Factors affecting the use of palliative radiotherapy in Ontario

Purpose: To describe the use of palliative radiotherapy (PRT) and to identi fy factors associated with the use of PRT. Materials and Methods: The Ontario Cancer Registry was used to identify 193 ,253 adult patients who died of cancer between 1986 and 1995, Radiotherapy records from all Ontario cancer centers and the data on socioeconomic statu s (SES) from the Canadian Census were linked to the Ontario Cancer Registry data. The proportion of cases who received at least one course of PRT at a ny time within 2 years of death (PRT2Y) was used as a primary measure of th e use rate of PRT, Results: Overall, 26.4% of cases underwent at least one course of PRT, PRT2 Y remained relatively constant over the study period. PRT2Y was disease-spe cific and ranged from 4% for pancreatic cancer to 41% for prostate cancer. Age was negatively associated with PRT2Y (adjusted odds ratio [OR], 4.5 for the youngest group), and SES was positively associated with PRT2Y (adjuste d OR, 1.2 for patients from wealthy communities). patients who were initial ly diagnosed in a hospital affiliated with a cancer center (adjusted OR, 1. 4) or who lived in a county in which a cancer center is located (adjusted O R, 1.2), or who resided in certain regions (adjusted OR, 1.20 for Hamilton and 1.17 for Kingston), were more likely ta be treated with PRT, Conclusion: The use of PRT varied across the dispersed papulation in Ontari o and was influenced by factors unrelated to the patient's needs. An effort should be made ta reduce barriers to access for disadvantaged groups, J Cl in Oncol 19:137-144, (C) 2001 by American Society of Clinical Oncology.