Who enrolls onto clinical oncology trials? A radiation Patterns Of Care Study analysis.
OBJECTIVE
To identify factors significantly influencing accrual to clinical protocols by analyzing radiation Patterns of Care Study (PCS) surveys of 3,047 randomly selected radiotherapy (RT) patients.


METHODS
Patterns of Care Study surveys from disease sites studied for the periods 1992-1994 and 1996-1999 (breast cancer, n = 1,080; prostate cancer, n = 1,149; esophageal cancer, n = 818) were analyzed. The PCS is a National Cancer Institute-funded national survey of randomly selected RT institutions in the United States. Patients with nonmetastatic disease who received RT as definitive or adjuvant therapy were randomly selected from eligible patients at each institution. To determine national estimates, individual patient records were weighted by the relative contribution of each institution and patients within each institution. Data regarding participation in clinical trials were recorded. The factors age, gender, race, type of insurance, and practice type of treating institution (academic or not) were studied by univariate and multivariate analyses.


RESULTS
Overall, only 2.7% of all patients were accrued to clinical protocols. Of these, 57% were enrolled on institutional review board-approved institutional trials, and 43% on National Cancer Institute collaborative group studies. On multivariate analysis, patients treated at academic facilities (p = 0.0001) and white patients (vs. African Americans, p = 0.0002) were significantly more likely to participate in clinical oncology trials. Age, gender, type of cancer, and type of insurance were not predictive.


CONCLUSIONS
Practice type and race significantly influence enrollment onto clinical oncology trials. This suggests that increased communication and education regarding protocols, particularly focusing on physicians in nonacademic settings and minority patients, will be essential to enhance accrual.
Movsas
Benjamin
B
Department of Radiation Oncology, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202, USA. bmovsas@hfhs.org
Moughan
Jennifer
J
Owen
Jean
J
Coia
Lawrence R
LR
Zelefsky
Michael J
MJ
Hanks
Gerald
G
Wilson
J Frank
JF
D000047:Academies and Institutes / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D044383:Black People / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000532:radiotherapy; D002986:Clinical Trials as Topic / Q000592:standards / Q000706:statistics & numerical data*; D004938:Esophageal Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000532:radiotherapy*; D018579:Patient Selection; D011364:Professional Practice / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D018787:Radiation Oncology / Q000145:classification / Q000706:statistics & numerical data; D012737:Sex Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American