Socioeconomic disparities in the receipt of radiation for node-positive prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 53-53
Author(s):  
Vinayak Muralidhar ◽  
Brandon Arvin Virgil Mahal ◽  
Yu-Wei Chen ◽  
Michelle Daniel Nezolosky ◽  
Paul L. Nguyen
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
African American ◽  
Background Radiation ◽  
Local Therapy ◽  
Income Level ◽  
Socioeconomic Disparities ◽  
Separate Analysis ◽  
Node Positive ◽  
To Receive

53 Background: Radiation therapy in the setting of node-positive prostate cancer has been controversial, although some recent data suggests a survival benefit to radiation in this setting. We evaluated socioeconomic disparities in the receipt of radiation for node-positive prostate cancer to identify groups that may be less likely to receive this potentially life-saving treatment. Methods: We identified 3,283 patients with N1M0 prostate cancer diagnosed 1982-2011 using the Surveillance, Epidemiology, and End Results database who were treated with radiation or no local therapy. We conducted multivariable logistic regression to determine socioeconomic predictors of not receiving radiation treatment. Results: Several patient and demographic factors were associated with a reduced likelihood of receiving radiation: African American (AA) vs non-AA race (31.7% vs. 37.7%, adjusted odds ratio [AOR] 0.74, p = 0.012); unmarried vs married status (31.9% vs 38.6%, AOR 0.72, p < 0.001); bottom third vs top third in income level (33.7% vs. 39.8%, AOR 0.72, p < 0.001); age over 65 versus < = 65 years (34.6% vs 39.8%, AOR 0.81, p = 0.005); diagnosis before 2000 versus starting in 2000 (31.6% vs 43.5%, AOR 0.56, p < 0.001). In a separate analysis, patients under the age of 65 who had Medicaid or no insurance were less likely than patients with other insurance to receive radiation (43.5% vs 55.9%, OR 0.61, p = 0.041), although on multivariable analysis, no significant association persisted (p = 0.512). Conclusions: African American race, unmarried status, lower income level, older age, and insurance status were all associated with significantly reduced odds of receiving radiation therapy for node-positive prostate cancer compared with no local therapy. Given the accumulating data suggesting that radiation therapy can improve survival in node-positive patients, it is increasingly important to understand the reasons for these treatment disparities so that they can be reduced.

scholarly journals RE: Androgen Deprivation With or Without Radiation Therapy for Clinically Node-Positive Prostate Cancer

2015 ◽  
Vol 107 (9) ◽  
Author(s):  
Alberto Briganti ◽  
Giorgio Gandaglia ◽  
Nicola Fossati ◽  
Marco Moschini ◽  
Francesco Montorsi
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation ◽  
Node Positive ◽  
Clinically Node Positive

scholarly journals Awareness amongst Audiologists Regarding Effects of Radiation Therapy on Auditory System

2018 ◽  
Vol 08 (04) ◽  
pp. 015-019
Author(s):  
Bennet Elsa Joseph ◽  
Nituna Vinod ◽  
Dona Maria Thomas ◽  
Arya Krishnan S.
Keyword(s):  
Hearing Loss ◽  
Radiation Therapy ◽  
Auditory System ◽  
Background Radiation ◽  
Interdisciplinary Approach ◽  
Post Radiation ◽  
Effects Of Radiation ◽  
The Many ◽  
To Receive ◽  
Descriptive Statistical Analysis

Abstract Background: Radiation therapy has been a life saver for patients suffering from cancer. Hearing loss can be one of the many side effects of radiation therapy. It can affect the integration of the patient into society after the treatment of cancer is complete. Along with hearing loss, the patients may also experience other auditory symptoms like tinnitus, loudness intolerance and speech perception difficulties which are to be assessed, diagnosed and treated by Audiologists. In order to provide effective rehabilitation, it is necessary that Audiologists are aware of the effect of radiation therapy on the auditory system and what role they play in the interdisciplinary approach. The aim of the present study was to briefly assess whether this awareness is present amongst Audiologists. Method : A questionnaire was prepared to comprise of questions related to the various aspects of effects of radiation therapy on the auditory system. The questionnaire was circulated online amongst Audiologists and completed questionnaires were subjected to descriptive statistical analysis. Results : Only 76.9% Audiologists who were part of the survey were sure that hearing loss can be a side effect of radiation therapy. Many of the Audiologists were not sure whether they should provide audiological services to the patient before radiation therapy or after radiation therapy. 44% were not sure about what measures could be taken to reduce the effect of radiation therapy on the auditory system. 96.3% stated that there is a need to receive more specific training in dealing with rehabilitative cases post radiation therapy.

Definitive Local Therapy and Survival in Clinically Node-Positive Prostate Cancer

2018 ◽  
Vol 102 (3) ◽  
pp. e139-e140
Author(s):  
R.R. Sarkar ◽  
A.K. Bryant ◽  
K. Kader ◽  
R. Mckay ◽  
J.P. Einck ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Therapy ◽  
Node Positive ◽  
Clinically Node Positive

Gastrointestinal toxicities following radiation therapy for localized prostate cancer.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 64-64
Author(s):  
G. L. Lu-Yao ◽  
S. Kim ◽  
D. Moore ◽  
W. Shih ◽  
Y. Lin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Proton Therapy ◽  
Background Radiation ◽  
Early Years ◽  
Localized Prostate Cancer ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Gi Toxicity ◽  
3D Crt

64 Background: Radiation therapy (RAD) is commonly employed to treat localized prostate cancer; however, representative data regarding treatment related toxicities compared to conservative management (CM) is sparse. Methods: We performed a population-based cohort study, using Medicare claims data linked to the Surveillance, Epidemiology, and End Results data, to evaluate gastrointestinal (GI) toxicities in men aged 65-85 years treated with either primary RAD or CM for T1-T2 prostate cancer diagnosed in 1992-2005. In this study, only GI toxicities requiring interventional procedures occurring after 6 months of cancer diagnosis were included. Competing risk models were used with the following covariates: year of diagnosis, comorbidity, age, tumor stage, cancer grade, hormone use within 1 year of diagnosis, region, race, poverty and marital status. Results: Among 41,859 patients in this study, 28,021 patients received radiation therapy, 19,287 with external beam radiation therapy (EBRT) alone, and 5,138 with brachytherapy alone. The most common GI toxicity was GI bleeding or ulceration. GI toxicity rates were 6.1% after 3D-conformal therapy (3D-CRT), 2.8% after intensity modulated radiation therapy (IMRT), 2.6% after brachytherapy, 8.2% after proton therapy and 1.1% for CM patients. In the multivariate models, RAD group was associated with a higher hazard of GI toxicities (hazard ratio [HR] 4.68; 95% CI, 3, 93-5.58) than CM. Comparing to 3D-CRT, brachytherapy (HR 0.62; 95% CI, 0.51-0.75) and IMRT (HR 0.67; 95% CI, 0.55-0.82) are associated with a lower hazard of GI toxicities, while proton therapy is associated with a higher hazard of GI toxicities (HR 2.15; 95% CI, 1.45-3.17). Conclusions: Radiation therapy is associated with a higher risk of GI toxicities than CM. Among different modalities of radiation therapy, protons therapy is associated with the highest risk of GI toxicities, followed by 3D-CRT, IMRT, and brachytherapy. The increased GI toxicities for patients with proton therapy may reflect a learning curve in the early years. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document