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Variation in Access to Palliative Radiotherapy in Prostate Cancer: A Population-Based Study in Canada.

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Summary

Nearly half of prostate cancer patients in Ontario received palliative radiotherapy before death. Factors like younger age, higher stage, and care at regional cancer centers were associated with its use, highlighting opportunities to improve access.

Keywords:
barriers to accessontariopalliative radiotherapyprostate cancerutilization of radiotherapy

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Area of Science:

  • Oncology
  • Palliative Care
  • Radiation Oncology

Background:

  • Increasing survival rates in metastatic cancer necessitate recognition of palliative radiotherapy's role.
  • Access to palliative radiotherapy remains a challenge, with many prostate cancer patients not receiving it before death.
  • This study investigates factors influencing palliative radiotherapy receipt in deceased prostate cancer patients in Ontario.

Purpose of the Study:

  • To identify and describe factors associated with palliative radiotherapy utilization.
  • To analyze predictors of radiotherapy receipt in a decedent cohort of prostate cancer patients.
  • To inform strategies for improving access to palliative radiotherapy.

Main Methods:

  • Utilized population-based administrative databases from Ontario, Canada.
  • Identified prostate cancer decedents aged 65+ who received androgen deprivation therapy (2013-2018).
  • Analyzed baseline and treatment characteristics using logistic regression for association with radiotherapy receipt within two years of death.

Main Results:

  • 49.9% of 3,788 identified prostate cancer decedents received radiotherapy in the two years preceding death.
  • Positive associations found with younger age at diagnosis, higher cancer stage, and care at regional cancer centers.
  • Receipt of care from radiation oncologists or medical oncologists was strongly associated with radiotherapy use; no association with income or distance to cancer center.

Conclusions:

  • Palliative radiotherapy utilization in Ontario prostate cancer patients varies by age, stage, comorbidities, and treatment center type.
  • No disparities in access were linked to patient income or proximity to cancer centers.
  • Findings suggest opportunities to enhance palliative radiotherapy access and referrals to multidisciplinary centers to improve patient quality of life.