Men with aggressive prostate cancer undergoing radiation therapy have better overall survival rates when the therapy is given at a facility that frequently performs it, researchers at Brigham and Women’s Hospital reported.
The study, “Association Between Treatment at a High-Volume Facility and Improved Survival for Radiation-Treated Men With High-Risk Prostate Cancer,” was published in the International Journal of Radiation Oncology, Biology, and Physics.
“Our paper shows that experience counts,” said Paul Nguyen, MD, a physician researcher in the department of Radiation Oncology at Brigham and the study’s corresponding author, in a press release. “For men with aggressive prostate cancer, survival is improved if they receive their radiation treatments at a high volume facility as opposed to a lower volume facility.”
Using the National Cancer Database (NCDB), researchers explored data from 19,565 patients diagnosed with high-risk prostate cancer from 2004 to 2006, and treated with radiation at 1,099 facilities. The radiation case volume (RCV) of each hospital was based on its number of radiation-treated prostate cancer patients, and a propensity score-based analysis was used to compare the overall survival in high- versus low-RCV hospitals.
After adjusting for tumor characteristics, sociodemographic factors, radiation type, and use of androgen deprivation therapy (ADT), results showed that patients who were treated with radiation at higher-volume facilities consistently had better survival rates compared to those treated at lower-volume facilities. High-volume hospitals were defined as treating more than 43 at-risk prostate cancer patients each year.
“We know that a surgeon who does a high volume of a specific procedure has better outcomes, and now we see that same trend when it comes to radiation therapy,” Dr. Nguyen said. “At a higher volume facility, not only will the radiation oncologist will have more experience at designing and delivering the appropriate treatment fields, but the multidisciplinary team of pathologists, radiologists, urologists, and medical oncologists will have greater expertise in making accurate diagnoses and tailoring the systemic therapy regimen to ensure the best-possible outcome for the patient.”
Further studies using other datasets are being planned to confirm the outcomes seen in this observational study.
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