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. 2013 May;112(3):393-401.
doi: 10.1007/s11060-013-1068-8. Epub 2013 Feb 15.

The influence of regional health system characteristics on the surgical management and receipt of post operative radiation therapy for glioblastoma multiforme

Sanjay Aneja  1 , Dhruv Khullar, James B Yu
Affiliations

The influence of regional health system characteristics on the surgical management and receipt of post operative radiation therapy for glioblastoma multiforme

Sanjay Aneja et al. J Neurooncol. 2013 May.

Abstract

Despite a known optimal treatment protocol for the management of glioblastoma multiforme (GBM), many patients fail to receive complete surgical resection or post-operative radiation therapy (PORT). The underlying reasons behind this disparity are unclear. Our study investigates the influence of regional health system resources on the surgical management and PORT receipt in patients with GBM. Surgical intervention, PORT receipt and patient data for patients diagnosed with GBM were obtained from the years 2004 to 2008 from the NCI Surveillance, Epidemiology, and End Results database and combined with the health system data from the Area Resource File. Four logistic models were constructed to test the effect of health system characteristics on surgical treatment choice and PORT receipt among health service areas (HSAs). We found that younger, married patients in HSAs with higher median incomes were significantly more likely to receive both gross total resection (p < 0.001, p < 0.001, p = 0.002) and PORT (p < 0.001, p < 0.001, p = 0.008). The density of radiation oncology equipped hospitals was also a significant predictor of PORT receipt (p = 0.002). Our findings suggest regional variations in of neuro-oncology services and income may have impact on GBM management. Policies aimed at narrowing disparities in treatment may need to focus on addressing regional variations in oncology resources.

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Conflict of interest statement

Conflict of interest The authors have no conflicts of interest, financial or otherwise, to report.

Figures

Fig. 1
Fig. 1
Distribution of neurosurgeons and radiation oncologist across the United States. **Note figure depicts all HSAs, regression analysis only includes those in SEER registry
Fig. 2
Fig. 2
Distribution of General Oncology and Radiation Therapy Equipped Hospitals across the United States **Note figure depicts all HSAs, regression analysis only includes those in SEER registry
See this image and copyright information in PMC

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