30-day mortality following palliative radiotherapy

Area of Science:

• Palliative Radiation Oncology
• Cancer Prognostics
• Quality Indicators in Healthcare

Background:

• 30-day mortality is a key quality indicator for palliative radiation, with <20% recommended.
• Palliative radiation aims to improve quality of life, not immediate survival.
• High early mortality suggests potential harm or suboptimal patient selection.

Purpose of the Study:

• Investigate 30-day mortality rates following palliative radiation at CRCHS.
• Evaluate the prognostic accuracy of the TEACHH model in this patient population.
• Assess the impact of treatment fractionation on short-term outcomes.

Main Methods:

• Retrospective review of palliative treatments from two 2-year periods (2012/2013, 2016/2017).
• Analysis of 30-day mortality and influencing variables.
• Stratification of patients into three groups using the TEACHH model.

Main Results:

• Overall 30-day mortality was 10% (1744 patients).
• Higher mortality observed in lung cancer patients (17%), <5 fractions (13%), and TEACHH groups B/C (11-21%).
• 84% of treatments used five fractions or less.

Conclusions:

• The observed 30-day mortality rate meets recommended quality standards.
• Increasing fractionation correlated with decreasing mortality, indicating appropriate patient selection.
• The TEACHH model effectively refines prognosis, guiding treatment decisions for palliative radiation.