scholarly journals Three discipline collaborative radiation therapy (3DCRT) special debate: The United States should build additional proton therapy facilities

2019 ◽  
Vol 20 (2) ◽  
pp. 7-12 ◽  
Author(s):  
Steve Braunstein ◽  
Li Wang ◽  
Wayne Newhauser ◽  
Todd Tenenholz ◽  
Yi Rong ◽  
...  
Keyword(s):  
United States ◽  
Radiation Therapy ◽  
Proton Therapy ◽  
The United States

scholarly journals SWK-11. ASSESSMENT OF THE INDIRECT COSTS ASSOCIATED WITH PROTON THERAPY TREATMENT FOR ALBERTA PATIENTS REFERRED OUT OF COUNTRY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel
Keyword(s):  
United States ◽  
Proton Therapy ◽  
Malignant Tumors ◽  
Indirect Costs ◽  
The United States ◽  
Current Data ◽  
Opportunity Costs ◽  
Proton Treatment ◽  
Out Of Pocket Expenses ◽  
The Cost

Abstract BACKGROUND Proton therapy for benign and malignant tumors has dosimetric and clinical advantages over photon therapy. Patients in Alberta, Canada are referred to the United States for proton treatment. The Alberta Heath Care Insurance Plan (AHCIP) pays for the proton treatment and the cost of flights to and from the United States (direct costs). This study aimed to determine the out-of-pocket expenses incurred by patients or their families (indirect costs). METHODS Invitation letters linked to an electronic survey were mailed to patients treated with protons between 2008 and 2018. Expenses for flights for other family members, accommodations, transportation, food, passports, insurance, and opportunity costs including lost wages and productivity were measured. RESULTS Fifty-nine invitation letters were mailed. Seventeen surveys were completed (28.8% response rate). One paper survey was mailed at participant request. Nine respondents were from parent/guardian, 8 from patients. All patients were accompanied to the US by a family member/friend. Considerable variability in costs and reimbursements were reported. Many of the accompanying family/friends had to miss work; only 3 patients themselves reported missed work. Time away from work varied, and varied as to whether it was paid or unpaid time off. CONCLUSIONS Respondents incurred indirect monetary and opportunity costs which were not covered by AHCIP when traveling out of country for proton therapy. Prospective studies could help provide current data minimizing recall bias. These data may be helpful for administrators in assessing the societal cost of out-of-country referral of patients for proton therapy.

Disparities in Patterns of Conventional Versus Stereotactic Body Radiotherapy in the Treatment of Spine Metastasis in the United States

2020 ◽  
pp. 082585972098220
Author(s):  
Ellen Kim ◽  
Shearwood McClelland ◽  
Jerry J. Jaboin ◽  
Albert Attia
Keyword(s):  
United States ◽  
Radiation Therapy ◽  
Private Insurance ◽  
Spinal Metastases ◽  
The United States ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Cancer Data ◽  
Spine Metastases ◽  
Population Type

Introduction: The improved survival of patients even with metastatic cancer has led to an increase in the incidence of spine metastases, suggesting the need for a more aggressive palliative treatment than conventional external beam radiation therapy (cEBRT). Consequently, spinal stereotactic body radiation therapy (SBRT) has increased in popularity over the past decade. However, there has been no comparison of patterns of usage of cEBRT versus SBRT in the treatment of spinal metastases in the US. Methods: The National Cancer Data Base (NCDB) from 2004-2013 was used for analysis. cEBRT was defined as 30 Gy in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in 1 fraction. SBRT was defined as 25-32 Gy infive5 fractions, 24-32 Gy in 4 fractions, 20-32 Gy in three fractions, 14-32 Gy in 2 fractions, or 14-24 Gy in 1 fraction. Single and multivariable associations between patient demographic and cancer characteristics and type of radiation were performed. Results: From 2004-2013, 23,181 patients with spinal metastases in the United States received cEBRT, while 1,030 received SBRT as part of their first course of treatment. Most patients (88%) received 10 fractions of radiation. Multivariable analysis suggested that non-Medicare or private insurance (adjusted OR 0.4-0.7), African-American race (adjusted OR = 0.8, 95%CI = 0.7-1.0), age 65+ (adjusted OR = 0.8), living in a region with lower population (adjusted OR 0.7), earlier year of diagnosis (OR = 0.9), and receiving treatment in a non-academic/research facility (adjusted OR 0.6) were associated with cEBRT. After controlling for other variables, regional education level was no longer significantly associated with cEBRT. Conclusions: Most patients with spine metastases were treated with cEBRT, usually with 10 fractions. Receipt of SBRT was significantly associated with race, insurance, geography, population, type of treatment facility, and year of diagnosis, even after controlling for other factors. These findings raise questions about disparities in access to and delivery of care that deserve further investigation.

scholarly journals Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030

2017 ◽  
Vol 26 (6) ◽  
pp. 963-970 ◽  
Author(s):  
Alex K. Bryant ◽  
Matthew P. Banegas ◽  
Maria Elena Martinez ◽  
Loren K. Mell ◽  
James D. Murphy
Keyword(s):  
United States ◽  
Radiation Therapy ◽  
Cancer Survivors ◽  
The United States

Trial of Therapy and Prospective Study of Nephroblastoma

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 638-639
Author(s):  
P. A. Voûte ◽  
J. Lemerle
Keyword(s):  
United States ◽  
Clinical Trial ◽  
Radiation Therapy ◽  
Prospective Study ◽  
International Society ◽  
Pediatric Oncology ◽  
The United States ◽  
Therapeutic Trial ◽  
A Prospective Study

The International Society of Pediatric Oncology (ISPO) is planning a clinical therapeutic trial on nephroblastoma in Europe. Large agreement exists on the treatment of these tumors; the principal modalities are surgery, radiation therapy, and chemotherapy. However, there are some unanswered questions as to the value of different forms of administration of radiation and chemotherapy, which we feel could best be elucidated by a prospective study in the form of a clinical trial. A trial has been going on in the United States for 2 years.

Sign in / Sign up

Export Citation Format

Share Document