Abstract 5323
Background
In terminal cancer patients with a limited prognosis, excessive radiotherapy (RT) fractionation can be considered an avoidable harm and poor use of healthcare resource. 30-day mortality (30DM) as a clinical indicator for the avoidance of harm, through appropriate patient selection, in palliative RT has not previously been demonstrated in Hong Kong. We aimed to assess 30DM following palliative RT at our centre.
Methods
A retrospective analysis of 30DM for all palliative RT delivered in Tuen Mun Hospital in 2017. Episodes were identified using the in-house radiotherapy electronic record with linkage to electronic patient records. 30DM was assessed across all patient groups and by sites and fractionation pattern.
Results
1,065 palliative RT episodes were identified. Overall, 199 (18.7%) treatment were delivered to the spine, 151 (14.2%) to the chest, 97 (9.1%) to the brain, and 77 (7.2%) to the bones. Median treatment duration was 5 days (range 1–12). 84.3% received 5 fractions or less. Overall 30DM was 17.7% (188 patients), among which 61 (32.4%) treatment episodes were delivered to female. The most commonly treated diagnosis was lung cancer (39.4%). Factors having a significant impact upon 30DM were sex (male vs female odds ratio [OR] 1.56, 95% confidence interval [CI] 1.12, 2.18) and primary cancer diagnosis (Lip, oral cavity, and pharynx OR 0.31 [0.11, 0.87], genitourinary organs OR 0.57 [0.33, 0.98], and respiratory and intrathoracic organs 1.60 [1.17, 2.20]).Table:
1602P odd ratios for different factors relating to the 30DM of palliative RT
Yes (mortality within 30 days) | No | ||
---|---|---|---|
Total n = 1065 | No. of Cases (%) | No. of Cases (%) | Odd ratios (95% CI) |
Radiotherapy Sites | |||
Lip, oral cavity, and pharynx | 4 (7) | 57 (93) | 0.31 (0.11, 0.87) |
Genitourinary organs | 16 (11) | 124 (89) | 0.57 (0.33, 0.98) |
Bone, connective tissue, skin and breast | 23 (14) | 144 (86) | 0.71 (0.44, 1.14) |
Other and unspecified sites | 8 (17) | 40 (83) | 0.93 (0.43, 2.02) |
Digestive organs and peritoneum | 35 (18) | 159 (82) | 1.03 (0.69, 1.55) |
Respiratory and intrathoracic organs | 92 (22) | 328 (78) | 1.60 (1.17, 2.20) |
Lymphatic and hematopoietic Tissue | 10 (29) | 25 (71) | 1.92 (0.90, 4.06) |
Sex | |||
Male | 127 (20) | 501 (80) | 1.56 (1.12, 2.18) |
Female | 61 (14) | 376 (86) |
Abbreviation: CI: confidence interval
Conclusions
This is the first large-scale study of 30-day mortality for unselected adult palliative RT in Hong Kong. A balance needs to be achieved between duration of RT course and potential benefits through appropriate patient selection. The observed differences in early mortality by fractionation support the use of this measure in assessing clinical decision making in palliative RT, and further studies in other centres and health care systems are required.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Shing Fung Lee.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5107 - Tolerability of PCV in Low Grade Glioma: a Real World Experience
Presenter: Razia Aslam
Session: Poster Display session 1
Resources:
Abstract
6171 - Molecular EGFR/PD-L1 profile of glioblastoma: Hints for therapeutic strategies
Presenter: Wojciech Szopa
Session: Poster Display session 1
Resources:
Abstract
4418 - Role of Intraoperative MRI (iMRI) in neurosurgery, potential imaging tool for maximizing gross total resection (GTR) rate of CNS tumours.
Presenter: Shweta Wadhwa
Session: Poster Display session 1
Resources:
Abstract
4791 - Tumor related impairments of neurocognitive functions in patients with brain metastases
Presenter: Lei Wen
Session: Poster Display session 1
Resources:
Abstract
5372 - Is radiation therapy influencing Alzheimer’s in Brain and Head and Neck Cancers?
Presenter: Anas Saad
Session: Poster Display session 1
Resources:
Abstract
2329 - Mature Treatment Results of 120 Cases of Acoustic Neuroma Treated with Cyberknife at a single institution.
Presenter: Shawn Malone
Session: Poster Display session 1
Resources:
Abstract
3207 - A phase II/III trial of high-dose, intermittent sunitinib in patients with recurrent glioblastoma: the STELLAR study
Presenter: Cyrillo Brahm
Session: Poster Display session 1
Resources:
Abstract
3589 - CNS penetration and Preliminary Efficacy of Sacutizumab Govitecan in Breast Brain Metastasis and Glioblastoma: A Surgical Study
Presenter: Andrew Brenner
Session: Poster Display session 1
Resources:
Abstract
1969 - Wedge resection with omission of lymph node dissection as an optional treatment strategy in octogenarians or older with early stage non-small cell lung cancers
Presenter: Takahiro Mimae
Session: Poster Display session 1
Resources:
Abstract
5116 - Characterization of lung tumorspheres reveals cancer stem-like cells potential targets and prognostic markers in non-small cell lung cancer
Presenter: Alejandro Herreros Pomares
Session: Poster Display session 1
Resources:
Abstract