B. Ashleigh Guadagnolo, M.D., M.P.H., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues analyzed data on radiation treatment in the last month of life from 202,299 elderly patients (65 years and older) who had died from various cancers from 2000 to 2007.

The researchers found that 7.6 percent of patients had received radiation therapy in their last month of life, and its use was influenced by factors including race, gender, income, and hospice care. Of patients who received radiation therapy, 17.8 percent had received more than 10 days of treatment, which was more likely for non-Hispanic whites, those not receiving hospice care, and those treated in a freestanding rather than a hospital-associated facility. Among those receiving radiation therapy in the last month of life, the total costs of care in the last month of life was 32 percent lower among those who received hospice care.

"It is possible, on the basis of overall low percentage of patients who received radiotherapy in the last 30 days of life, that there is underuse of this modality in end-stage cancer care," Guadagnolo and colleagues conclude. "However, dosing regimens that require dying patients to spend a significant proportion of their final days visiting a radiation therapy suite likely counters the overall aim of palliative care."

One author received funding from Helsinn.

Abstract
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