involvement of oncologists. There were no differences detected based on income or distance from a cancer center. The findings of this study represent an important opportunity to facilitate better access to palliative radiotherapy and referrals to multidisciplinary regional cancer centers, to improve the quality of life of this patient population.
由于癌症治疗方法的改进，转移性恶性肿瘤患者的生存期延长，姑息性放疗的作用也越来越受到认可。然而，获得足够的姑息性放疗可能仍然是一项挑战，从未接受姑息性放疗的前列腺癌患者的高死亡率就证明了这一点。本研究的主要目的是确定并描述安大略省前列腺癌患者死亡队列中接受姑息性放射治疗的相关因素。
利用加拿大安大略省基于人群的行政数据库，确定2013年1月1日至2018年12月31日期间接受雄激素剥夺治疗的65岁及以上前列腺癌死者。在死亡前的两年观察期内，使用单变量和多变量逻辑回归模型分析基线和治疗特征与接受放疗之间的关联。
我们在2013年至2018年间确定了3788例前列腺癌死者；其中，49.9%在死亡前两年接受了放疗。接受放疗与诊断时年龄较轻（优势比[OR]1.6，95%置信区间[CI]1.1-2.3）、诊断时分期较高（OR 1.3，95%CI 1.1-1.7）、在区域癌症中心接受治疗（OR 1.8，95%CI 1.
