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Physicians have not adopted single-fraction radiotherapy into routine practice for uncomplicated bone metastases of prostate cancer, as has been recommended, according to a report in the Oct. 9 issue of JAMA.
In a Research Letter to the editor, investigators reported that 3% of a series of 3,050 patients eligible for single-fraction palliative radiotherapy received it, even though this approach yields pain relief for bone metastases that is comparable to that of multiple-fraction radiotherapy.
Palliative radiotherapy, with either one or multiple fractions given daily, is the mainstay of treatment for painful bone metastases. Several trials have demonstrated that single-fraction and multiple-fraction approaches deliver the same pain relief, and single-fraction radiotherapy is significantly less expensive, said Dr. Justin E. Bekelman of the department of radiation oncology, University of Pennsylvania, Philadelphia, and his associates.
In addition, single-fraction radiotherapy has other patient-centric benefits, including improved quality of life, greater convenience, and reduced travel time. It is advocated over multiple-fraction radiotherapy by the Choosing Wisely campaign, they noted.
Dr. Bekelman and his colleagues analyzed information from the Surveillance, Epidemiology, and End Results database to assess whether single-fraction radiotherapy has been incorporated into routine clinical practice as recommended. They reviewed reimbursement records for Medicare beneficiaries with prostate cancer who were treated during a 3-year period.
The median patient age was 78 years, and 82% had two or more comorbid illnesses.
Of these patients, 3.3% received single-fraction radiotherapy, while the rest received multiple-fraction radiotherapy. Half of the patients received 10 or more fractions per day, the investigators said (JAMA 2013;310:1501-2).
In a sensitivity analysis restricted to the 2,028 patients who had no previous complicating events, 3.8% received single-fraction radiotherapy, confirming the results of the primary analysis.
The mean radiotherapy-related expenditures were 62% lower for patients who received single-fraction radiotherapy ($1,873), compared with those for patients who received multiple-fraction radiotherapy ($4,967).
This study was supported by the National Cancer Institute, the American Cancer Society, and the Leonard Davis Institute for Health Economics. No relevant financial conflicts of interest were reported.
Physicians have not adopted single-fraction radiotherapy into routine practice for uncomplicated bone metastases of prostate cancer, as has been recommended, according to a report in the Oct. 9 issue of JAMA.
In a Research Letter to the editor, investigators reported that 3% of a series of 3,050 patients eligible for single-fraction palliative radiotherapy received it, even though this approach yields pain relief for bone metastases that is comparable to that of multiple-fraction radiotherapy.
Palliative radiotherapy, with either one or multiple fractions given daily, is the mainstay of treatment for painful bone metastases. Several trials have demonstrated that single-fraction and multiple-fraction approaches deliver the same pain relief, and single-fraction radiotherapy is significantly less expensive, said Dr. Justin E. Bekelman of the department of radiation oncology, University of Pennsylvania, Philadelphia, and his associates.
In addition, single-fraction radiotherapy has other patient-centric benefits, including improved quality of life, greater convenience, and reduced travel time. It is advocated over multiple-fraction radiotherapy by the Choosing Wisely campaign, they noted.
Dr. Bekelman and his colleagues analyzed information from the Surveillance, Epidemiology, and End Results database to assess whether single-fraction radiotherapy has been incorporated into routine clinical practice as recommended. They reviewed reimbursement records for Medicare beneficiaries with prostate cancer who were treated during a 3-year period.
The median patient age was 78 years, and 82% had two or more comorbid illnesses.
Of these patients, 3.3% received single-fraction radiotherapy, while the rest received multiple-fraction radiotherapy. Half of the patients received 10 or more fractions per day, the investigators said (JAMA 2013;310:1501-2).
In a sensitivity analysis restricted to the 2,028 patients who had no previous complicating events, 3.8% received single-fraction radiotherapy, confirming the results of the primary analysis.
The mean radiotherapy-related expenditures were 62% lower for patients who received single-fraction radiotherapy ($1,873), compared with those for patients who received multiple-fraction radiotherapy ($4,967).
This study was supported by the National Cancer Institute, the American Cancer Society, and the Leonard Davis Institute for Health Economics. No relevant financial conflicts of interest were reported.
Physicians have not adopted single-fraction radiotherapy into routine practice for uncomplicated bone metastases of prostate cancer, as has been recommended, according to a report in the Oct. 9 issue of JAMA.
In a Research Letter to the editor, investigators reported that 3% of a series of 3,050 patients eligible for single-fraction palliative radiotherapy received it, even though this approach yields pain relief for bone metastases that is comparable to that of multiple-fraction radiotherapy.
Palliative radiotherapy, with either one or multiple fractions given daily, is the mainstay of treatment for painful bone metastases. Several trials have demonstrated that single-fraction and multiple-fraction approaches deliver the same pain relief, and single-fraction radiotherapy is significantly less expensive, said Dr. Justin E. Bekelman of the department of radiation oncology, University of Pennsylvania, Philadelphia, and his associates.
In addition, single-fraction radiotherapy has other patient-centric benefits, including improved quality of life, greater convenience, and reduced travel time. It is advocated over multiple-fraction radiotherapy by the Choosing Wisely campaign, they noted.
Dr. Bekelman and his colleagues analyzed information from the Surveillance, Epidemiology, and End Results database to assess whether single-fraction radiotherapy has been incorporated into routine clinical practice as recommended. They reviewed reimbursement records for Medicare beneficiaries with prostate cancer who were treated during a 3-year period.
The median patient age was 78 years, and 82% had two or more comorbid illnesses.
Of these patients, 3.3% received single-fraction radiotherapy, while the rest received multiple-fraction radiotherapy. Half of the patients received 10 or more fractions per day, the investigators said (JAMA 2013;310:1501-2).
In a sensitivity analysis restricted to the 2,028 patients who had no previous complicating events, 3.8% received single-fraction radiotherapy, confirming the results of the primary analysis.
The mean radiotherapy-related expenditures were 62% lower for patients who received single-fraction radiotherapy ($1,873), compared with those for patients who received multiple-fraction radiotherapy ($4,967).
This study was supported by the National Cancer Institute, the American Cancer Society, and the Leonard Davis Institute for Health Economics. No relevant financial conflicts of interest were reported.
FROM JAMA
Major Finding: The mean radiotherapy-related expenditures were 62% lower for patients who received single-fraction radiotherapy ($1,873), compared with patients who received multiple-fraction radiotherapy ($4,967).
Data Source: An analysis of data for 3,050 patients (median age, 78 years) who received palliative radiotherapy for prostate cancer bone metastases in a 3-year period.
Disclosures: This study was supported by the National Cancer Institute, the American Cancer Society, and the Leonard Davis Institute for Health Economics. No relevant financial conflicts of interest were reported.