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Sociodemographic factors contribute to underutilization of radiation in glioblastoma
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Several sociodemographic factors may contribute to the omission of radiation from treatment protocols for patients with glioblastoma, study results suggest.
Prior randomized studies have demonstrated that use of radiation improves survival among patients with glioblastoma.
However, use of radiation appears to have declined during the past two decades, and risk factors for underutilization of radiation therapy are unknown, according to background information provided by researchers.
Ayal A. Aizer
Ayal A. Aizer, MD, MHS, of the Harvard Radiation Oncology Program, and colleagues used the SEER database to review data on 22,777 patients diagnosed with glioblastoma between 1988 and 2007.
They determined 74% of patients underwent radiation and 26% did not.
Radiation use was significantly associated with improved 2-year OS (14.6% vs. 4.2%; P<.001). Researchers calculated an adjusted HR of 2.09 (95% CI, 2.02-2.16).
Aizer and colleagues determined several sociodemographic factors were associated with omission of radiation, including older age (OR=1.048 per year increase; 95% CI; 1.046-1.051); lower annual income (OR=0.93; per $10,000 increase; 95% CI, 0.90-0.96); black race (reference=white; HR=1.19; 95% CI, 1.03-1.37); Hispanic race (OR=1.34; 95% CI, 1.19-1.50); Asian race (OR=1.24; 95% CI, 1.04-1.48); unmarried status (OR=1.71; 95% CI, 1.60-1.83); and receipt of subtotal resection or biopsy (OR=1.82; 95% CI, 1.69-1.96).
“Our study suggests that sociodemographic factors — particularly age, income, race, and marital status — have significant impact on underutilization of radiation in patients with glioblastoma,” Aizer and colleagues wrote. “Clinicians should be aware of the risk factors ... [and] the underlying causes of these differences in care require further research.”
Disclosure: The researchers report research finding from Varian, as well as consulting fees from Astellas Pharmaceuticals, Ferring Inc. and Medivation.
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