Are Black Patients With Myeloma as Likely as White Patients to Receive Palliative Radiotherapy?
Posted: Wednesday, November 3, 2021
According to results published in the journal Leukemia and Lymphoma, Black patients with multiple myeloma may be less likely to receive palliative radiotherapy within 1 year of their diagnosis and within 30 days of the end of life than their non-Hispanic White counterparts. Leslie K. Ballas, MD, of the USC Keck School of Medicine, Los Angeles, and colleagues indicated that possible reasons for the decreased use of palliative radiotherapy in Black patients are numerous and complex, deserving of further consideration.
“There is no reason to believe that African American patients are actually experiencing less pain than non-Hispanic White patients, and it is actually more likely that African Americans have inferior medical management of pain based on prior studies,” the authors wrote.
A total of 23,728 patients from the National Cancer Database (2004–2016) receiving palliative radiotherapy were analyzed. Specifically, patients who received between 4 Gy and 30 Gy of radiotherapy within the first 12 months of a multiple myeloma diagnosis were the focus of the study. Researchers then assessed the vital status of these patients within 30 days of initiation of radiotherapy to determine which ones were more likely to receive near end-of-life radiation.
The percentage of patients receiving palliative radiotherapy within 12 months of diagnosis were 14.4% Black and 15.5% non-Hispanic White. Of these patients, Black individuals were 18% less likely to die within 30 days of treatment initiation compared with their non-Hispanic White counterparts (odds ratio = 0.82, 95% confidence interval = 0.67–0.995).
The authors noted that the lower likelihood of Black patients receiving end-of-life palliative radiotherapy may be because of factors such as provider-related explanations such as inaccurate perceptions of pain, unconscious bias among providers, and barriers to accessing care.
Disclosure: The study authors reported no conflicts of interest.