Contributing Factors to Delay of Adjuvant Postsurgical Radiation for Malignant Brain Tumors: A Single Institution...

Malignant tumors of the central nervous system (CNS) are associated with high morbidity and mortality, requiring prompt and coordinated multidisciplinary care. Although adjuvant radiotherapy (RT) is a standard component of treatment that improves survival, delays in initiating RT remain common and may negatively impact patient outcomes. This study investigates patient-related factors contributing to delayed adjuvant RT in individuals with high-grade gliomas (HGGs) and brain metastases (BMs) treated at a tertiary care center in Arkansas.

Electronic medical records (EMR) were retrospectively reviewed for patients diagnosed with HGGs and BMs who sought medical treatment at the University of Arkansas for Medical Sciences (UAMS) from 2019 to 2022. Statistical analysis included evaluation of the association of sociodemographic and clinical variables with radiotherapy status, using multivariable logistic regression and survival analysis.

Our sample included 219 patients diagnosed with HGGs or BMs who were treated at UAMS. Out of the 219 patients, 72.1% (n=158) patients received adjuvant RT treatment. In this group, 102 patients underwent timely RT treatment while 53 received delayed treatment. The timing of radiation was not available for 3 patients. Our analysis revealed an association between the Charlson Comorbidities Index (CCI) and RT timing status, suggesting a higher probability of receiving late RT with a higher CCI score ( P =0.048). In addition, patients who received delayed RT also had a significantly longer interval between surgery and RT treatment compared with patients with timed adjuvant RT ( P <0.0001 for both).

We found that patients with a higher CCI score suggested an increased probability of experiencing delayed RT.