Utilization Patterns of Single Fraction Radiation Therapy for Multiple Myeloma

Salgado, L.; Chang, Sanders; Ru, Meng; Moshier, Erin; Ghiassi–Nejad, Zahra; Lazarev, Stanislav; Smith, William C.; Thompson, M.R.; Dharmarajan, Kavita V.

doi:10.1016/j.clml.2019.02.010

Cited by 7 publications

(11 citation statements)

References 25 publications

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“…The majority of studies focusing on utilisation of PRT (online supplemental table 1) identified an association between living further away from a radiotherapy centre and being less likely to receive PRT,6 18 19 22–27 35 with the exception of only one study, which did not find an association 32. When comparing the utilisation of SF versus MF (table 2), all but one study17 identified an association with patients living further away from the radiotherapy centre and being more likely to receive SF 20 21 28–30 34 36…”

Section: Resultsmentioning

confidence: 99%

“…The studies were all from Global North countries despite the study team not imposing any restrictions on healthcare system or country in the searches. These included 11 studies from Canada,6 18–27 four studies from the USA,28–32 one from Australia,33 two from Norway34 35 and one from France 17. This represented a mixture of healthcare systems from the free at the point of use systems in Canada, Norway and Australia to a mixture of insurance and non-insurance-based healthcare systems in the USA and France.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the studies in the review (14 studies) drew their populations from cancer registries and included different primary cancer sites in their analysis. Seven studies focused on specific primary cancers, which were prostate cancer,30 31 36 breast cancer,18 non-small cell lung cancer31 and multiple myeloma 28 32. The majority of studies (19 studies) focused on PRT for bone metastases, with two studies looking specifically at PRT to the whole of the brain 23 24…”

Section: Resultsmentioning

confidence: 99%

“…The start of the journey to the radiotherapy centre was calculated using either residential location at death,22 25 residential location at diagnosis6 27 or the patients’ residence 29. The end point of the journey was described as the nearest radiotherapy centre, the centre attended,31 the reporting facility28 29 and the cancer centre most frequently visited by patients in the same census subdivision 27 35. The calculation of distance and travel time using these origins and destination also varied across the studies with some using straight line distance ‘as the crow flies’,22–24 27 29 road distance17–21 24 26 28 30–36 and travel time 6 25.…”

Section: Resultsmentioning

confidence: 99%

“…The end point of the journey was described as the nearest radiotherapy centre, the centre attended,31 the reporting facility28 29 and the cancer centre most frequently visited by patients in the same census subdivision 27 35. The calculation of distance and travel time using these origins and destination also varied across the studies with some using straight line distance ‘as the crow flies’,22–24 27 29 road distance17–21 24 26 28 30–36 and travel time 6 25. All studies with the exception of Laugsand et al 34 (who included travel distance as a continuous variable) split the calculated travel distances and times into categories.…”

Section: Resultsmentioning

confidence: 99%

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Geographical distance and reduced access to palliative radiotherapy: systematic review and meta-analysis

Chand

Greenley

Macleod

et al. 2022

BMJ Support Palliat Care

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BackgroundPalliative radiotherapy (PRT) is an effective way of reducing symptoms caused by advanced incurable cancer. Several studies have investigated factors that contribute to inequalities in access to PRT; distance to a radiotherapy centre has been identified as one potential barrier.AimTo assess whether there is an association between distance to a radiotherapy centre and utilisation rates of PRT in adults with cancer.MethodsA systematic review and meta-analysis protocol was registered in the PROSPERO database (CRD42020190772). MEDLINE, EMBASE, CINAHL and APA-PsycINFO were searched for relevant papers up to 28 February 2021.ResultsTwenty-one studies were included. Twelve studies focused on whether patients with incurable cancer received PRT, as part of their treatment package. Pooled results reported that living ≥50 km vs <50 km from the radiotherapy centre was associated with a reduced likelihood of receiving PRT (OR 0.84 (95%CI 0.80, 0.88)). Nine focused on distance from the radiotherapy centre and compared single-fraction (SF) versus multiple-fraction PRT, indicating that patients living further away were more likely to receive SF. Pooled results comparing ≥50 km versus <50 km showed increased odds of receiving SF for those living ≥50 km (OR 1.48 (95%CI 1.26,1.75)).ConclusionPatients living further away from radiotherapy centres were less likely to receive PRT and those who received PRT were more likely to receive SF PRT, providing some evidence of inequalities in access to PRT treatment based on proximity to centres providing radiotherapy. Further research is needed to understand whether these inequalities are influenced by clinical referral patterns or by patients unwilling or unable to travel longer distances.PROSPERO registration numberCRD42020190772.

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Section: Resultsmentioning

confidence: 99%