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Utilization of hypofractionated radiotherapy in treatment of glioblastoma multiforme in elderly patients not receiving adjuvant chemoradiotherapy: A National Cancer Database Analysis
To assess the utilization and outcomes of adjuvant monotherapy with hypofractionated radiation (RT) among elderly patients not receiving traditional adjuvant chemoradiotherapy (cRT) for glioblastoma multiforme (GBM). A retrospective analysis using the National Cancer Data Base with GBM patients aged...
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| Published in: | Journal of neuro-oncology 2018, Vol.136 (2), p.385-394 |
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| container_title | Journal of neuro-oncology |
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| creator | Bingham, Brian Patel, Chirayu G. Shinohara, Eric T. Attia, Albert |
| description | To assess the utilization and outcomes of adjuvant monotherapy with hypofractionated radiation (RT) among elderly patients not receiving traditional adjuvant chemoradiotherapy (cRT) for glioblastoma multiforme (GBM). A retrospective analysis using the National Cancer Data Base with GBM patients aged 65 years or older treated between 2005 and 2012 was conducted. Patients who underwent hypofractionated RT (40 Gy), conventional RT (60 Gy), chemotherapy, or best supportive care alone were included. Statistical methods included logistic regression for utilization and Cox regression for survival analysis. A total of 9556 patients were analyzed. On multivariate analysis (compared to those receiving conventional RT), patients more likely to be treated with hypofractionated RT were older (75–84 years old OR 2.05;
p
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| doi_str_mv | 10.1007/s11060-017-2665-8 |
| format | article |
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p
< 0.01 and ≥ 85 years old OR 3.32;
p
< 0.01), with a Charlson/Deyo score of 2 or higher (OR 1.80;
p
= 0.05), from communities > 50 miles from their treatment facility (50–100 miles OR 8.03;
p
< 0.01 and > 100 miles OR 7.16;
p
< 0.01), treated at an Academic/Research facility (OR 2.85;
p
= 0.04), and diagnosed between 2011 and 2012 (OR 4.15;
p
< 0.01). On Cox regression, hypofractionated RT (HR 0.65;
p
< 0.01), conventional RT (HR 0.60;
p
< 0.01), and chemotherapy alone (HR 0.69;
p
< 0.01) were all associated with decreased risk of death compared to no adjuvant therapy. Among patients receiving adjuvant treatment, utilization of hypofractionated RT increased from 7 to 19% during the study period. Among elderly patients with GBM not receiving cRT, the utilization of adjuvant monotherapy with hypofractionated RT has increased over time. Retrospective evidence suggests it may be better than best supportive care alone and as good as conventionally fractionated RT alone.]]></description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-017-2665-8</identifier><identifier>PMID: 29209874</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Aged, 80 and over ; Brain cancer ; Brain Neoplasms - radiotherapy ; Chemoradiotherapy ; Chemotherapy ; Clinical Study ; Databases, Factual ; Female ; Geriatrics ; Glioblastoma ; Glioblastoma - radiotherapy ; Humans ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Neurology ; Oncology ; Patients ; Radiation Dose Hypofractionation ; Radiation therapy ; Radiotherapy, Adjuvant - statistics & numerical data ; Retrospective Studies ; Survival analysis ; Treatment Outcome</subject><ispartof>Journal of neuro-oncology, 2018, Vol.136 (2), p.385-394</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2017</rights><rights>Journal of Neuro-Oncology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-7bd1553cf3594fdaa4352d9c154fe85f4e612a069a50aa82a12683ac934634ef3</citedby><cites>FETCH-LOGICAL-c372t-7bd1553cf3594fdaa4352d9c154fe85f4e612a069a50aa82a12683ac934634ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29209874$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bingham, Brian</creatorcontrib><creatorcontrib>Patel, Chirayu G.</creatorcontrib><creatorcontrib>Shinohara, Eric T.</creatorcontrib><creatorcontrib>Attia, Albert</creatorcontrib><title>Utilization of hypofractionated radiotherapy in treatment of glioblastoma multiforme in elderly patients not receiving adjuvant chemoradiotherapy: A National Cancer Database Analysis</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description><![CDATA[To assess the utilization and outcomes of adjuvant monotherapy with hypofractionated radiation (RT) among elderly patients not receiving traditional adjuvant chemoradiotherapy (cRT) for glioblastoma multiforme (GBM). A retrospective analysis using the National Cancer Data Base with GBM patients aged 65 years or older treated between 2005 and 2012 was conducted. Patients who underwent hypofractionated RT (40 Gy), conventional RT (60 Gy), chemotherapy, or best supportive care alone were included. Statistical methods included logistic regression for utilization and Cox regression for survival analysis. A total of 9556 patients were analyzed. On multivariate analysis (compared to those receiving conventional RT), patients more likely to be treated with hypofractionated RT were older (75–84 years old OR 2.05;
p
< 0.01 and ≥ 85 years old OR 3.32;
p
< 0.01), with a Charlson/Deyo score of 2 or higher (OR 1.80;
p
= 0.05), from communities > 50 miles from their treatment facility (50–100 miles OR 8.03;
p
< 0.01 and > 100 miles OR 7.16;
p
< 0.01), treated at an Academic/Research facility (OR 2.85;
p
= 0.04), and diagnosed between 2011 and 2012 (OR 4.15;
p
< 0.01). On Cox regression, hypofractionated RT (HR 0.65;
p
< 0.01), conventional RT (HR 0.60;
p
< 0.01), and chemotherapy alone (HR 0.69;
p
< 0.01) were all associated with decreased risk of death compared to no adjuvant therapy. Among patients receiving adjuvant treatment, utilization of hypofractionated RT increased from 7 to 19% during the study period. Among elderly patients with GBM not receiving cRT, the utilization of adjuvant monotherapy with hypofractionated RT has increased over time. Retrospective evidence suggests it may be better than best supportive care alone and as good as conventionally fractionated RT alone.]]></description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Clinical Study</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Glioblastoma</subject><subject>Glioblastoma - radiotherapy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Radiation Dose Hypofractionation</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Survival analysis</subject><subject>Treatment Outcome</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc-O0zAQhy0EYkvhAbggS1y4BPwnjhNuVWEBaQUXVuIWTZ1x6yqJi-2sFB6M51tnu6AVEifL9jffjOZHyEvO3nLG9LvIOatYwbguRFWpon5EVlxpWWip5WOyYrzShWrKHxfkWYxHxlipJX9KLkQjWFPrckV-XyfXu1-QnB-pt_Qwn7wNYJY7JOxogM75dMAAp5m6kaaAkAYc00Lve-d3PcTkB6DD1CdnfRhw4bDvMPQzPWV1piMdfaIBDbobN-4pdMfpBrLFHHDwD5u8pxv69W4e6OkWRoOBfoAEO4hIN_lxji4-J08s9BFf3J9rcn358fv2c3H17dOX7eaqMFKLVOhdx5WSxsq8BdsBlFKJrjFclRZrZUusuABWNaAYQC2Ai6qWYBpZVrJEK9fkzdl7Cv7nhDG1g4sG-x5G9FNseaMzyuq89DV5_Q969FPI895RotZSsTpT_EyZ4GMMaNtTcAOEueWsXUJtz6G2OdR2CbVdal7dm6fdgN3fij8pZkCcgZi_xj2GB63_a70FXP6xiQ</recordid><startdate>2018</startdate><enddate>2018</enddate><creator>Bingham, Brian</creator><creator>Patel, Chirayu G.</creator><creator>Shinohara, Eric T.</creator><creator>Attia, Albert</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2018</creationdate><title>Utilization of hypofractionated radiotherapy in treatment of glioblastoma multiforme in elderly patients not receiving adjuvant chemoradiotherapy: A National Cancer Database Analysis</title><author>Bingham, Brian ; Patel, Chirayu G. ; Shinohara, Eric T. ; Attia, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7bd1553cf3594fdaa4352d9c154fe85f4e612a069a50aa82a12683ac934634ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Clinical Study</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Glioblastoma</topic><topic>Glioblastoma - radiotherapy</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Radiation Dose Hypofractionation</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Survival analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bingham, Brian</creatorcontrib><creatorcontrib>Patel, Chirayu G.</creatorcontrib><creatorcontrib>Shinohara, Eric T.</creatorcontrib><creatorcontrib>Attia, Albert</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bingham, Brian</au><au>Patel, Chirayu G.</au><au>Shinohara, Eric T.</au><au>Attia, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilization of hypofractionated radiotherapy in treatment of glioblastoma multiforme in elderly patients not receiving adjuvant chemoradiotherapy: A National Cancer Database Analysis</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2018</date><risdate>2018</risdate><volume>136</volume><issue>2</issue><spage>385</spage><epage>394</epage><pages>385-394</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract><![CDATA[To assess the utilization and outcomes of adjuvant monotherapy with hypofractionated radiation (RT) among elderly patients not receiving traditional adjuvant chemoradiotherapy (cRT) for glioblastoma multiforme (GBM). A retrospective analysis using the National Cancer Data Base with GBM patients aged 65 years or older treated between 2005 and 2012 was conducted. Patients who underwent hypofractionated RT (40 Gy), conventional RT (60 Gy), chemotherapy, or best supportive care alone were included. Statistical methods included logistic regression for utilization and Cox regression for survival analysis. A total of 9556 patients were analyzed. On multivariate analysis (compared to those receiving conventional RT), patients more likely to be treated with hypofractionated RT were older (75–84 years old OR 2.05;
p
< 0.01 and ≥ 85 years old OR 3.32;
p
< 0.01), with a Charlson/Deyo score of 2 or higher (OR 1.80;
p
= 0.05), from communities > 50 miles from their treatment facility (50–100 miles OR 8.03;
p
< 0.01 and > 100 miles OR 7.16;
p
< 0.01), treated at an Academic/Research facility (OR 2.85;
p
= 0.04), and diagnosed between 2011 and 2012 (OR 4.15;
p
< 0.01). On Cox regression, hypofractionated RT (HR 0.65;
p
< 0.01), conventional RT (HR 0.60;
p
< 0.01), and chemotherapy alone (HR 0.69;
p
< 0.01) were all associated with decreased risk of death compared to no adjuvant therapy. Among patients receiving adjuvant treatment, utilization of hypofractionated RT increased from 7 to 19% during the study period. Among elderly patients with GBM not receiving cRT, the utilization of adjuvant monotherapy with hypofractionated RT has increased over time. Retrospective evidence suggests it may be better than best supportive care alone and as good as conventionally fractionated RT alone.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>29209874</pmid><doi>10.1007/s11060-017-2665-8</doi><tpages>10</tpages></addata></record> |
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| issn | 0167-594X 1573-7373 |
| language | eng |
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| subjects | Aged Aged, 80 and over Brain cancer Brain Neoplasms - radiotherapy Chemoradiotherapy Chemotherapy Clinical Study Databases, Factual Female Geriatrics Glioblastoma Glioblastoma - radiotherapy Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Neurology Oncology Patients Radiation Dose Hypofractionation Radiation therapy Radiotherapy, Adjuvant - statistics & numerical data Retrospective Studies Survival analysis Treatment Outcome |
| title | Utilization of hypofractionated radiotherapy in treatment of glioblastoma multiforme in elderly patients not receiving adjuvant chemoradiotherapy: A National Cancer Database Analysis |
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