Referral Patterns and Treatment Delays in Medulloblastoma: A Large Academic Proton Center Experience

被引:13
作者
Liu, Sean M. [1 ]
Brooks, Eric D. [1 ,2 ,3 ]
Rubin, M. Laura [1 ]
Grosshans, David R. [1 ,2 ]
Frank, Steven J. [1 ,2 ]
McAleer, Mary Frances [1 ,2 ]
McGovern, Susan L. [1 ,2 ]
Paulino, Arnold C. [1 ,2 ]
Woodhouse, Kristina D. [1 ,2 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Proton Therapy Ctr, Houston, TX 77030 USA
[3] Univ Florida, Hlth Proton Therapy Inst, Jacksonville, FL USA
关键词
medulloblastoma; proton; travel; distance; delay; RADIATION-THERAPY; NEUROCOGNITIVE CONSEQUENCES; CRANIOSPINAL IRRADIATION; BRAIN-TUMOR; RADIOTHERAPY; CANCER; RISK; TOXICITY; SURVIVAL; IMPACT;
D O I
10.14338/IJPT-20-00038.1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Patient travel time can cause treatment delays when providers and families decide to seek proton therapy. We examined whether travel distance or referral pattern (domestic versus international) affects time to radiation therapy and subsequent disease outcomes in patients with medulloblastoma at a large academic proton center. Patients and Methods: Children with medulloblastoma treated at MD Anderson (MDA) with a protocol of proton beam therapy (PBT) between January 4, 2007, and June 25, 2014, were included in the analysis. The Wilcoxon rank-sum test was used to study the association between time to start of radiation and distance. Classification- and regression-tree analyses were used to explore binary thresholds for continuous covariates (ie, distance). Failure-free survival was defined as the time interval between end of radiation and failure or death. Results: 96 patients were included in the analysis: 17 were international (18%); 19 (20%) were from Houston, Texas; 21 were from other cities inside Texas (21%); and 39 (41%) were from other US states. The median time from surgery to start of radiation was not significantly different for international patients (median = 1.45 months) compared with US patients (median = 1.15 months; P = .13). However, time from surgery to start of radiation was significantly longer for patients residing >1716 km (>1066 miles) from MDA (median = 1.31 months) than for patients residing <= 1716 km (<= 1066 miles) from MDA (median = 1.05 months; P = .01). This 1- to 2-week delay (median = 7.8 days) did not affect failure-free survival (hazard ratio = 1.34; P = .43). Conclusion: We found that short delays in proton access can exist for patients traveling long distances to proton centers. However, in this study, treatment delays did not affect outcomes. This highlights the appropriateness of PBT in the face of travel coordination. Investment by proton centers in a rigorous intake process is justified to offer timely access to curative PBT.
引用
收藏
页码:1 / 10
页数:10
相关论文
共 50 条
[41]   Patterns of care, toxicity and outcome in the treatment of salivary gland carcinomas: long-term experience from a tertiary cancer center [J].
von der Grun, Jens ;
Winkelmann, Ria ;
Rodel, Franz ;
Balster, Sven ;
Neumayer, Thomas ;
Ghanaati, Shahram ;
Brandts, Christian ;
Burck, Iris ;
Martin, Daniel ;
Roedel, Claus ;
Kesar, Nikolina ;
Balermpas, Panagiotis .
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, 2021, 278 (11) :4411-4421
[42]   Patterns of care, toxicity and outcome in the treatment of salivary gland carcinomas: long-term experience from a tertiary cancer center [J].
Jens von der Grün ;
Ria Winkelmann ;
Franz Rödel ;
Sven Balster ;
Thomas Neumayer ;
Shahram Ghanaati ;
Christian Brandts ;
Iris Burck ;
Daniel Martin ;
Claus Rödel ;
Nikolina Kesar ;
Panagiotis Balermpas .
European Archives of Oto-Rhino-Laryngology, 2021, 278 :4411-4421
[43]   Patterns of change in treatment, response, and outcome in patients with follicular lymphoma over the last four decades: a single-center experience [J].
Mozas, Pablo ;
Nadeu, Ferran ;
Rivas-Delgado, Alfredo ;
Rivero, Andrea ;
Garrote, Marta ;
Balague, Olga ;
Gonzalez-Farre, Blanca ;
Veloza, Luis ;
Baumann, Tycho ;
Gine, Eva ;
Delgado, Julio ;
Villamor, Neus ;
Campo, Elias ;
Magnano, Laura ;
Lopez-Guillermo, Armando .
BLOOD CANCER JOURNAL, 2020, 10 (03)
[44]   Treatment Refusal and Abandonment Remain Major Concerns Despite Good Outcomes with Multi-Modality Management in Pediatric Medulloblastoma: Experience from a Cancer Center in Eastern India [J].
Das, Anirban ;
Achari, Rimpa Basu ;
Sena, Saugata ;
Krishnan, Shekhar ;
Bhattacharyya, Arpita ;
Zameer, Lateef .
INDIAN JOURNAL OF MEDICAL AND PAEDIATRIC ONCOLOGY, 2019, 40 :S13-S15
[45]   Treatment outcome and patterns of failure in patients of non-pineal supratentorial primitive neuroectodermal tumor: review of literature and clinical experience form a regional cancer center in north India [J].
Ahitagni Biswas ;
Supriya Mallick ;
Suvendu Purkait ;
Soumyajit Roy ;
Chitra Sarkar ;
Sameer Bakhshi ;
Manmohan Singh ;
Pramod Kumar Julka ;
Goura Kishor Rath .
Acta Neurochirurgica, 2015, 157 :1251-1266
[46]   Changes in the Cath Lab in the Treatment of Adult Patients with Congenital Heart Disease: A 12-Year Experience in a Single Referral Center with the Establishment of a Dedicated Working Group [J].
Gagliardi, Maria Giulia ;
Formigari, Roberto ;
Perrone, Marco Alfonso ;
Pomiato, Elettra ;
Fanisio, Francesca ;
Panebianco, Mario ;
Barracano, Rosaria ;
Guccione, Paolo ;
Palmieri, Rosalinda ;
Raponi, Massimiliano ;
Galletti, Lorenzo .
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE, 2023, 10 (08)
[47]   Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center [J].
Schnitzler, Fabian ;
Tillack-Schreiber, Cornelia ;
Szokodi, Daniel ;
Braun, Isabel ;
Tomelden, June ;
Sohn, Maximilian ;
Bader, Franz ;
Waggershauser, Constanze ;
Ochsenkuehn, Thomas .
PLOS ONE, 2024, 19 (01)
[48]   Treatment of Children With Cancer and/or Hematopoietic Stem Cell Transplantation in the Intensive Care Unit: Experience at a Large European Pediatric Cancer Center [J].
Barking, Catharina T. M. M. ;
Masjosthusmann, Katja ;
Rellensmann, Georg ;
Ehlert, Karoline ;
Zoellner, Stefan ;
Jocham, Sophie ;
Kremer, Almut ;
Potratz, Jenny ;
Rieger-Fackeldey, Esther ;
Groll, Andreas H. .
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 2020, 42 (07) :E583-E588
[49]   Real-world effectiveness and safety of direct-acting antivirals for the treatment of hepatitis C virus in kidney and liver transplant recipients: experience of a large transplant center in Brazil [J].
Pacheco, Larissa Sgaria ;
Ventura, Pedro Enrico ;
Kist, Roger ;
Garcia, Valter Duro ;
Meinerz, Gisele ;
Tovo, Cristiane Valle ;
Cantisani, Guido Pio Cracco ;
Zanotelli, Maria Lucia ;
Mucenic, Marcos ;
Keitel, Elizete .
REVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO, 2023, 65
[50]   Clinicopathologic Profile and Treatment Outcomes of Children With Diffuse Large B-cell Lymphomas: Experience From a Tertiary Cancer Center in India [J].
Mande, Radnyi ;
Moulik, Nirmalya Roy ;
Shet, Tanuja ;
Narula, Gaurav ;
Prasad, Maya ;
Dhamne, Chetan ;
Bhat, Vasudeva ;
Parambil, Badira Cheriyalinkal ;
Shah, Sneha ;
Shridhar, Epari ;
Gujral, Sumeet ;
Banavali, Shripad .
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 2022, 44 (03) :E760-E764