RTHP-08. FAILURE TO COMPLETE STANDARD RADIATION THERAPY IN GLIOBLASTOMA PATIENTS: PATTERNS FROM A NATIONAL DATABASE WITH IMPLICATIONS FOR SURVIVAL AND THERAPEUTIC DECISION MAKING. (11th November 2019)

• Record Type: Journal Article
• Authors: Yusuf, Mehran; Gaskins, Jeremy; Gilbert, Mark; Woo, Shiao; Burton, Eric
• Is Part Of: Neuro-oncology. Volume 21(2019)Supplement 6
• Page Start: vi211
• Page End: vi211
• Publication Date: 2019-11-11
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noz175.881
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Approximately 5%-10% of patients with newly diagnosed glioblastoma (GBM) will fail to complete standard radiotherapy (SRT). We sought to determine the impact on survival and to identify risk factors for failure to complete SRT. METHODS: A cohort of 17, 451 adults with GBM were identified from the National Cancer Database. The cohort was restricted to patients diagnosed between 2005 to 2012 that were started on conventionally fractionated RT of 1.8 to 2.0 Gy per fraction to a dose of < 66Gy and. Patients were stratified by RT dose achieved: (a.) completed RT > 58Gy, (b.) nearly completed RT > 50Gy - < 58Gy, and (c.) did not complete RT < 50Gy. RESULTS: Radiotherapy completion rates correlated with survival, 87% of patients completed RT and had a median OS of 13.5 months, 4% were near completers (median OS 5.7 months), and 9% did not complete RT (median OS 1.9 months). Risk factors for not completing SRT were: older age, biopsy alone, government insurance, high comorbidity score and lower income zip code (all OR > 1 and p-values < 0.05). Twenty-eight percent of patients > 80 yrs did not complete SRT (OR 2.99, 95% CI 2.36–3.80, relative to 40–49 yrs) and 19% of 70-79-yrs did not complete SRT (OR 1.99, 95% CI 1.63–2.42). CONCLUSIONS: Failure to complete SRT was associated with decreased survival in our cohort. Risk factors for failure to complete SRT, include older age, biopsy alone and substantial comorbidities. Other studies have shown SRT is discontinued primarily due to clinical deterioration and/or disease progression. Therefore, these patients should be considered for alternative therapeutic management such as hypofractionated radiotherapy.