Multiple Myeloma Coverage from Every Angle

ASTRO 2020: U.S. Trends in Use of Palliative Radiotherapy for Myeloma

By: Susan Reckling
Posted: Tuesday, November 3, 2020

To gain a better understanding of the contemporaneous use of initial palliative radiotherapy for patients with myeloma in the era of novel systemic therapies, Croix Fossum, MD, of the University of Southern California, Keck School of Medicine, Los Angeles, and colleagues focused on data from the National Cancer Database. Although the use of palliative radiotherapy in the United States in these patients has “declined slightly over time,” for those who did receive such radiotherapy, a trend toward earlier treatment was observed. These findings were presented during the virtual edition of the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 3770).

“Our survival analysis does not support the hypothesis that patients are receiving their initial radiotherapy course closer to the end of life,” the investigators concluded.

This study centered on patients diagnosed with multiple myeloma from 2004 to 2016. The investigators focused their attention on radiation dose and fractionation, time from diagnosis to first radiation therapy, time from radiation therapy to death, and use of postoperative radiation therapy (within 56 days of surgery).

Approximately 14% of the 174,551 patients in this study (n = 23,901) received palliative radiotherapy. From 2004 to 2016, the number of patients receiving radiotherapy decreased gradually, from 15.5% to 13.2% (P = .0002). In addition, over the study years, the median number of fractions decreased (from 14 to 10; P = .0001), as did the average time from diagnosis to initial use of radiotherapy (from 42.7 to 39.6 years; P = .014). As for overall survival after receiving initial radiotherapy, it was longer for those diagnosed between 2010 and 2015 than it was for those diagnosed between 2004 and 2009. Finally, less than 5% of all radiotherapy cases were postoperative, with a fluctuating frequency of postoperative radiotherapy over time.

Disclosure: The study authors reported no conflicts of interest.

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