TY - JOUR
T1 - Contemporary prostate cancer radiation therapy in the United States
T2 - Patterns of care and compliance with quality measures
AU - Lee, Daniel J.
AU - Barocas, Daniel A.
AU - Zhao, Zhiguo
AU - Huang, Li Ching
AU - Koyama, Tatsuki
AU - Resnick, Matthew J.
AU - Conwill, Ralph
AU - McCollum, Dan
AU - Cooperberg, Matthew R.
AU - Goodman, Michael
AU - Greenfield, Sheldon
AU - Hamilton, Ann S.
AU - Hashibe, Mia
AU - Kaplan, Sherrie H.
AU - Paddock, Lisa E.
AU - Stroup, Antoinette M.
AU - Wu, Xiao Cheng
AU - Penson, David F.
AU - Hoffman, Karen E.
N1 - Publisher Copyright:
© 2018 American Society for Radiation Oncology
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose: Quality measures represent the standards of appropriate treatment agreed upon by experts in the field and often supported by data. The extent to which providers in the community adhere to quality measures in radiation therapy (RT) is unknown. Methods and materials: The Comparative Effectiveness Analysis of Surgery and Radiation study enrolled men with clinically localized prostate cancer in 2011 and 2012. Patients completed surveys and medical records were reviewed. Patients were risk-stratified according to D'Amico classification criteria. Patterns of care and compliance with 8 quality measures as endorsed by national consortia as of 2011 were assessed. Results: Overall, 926 men underwent definitive RT (69% external beam radiation therapy [EBRT]), 17% brachytherapy (BT), and 14% combined EBRT and BT with considerable variation in radiation techniques across risk groups. Most men who received EBRT had dose-escalated EBRT (>75 Gy; 93%) delivered with conventional fractionation (<2 Gy; 95%), intensity modulated RT (76%), and image guided RT (85%). Most men treated with BT received I125 (77%). Overall, 73% of the men received EBRT that was compliant with the quality measures (dose-escalation, image-guidance, appropriate use of androgen deprivation therapy, and appropriate treatment target) but only 60% of men received BT that was compliant with quality measures (postimplant dosimetry and appropriate dose). African-American men (64%) and other minorities (62%) were less likely than white men (77%) to receive EBRT that was compliant with quality measures. Conclusions: Most men who received RT for localized prostate cancer were treated with an appropriately high dose and received image guidance and intensity modulated RT. However, compliance with some nationally recognized quality measures was relatively low and varied by race. There are significant opportunities to improve the delivery of RT and especially for men of a minority race.
AB - Purpose: Quality measures represent the standards of appropriate treatment agreed upon by experts in the field and often supported by data. The extent to which providers in the community adhere to quality measures in radiation therapy (RT) is unknown. Methods and materials: The Comparative Effectiveness Analysis of Surgery and Radiation study enrolled men with clinically localized prostate cancer in 2011 and 2012. Patients completed surveys and medical records were reviewed. Patients were risk-stratified according to D'Amico classification criteria. Patterns of care and compliance with 8 quality measures as endorsed by national consortia as of 2011 were assessed. Results: Overall, 926 men underwent definitive RT (69% external beam radiation therapy [EBRT]), 17% brachytherapy (BT), and 14% combined EBRT and BT with considerable variation in radiation techniques across risk groups. Most men who received EBRT had dose-escalated EBRT (>75 Gy; 93%) delivered with conventional fractionation (<2 Gy; 95%), intensity modulated RT (76%), and image guided RT (85%). Most men treated with BT received I125 (77%). Overall, 73% of the men received EBRT that was compliant with the quality measures (dose-escalation, image-guidance, appropriate use of androgen deprivation therapy, and appropriate treatment target) but only 60% of men received BT that was compliant with quality measures (postimplant dosimetry and appropriate dose). African-American men (64%) and other minorities (62%) were less likely than white men (77%) to receive EBRT that was compliant with quality measures. Conclusions: Most men who received RT for localized prostate cancer were treated with an appropriately high dose and received image guidance and intensity modulated RT. However, compliance with some nationally recognized quality measures was relatively low and varied by race. There are significant opportunities to improve the delivery of RT and especially for men of a minority race.
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U2 - 10.1016/j.prro.2018.04.009
DO - 10.1016/j.prro.2018.04.009
M3 - Article
C2 - 30177030
AN - SCOPUS:85048310552
SN - 1879-8500
VL - 8
SP - 307
EP - 316
JO - Practical radiation oncology
JF - Practical radiation oncology
IS - 5
ER -