title: Radiation therapy in the last month of life.
abstract: OBJECTIVE
  We sought to survey a large, multi-center patient sample to better characterize/quantify RT utilization at the end of life.
  
  
  BACKGROUND
  Few objective data exist for radiation therapy (RT) delivery at end of life (EOL).
  
  
  METHODS
  Data were retrieved for all patients receiving RT in calendar year 2010 in the Department of Radiation Oncology at Indiana University (IU) and Howard University (HU) hospitals. Specific attention was made of the group of patients receiving RT in the last 30 days of life.
  
  
  RESULTS
  A total of 852 patients received all or part of their RT during 2010 (HU: 139, IU: 713). At time of analysis in early 2012, 179 patients had died (21%). Fifty-four patients (6.3% of total; 30% of expired patients) died within 30 days of receiving their last treatment. Twenty patients (2.3% of total; 11.2% of expired patients) received RT within their last week of life. For both sites, the median time until death from completion of therapy was 12.5 days (range 2-30 days).
  
  
  CONCLUSIONS
  Radiation in the last month of life is likely to provide minimal palliation or survival benefit. This, coupled with the financial implications, time investment, and physical costs, suggests that physicians and patients should more strongly consider hospice, and minimize duration of palliative RT courses as far as possible. As with chemotherapy, RT utilization at EOL should be considered for collection as an overuse metric.
authors.affiliation: Department of Radiation Oncology, Howard University Hospital, Washington, DC 20001, United States.
authors.forename: Anand
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Radiation Oncology, Howard University Hospital, Washington, DC 20001, United States.
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Dunmore-Griffith
authors.affiliation: Department of Radiation Oncology, Blanchard Valley Health System, Findlay, OH 45840, United States.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lutz
authors.affiliation: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
authors.forename: Peter A S
authors.initials: PA
authors.lastname: Johnstone
keywords: Health services research; Palliative care; Radiotherapy