Journal
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
Volume 30, Issue -, Pages 78-83Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ctro.2021.08.004
Keywords
Stent; SEER-Medicare; Oral mucositis; Head and neck cancer; Radiation
Funding
- CPRIT [RP160674]
- Komen [SAC150061]
- National Institutes of Health (NIH) National Institute of Biomedical Imaging and Bioengineering (NIBIB) Research Education Programs for Residents and Clinical Fellows Grant [R25EB025787-01]
- National Institute for Dental and Craniofacial Research [1R01DE025248/R56DE025248, R01DE028290]
- NCI Early Phase Clinical Trials in Imaging and Image-Guided Interventions Program [1R01CA218148]
- NIH/NCI Cancer Center Support Grant (CCSG) Pilot Research Program Award from the UT MD Anderson CCSG Radiation Oncology and Cancer Imaging Program [P30CA016672]
- NIH/NCI Head and Neck Specialized Programs of Research Excellence (SPORE) Developmental Research Program Award [P50 CA097007]
- NIH Big Data to Knowledge (BD2K) Program of the National Cancer Institute (NCI) Early Stage Development of Technologies in Biomedical Computing, Informatics, and Big Data Science Award [1R01CA214825]
- National Science Foundation (NSF), Division of Mathematical Sciences, Joint NIH/NSF Initiative on Quantitative Approaches to Biomedical Big Data (QuBBD) Grant [NSF 1557679]
- NSF Division of Civil, Mechanical, and Manufacturing Innovation (CMMI) grant [NSF 1933369]
- Stiefel Oropharyngeal Research Fund of the University of Texas MD Anderson Cancer
- MD Anderson Program in Image-guided Cancer Therapy
- Elekta AB
- Radiation Oncology Strategic Initiatives (ROSI) at MD Anderson
- [P30 CA016672]
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The purpose of this study was to identify clinical and epidemiological factors associated with the utilization of a complex oral treatment device for head and neck cancer patients undergoing radiation therapy. Retrospective analysis of data from the SEER-Medicare databases revealed that age, gender, and geographical disparities were linked to the utilization of the device. Further research and development are needed to improve availability and increase utilization among specific patient populations.
Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC). Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed. Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66-70 (OR = 0.713, 95% CI: 0.528-0.962), male patients (OR = 0.817, 95% CI: 0.710-0.941), nonHispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582-0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279-0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage. Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.
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