scholarly journals Rapid Access Multidisciplinary Bone Metastases Clinic Decreases Financial Toxicity for Patients Undergoing Palliative Radiation

2019 ◽  
Vol 105 (1) ◽  
pp. S47-S48
Author(s):  
J.A. Maldonado ◽  
L.E. Colbert ◽  
M.M. Gomez ◽  
S.E. Todd ◽  
K.M. Christopherson ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Financial Toxicity ◽  
Palliative Radiation ◽  
Rapid Access

Use of a rapid access multidisciplinary bone metastases clinic to decrease financial toxicity for patients undergoing single-fraction palliative radiation.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 24-24
Author(s):  
Jose Alberto Maldonado ◽  
Minsoo Kim ◽  
Prasamsa Pandey ◽  
Sarah Todd ◽  
Kaitlin Marie Christopherson ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Radiation Treatment ◽  
Travel Distance ◽  
Cancer Center ◽  
Cost Burden ◽  
Financial Toxicity ◽  
Single Fraction ◽  
Palliative Radiation ◽  
Rapid Access ◽  
Significant Difference

24 Background: A rapid access bone metastases clinic (RABC) was instituted at MD Anderson Cancer Center (MDACC) to allow outpatient consult, simulation and radiation treatment (RT) initiation in < 6 hours for patients with painful bone metastases. Patients underwent multidisciplinary evaluation with orthopedics and radiation oncology. One aspect of financial toxicity is distress due to out-of-pocket (OOP) cost associated with a treatment. We hypothesized the RABC would decrease financial toxicity for MDACC patients over traditional RT. Methods: RABC patients surveyed between April 2018 and January 2020 were included. Patients were asked to estimate OOP cost for RT (including travel and treatment cost) and perceived cost burden of treatment. Travel distance was hometown distance to MDACC. Subset analyses were performed for patients receiving single fraction (1fx) and 2-5 fractions (2-5fx). Estimated OOP cost (1fx: RABCN= 34, nonRABCN= 20; 2-5fx: RABCN= 4, nonRABCN= 22), perceived cost burden (1fx: RABCN= 32, nonRABCN= 27; 2-5fx: RABCN= 7, nonRABCN= 38) and travel distance (1fx: RABCN= 34, nonRABCN= 28; 2-5fx: RABCN= 7, nonRABCN= 38) were compared using a Mann-Whitney U Test. Travel distance was also compared to OOP cost. Patients treated with 6+ fractions were excluded. Results: Median estimated OOP cost was significantly lower for 1fx RABC patients vs. 1fx non-RABC patients ($450 [IQR $187.5-$1,050] vs. $2,000 [$625-$4,000]; p = 0.008), but there was no significant difference for 2-5fx ($1,900 vs. $1,375; p = 0.593). Overall patient satisfaction with cost burden was high regardless of treatment setting (1fx: 10 [8-10]; 2-5fx: 10 [8-10]). Median travel distance was not significantly different between clinics (1fx: 245 [39.8-351.5] vs. 262.5 [83-879.3], p = 0.3651; 2-5fx: 274 [36-1293] vs. 176 [25-626], p = 0.2721). Travel distance was directly correlated with out of pocket cost for single fraction (1fx: R2= 0.125, p = 0.0109; 2-5fx: R2= 0.037, p = 0.3433). Conclusions: The establishment of a RABC at MDACC significantly decreased financial toxicity for 1fx patients receiving palliative RT, but not in the 2-5fx cohort. Increased financial toxicity was associated with longer travel distance for 1fx palliative radiation. Implementation of a similar model in local community centers may decrease financial toxicity for patients receiving palliative radiation.

Toxicity following palliative radiation therapy for painful metastatic bone lesions.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 126-126 ◽  
Author(s):  
Mikayla Jenkins ◽  
Mark Raymond Waddle ◽  
Tasneem Kaleem ◽  
William C Stross ◽  
Timothy D Malouff ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Radiation Treatment ◽  
Performance Status ◽  
Poor Performance ◽  
Patient Characteristics ◽  
Bone Lesions ◽  
Poor Performance Status ◽  
Financial Toxicity ◽  
Palliative Radiation ◽  
Ed Visits

126 Background: Palliative radiation treatment (pRT) is a common and effective treatment for patients with symptomatic bone metastases. However, patients receiving RT for bone metastases often may have a poor performance status and are more likely to experience toxicity during or after treatment. This study aims to investigate the number and type of toxicity event occurring during or after pRT for bone metastases. Methods: Patients treated with RT for bone metastases at Mayo Clinic from 2007 to 2016 were included in this study. Demographic, disease, treatment, and toxicity information were collected. Specifically, toxicity events were identified as emergency department (ED) visits and inpatient hospitalization (IH) within 90 days, breaks in treatment >4 days, and excessive 30 day financial toxicity defined as standardized Medicare costs >1 standard deviation above the mean. RT treatment was compared by dose and fractionation via descriptive statistics. Results: A total of 538 patients treated with pRT were identified, 124 receiving 8Gy x1, 204 receiving 4Gy x5, and 210 receiving 3Gy x10. Patients with breast and prostate cancer were most likely to be treated with 3Gy x10 and patients with GI and Lung cancer were most likely to be treated with 8Gy x1. A description of the patient characteristics and toxicities are shown in Table 1. For 8Gy x1, 4Gy x5, and 3Gy x10 breaks in treatment were rare (0%, 2%, and 3.3%), ED visits (15%, 24%, & 28%), IH (12%, 23%, & 19%), and financial toxicity (13%, 18%, & 21%) were common. A total of 22.6%, 27.5%, and 38.6% of patients were alive two years following pRT from each group. Conclusions: Toxicity during or shortly after pRT of bone metastases is common. This study confirms that additional steps should be taken to monitor and mitigate toxicity in this vulnerable patient group. [Table: see text]

The Fractionation of Palliative Radiation Therapy for Bone Metastases in Ontario: Do Guidelines Guide Practice?

2014 ◽  
Vol 90 (1) ◽  
pp. S63-S64 ◽  
Author(s):  
A. Ashworth ◽  
W. Kong ◽  
E.L. Chow ◽  
W. Mackillop
Keyword(s):  
Radiation Therapy ◽  
Bone Metastases ◽  
Palliative Radiation ◽  
Palliative Radiation Therapy

The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic

2008 ◽  
Vol 17 (2) ◽  
pp. 163-170 ◽  
Author(s):  
A. Fairchild ◽  
E. Pituskin ◽  
B. Rose ◽  
S. Ghosh ◽  
J. Dutka ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Rapid Access ◽  
One Stop

scholarly journals Nurse Practitioner Navigation Program within a Rapid Access Bone Metastases Clinic Improves Patient Access to Radiation

2020 ◽  
Vol 108 (3) ◽  
pp. e166-e167
Author(s):  
P. Pandey ◽  
M. Kim ◽  
S.E. Todd ◽  
D.R. Grosshans ◽  
M.P. Mitchell ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Nurse Practitioner ◽  
Patient Access ◽  
Rapid Access ◽  
Navigation Program

Trends in Regimen for Palliative Radiation Therapy of Bone Metastases in Patients with Non-Small Cell Lung Cancer

2018 ◽  
Vol 102 (3) ◽  
pp. e440-e441 ◽  
Author(s):  
M. Goldstein ◽  
B.W. Fischer-Valuck ◽  
P. Samson ◽  
C.G. Robinson ◽  
J.D. Bradley ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Bone Metastases ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Palliative Radiation ◽  
Palliative Radiation Therapy
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