Central Nervous System

PV QA 2 - Poster Viewing Q&A 2

MO_3_2515 - National Practice Patterns of Proton versus Photon Therapy in the Treatment of Adult Patients with Primary Brain Tumors

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

National Practice Patterns of Proton versus Photon Therapy in the Treatment of Adult Patients with Primary Brain Tumors
V. Ganesan1, J. Ryckman2, V. Verma3, and C. Zhang2; 1College of Medicine, University of Nebraska Medical Center, Omaha, NE, 2Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, 3Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA

Purpose/Objective(s): We examined patterns of care associated with administration of proton versus photon therapy for adult patients with primary brain tumors in a large observational cohort in order to assess differences in socioeconomic and treatment facility factors associated with administration of each treatment modality.

Materials/Methods: The National Cancer Data Base (NCDB) was queried for newly-diagnosed primary brain tumors (2004-2014) receiving proton or photon particle radiotherapy age 18 and older. Clinical features, patient demographics, and treatment parameters were extracted. Differences between groups were assessed in a multivariable Cox analysis using logistic regression analysis.

Results: In total, 73,073 patients were analyzed (n=72, 635 [99.4%] photon therapy, n=438 [0.6%] proton therapy). Groups were not well-balanced, with patients receiving proton therapy more likely to be younger, requiring further travel to treatment facility, of the highest income quartile, with private or non-Medicare type insurance, of metro location, receiving treatment in an academic institution or Western or non-Southern/Midwestern regional facility location, with year of diagnosis of 2010 or later, with a Charlson-Deyo score of 0, or had non-glioblastoma histology (all p-values <0.001). On multivariable analysis of photon versus proton therapy, several factors were predictive for receipt of proton therapy, including patients who were younger (p=.041), of the highest income quartile (p=.007), receiving treatment in an academic institution (p<.001) or Western or non-Midwestern/Southern regional facility (p<.001), with a year of diagnosis of 2010 or later (p=.003), with a Charlson-Deyo score of 0 (p<.001), or had non-glioblastoma histology (p<.001).

Conclusion: This is the largest analysis to date evaluating utilization of photon therapy versus proton therapy for primary brain tumors in the adult population. Analysis of patient demographics indicates that there are several significant socioeconomic variables that influence the demographics of patients likely to receive photon therapy versus proton therapy. Although these data must be further validated with better defined patient selection and do not imply causation, the socioeconomic findings discovered herein must be addressed in order to ensure the highest quality cancer care to all patients.

Author Disclosure: V. Ganesan: None. V. Verma: None.

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