Almost half of patients with advanced stage lung cancer are receiving more than the recommended number of palliative radiation treatments, says a new study published in the Journal of the National Cancer Institute.
Guidelines developed from clinical trials recommend that no more than 15 radiation treatments should be given to palliative patients with stage 4 lung cancer. Additionally, in order to reduce the risk of toxicity, patients should not receive radiation at the same time that they receive chemotherapy.
Researchers analyzed more than 47,000 patients who received palliative radiation for stage 4 lung cancer in the United States from 2004 to 2012, and they found that 49% received more than 15 radiation treatments and 28% received more than 25 treatments. About 19% of patients were receiving chemotherapy at the same time.
The study also found that patients with private insurance were 40% more likely to be over-treated with radiation than uninsured patients. In a press release, lead author of the study, Matthew Koshy, MD, a radiation oncologist at the University of Illinois, said that some physicians’ decisions could be financially motivated. Services for the privately insured are billed per treatment, meaning that some institutions could take advantage by offering extra radiation treatments even though they are not needed. Alternatively, doctors may give more radiation treatments to this patient group because they are perceived to have a better chance of positive outcomes.
Dr. Koshy concluded, “more education is needed for radiation oncologists, to prevent overtreatment -- which has not been proven to further improve symptoms or quality of life, and can have some significant side effects.”
