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

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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

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

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Authors and Affiliations

  1. Yale School of Medicine, New Haven, CT, USA

    Sanjay Aneja & Dhruv Khullar

  2. Department of Therapeutic Radiology, Yale School of Medicine, HRT 138, 333 Cedar Street, New Haven, CT, 06520, USA

    James B. Yu

  3. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale, New Haven, CT, USA

    James B. Yu

Authors
  1. Sanjay Aneja
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  2. Dhruv Khullar
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  3. James B. Yu
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Correspondence to James B. Yu.

Additional information

Sanjay Aneja and Dhruv Khullar contributed equally to this work.

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Aneja, S., Khullar, D. & Yu, J.B. The influence of regional health system characteristics on the surgical management and receipt of post operative radiation therapy for glioblastoma multiforme. J Neurooncol 112, 393–401 (2013). https://doi.org/10.1007/s11060-013-1068-8

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