Characteristics and survival outcomes associated with the lack of radiation in the treatment of glioblastoma

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From: Medical Oncology(Vol. 35, Issue 5)
Publisher: Springer
Document Type: Report
Length: 441 words

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To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s12032-018-1134-3 Byline: Bin Huang (1,6), Therese A. Dolecek (2), Quan Chen (6), Catherine R. Garcia (6), Thomas Pittman (5,6), John L. Villano (3,4,5,6) Keywords: Glioblastoma; Race; Radiation therapy; Disparity; Surgery Abstract: Radiation increases survival in glioblastoma (GBM) however, 30% do not receive this treatment. We sought to identify characteristics associated with not receiving radiation and the impact on outcomes. We analyzed the Surveillance, Epidemiology, and End Results program (SEER) 18 registries 2000--2013 research database on 30,479 GBM cases that were aged 20 years and older. In total, 21,179 received radiation as first course of therapy, while 8218 did not with 5178 (63%) being 65 years and older. Early decisions on surgery often predicted radiation therapy with 61% having only a biopsy or no surgery at diagnosis. Radiation use as upfront therapy has slowly increased over time at a rate of 0.4% per year still 25% did not receive radiation in 2013. Cases treated with radiation were more likely to be younger, underwent surgery, lived in a metropolitan area, had higher socioeconomic status, and were in a couple-based relationship. An increased survival in GBM was associated with the use of upfront radiation along with younger age, being of race other than white, undergoing surgery, and a more recent diagnosis. Not receiving radiation therapy adversely affects survival. A trend toward an increased use of radiation was observed although many young adults still do not receive this treatment. Decreased usage of radiation in the elderly and in biopsy-only surgeries was anticipated, but race, gender, and poverty were also statistically significant. Clinicians should be aware of this underutilization, and an increased usage of radiation should improve outcomes for glioblastoma. Author Affiliation: (1) 0000 0004 1936 8438, grid.266539.d, Division of Cancer Biostatistics, College of Public Health, University of Kentucky, 2365 Harrodsburg Road Suite A230, Lexington, KY, 40504, USA (2) 0000 0001 2175 0319, grid.185648.6, Division of Epidemiology and Biostatistics and Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 809 South Marshfield Avenue, MB 502, M/C 551, Chicago, IL, 60612-7205, USA (3) 0000 0004 1936 8438, grid.266539.d, Department of Neurology, University of Kentucky, Lexington, KY, USA (4) 0000 0004 1936 8438, grid.266539.d, Department of Medicine, University of Kentucky, Lexington, KY, USA (5) 0000 0004 1936 8438, grid.266539.d, Department of Neurosurgery, University of Kentucky, MS105 Medical Science Building, Lexington, KY, 40536-0298, USA (6) 0000 0004 1936 8438, grid.266539.d, Markey Cancer Center, University of Kentucky, 800 Rose St., Lexington, KY, 40536-0093, USA Article History: Registration Date: 12/04/2018 Received Date: 04/04/2018 Accepted Date: 11/04/2018 Online Date: 17/04/2018

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Gale Document Number: GALE|A535124008