The use of palliative radiotherapy for bone metastasis.
BACKGROUND
The value of palliative radiotherapy (PRT) for bone metastases is well established, but little is known about its use in the general population.


OBJECTIVE
To describe the use of PRT for bone metastases in Ontario.


METHODS
This was a retrospective cohort study. Treatment records from all Ontario RT departments were linked to a population-based cancer registry to describe the use of PRT.


RESULTS
12.2% of the 434,241 patients, who died of cancer in Ontario between 1984 and 2004, received at least one course of PRT for bone metastases in the last 2 years of life. The rate of use of PRT varied across the province (inter-county range, 8.2-18.6%). Older patients and residents of poorer areas were less likely to receive PRT (p<0.0001). Patients diagnosed with cancer in a hospital with a radiotherapy facility and those who lived closer to a radiotherapy centre were more likely to receive PRT (p<0.0001). Over the study period, the use of PRT decreased in breast cancer and myeloma, but increased in prostate cancer (p<0.0001).


CONCLUSIONS
Access to PRT appears to be inequitable. More effort is required to make this useful treatment available to all those who would benefit from it.
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada.
Daniel S
DS
Sutton
Weidong
W
Kong
Keyue
K
Ding
William J
WJ
Mackillop
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010166:Palliative Care; D014850:Waiting Lists