open access

Vol 19, No 3 (2014)
Published online: 2014-05-01
Submitted: 2013-06-19
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Radiation therapy in the last month of life

Anand Patel, Jacquelyn Dunmore-Griffith, Stephen Lutz, Peter A.S. Johnstone
DOI: 10.1016/j.rpor.2013.09.010
·
Rep Pract Oncol Radiother 2014;19(3):191-194.

open access

Vol 19, No 3 (2014)
Published online: 2014-05-01
Submitted: 2013-06-19

Abstract

Aim

We sought to survey a large, multi-center patient sample to better characterize/quantify RT utilization at the end of life.

Background

Few objective data exist for radiation therapy (RT) delivery at end of life (EOL).

Materials and methods

Data were retrieved for all patients receiving RT in calendar year 2010 in the Department of Radiation Oncology at Indiana University (IU) and Howard University (HU) hospitals. Specific attention was made of the group of patients receiving RT in the last 30 days of life.

Results

A total of 852 patients received all or part of their RT during 2010 (HU: 139, IU: 713). At time of analysis in early 2012, 179 patients had died (21%). Fifty-four patients (6.3% of total; 30% of expired patients) died within 30 days of receiving their last treatment. Twenty patients (2.3% of total; 11.2% of expired patients) received RT within their last week of life. For both sites, the median time until death from completion of therapy was 12.5 days (range 2–30 days).

Conclusions

Radiation in the last month of life is likely to provide minimal palliation or survival benefit. This, coupled with the financial implications, time investment, and physical costs, suggests that physicians and patients should more strongly consider hospice, and minimize duration of palliative RT courses as far as possible. As with chemotherapy, RT utilization at EOL should be considered for collection as an overuse metric.

Abstract

Aim

We sought to survey a large, multi-center patient sample to better characterize/quantify RT utilization at the end of life.

Background

Few objective data exist for radiation therapy (RT) delivery at end of life (EOL).

Materials and methods

Data were retrieved for all patients receiving RT in calendar year 2010 in the Department of Radiation Oncology at Indiana University (IU) and Howard University (HU) hospitals. Specific attention was made of the group of patients receiving RT in the last 30 days of life.

Results

A total of 852 patients received all or part of their RT during 2010 (HU: 139, IU: 713). At time of analysis in early 2012, 179 patients had died (21%). Fifty-four patients (6.3% of total; 30% of expired patients) died within 30 days of receiving their last treatment. Twenty patients (2.3% of total; 11.2% of expired patients) received RT within their last week of life. For both sites, the median time until death from completion of therapy was 12.5 days (range 2–30 days).

Conclusions

Radiation in the last month of life is likely to provide minimal palliation or survival benefit. This, coupled with the financial implications, time investment, and physical costs, suggests that physicians and patients should more strongly consider hospice, and minimize duration of palliative RT courses as far as possible. As with chemotherapy, RT utilization at EOL should be considered for collection as an overuse metric.

Get Citation

Keywords

Health services research; Palliative care; Radiotherapy

About this article
Title

Radiation therapy in the last month of life

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 19, No 3 (2014)

Pages

191-194

Published online

2014-05-01

DOI

10.1016/j.rpor.2013.09.010

Bibliographic record

Rep Pract Oncol Radiother 2014;19(3):191-194.

Keywords

Health services research
Palliative care
Radiotherapy

Authors

Anand Patel
Jacquelyn Dunmore-Griffith
Stephen Lutz
Peter A.S. Johnstone

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