Late-stage cancer often over-treated with radiation

Privately-insured patients and those being treated at community cancer centers were more likely to be given more than the recommended number of radiation doses.

By Stephen Feller

CHICAGO, Oct. 1 (UPI) -- Radiation treatment is often used with late-stage lung cancer patients to relieve pain and improve quality of life, but a new study found that nearly half of these patients receive more than the recommended number of treatments.

Unnecessary treatments, found most often among patients with private health insurance, can increase costs and cause other unwanted side effects.


Guidelines for using radiation to control pain recommend 15 or fewer treatments, and that they not be given at the same time patients are undergoing chemotherapy in order to reduce the risk of toxicity.

"This study uncovered that there's a lot of treatment of late-stage lung cancer with palliative radiation that goes beyond what is recommended by several national guidelines and multiple clinical trials," said Dr. Matthew Koshy, a radiation oncologist at the University of Illinois Hospital and Health Sciences System, in a press release.

Researchers analyzed data on 46,803 Stage IV lung cancer patients collected between 2004 and 2012 as part of the National Cancer Database, finding 49 percent received more than 15 radiation treatments and 28 percent received more than 25 treatments. About 19 percent were found to be receiving chemotherapy at the same time as radiation.


The data showed the greatest predictor for receiving more than 15 treatments was patients with private insurance -- they are 40 percent more likely to be over-treated with radiation than uninsured patients. People being treated at community cancer centers, rather than centers connected to an academic institution, also were more likely to be over-treated.

Koshy said it's possible some physicians may be financially motivated to over-treat privately insured patients because the services are billed per treatment, adding that extra radiation may also be given to patients because their doctors feel they have the potential for healthier outcome as a result.

"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," Koshy said.

The study is published in the Journal of the National Cancer Institute.

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