Most older patients with indolent lymphoma were treated with long-course radiation therapy (LC-RT) rather than the short-course RT (SC-RT) recommended during the COVID-19 pandemic, according to the results of the phase 3 A-LONG trial published in JAMA Health Forum.
During the COVID-19 pandemic, emergency RT guidelines recommended the use of SC-RT to reduce the risk of exposure to SARS-CoV-2. The aim of this study was to evaluate the adoption of SC-RT among Medicare beneficiaries.
The single-center, cross-sectional study evaluated data from 10,447 radiation episodes conducted between 2015 and 2019. All patients were at least age 65 and had indolent lymphoma not treated with systemic therapy.
The majority of radiation episodes were with conventional RT at 78%. From 2015 to 2019, the use of IMRT increased from 17% to 25% (P <.001).
LC-RT was used more commonly than SC-RT, with SC-RT administered to 29% of patients. The use of SC-RT was significantly associated with age 85 or older (odds ratio [OR], 2.18; 95% CI, 1.94-2.45), hospital-affiliated rather than free-standing care (OR, 1.74; 95% CI, 1.57-1.93), and use of conventional RT rather than IMRT (OR, 5.18; 95% CI, 4.45-6.02).
The cost of SC-RT was lower at $4279 compared with $8484 for LC-RT. IMRT was associated with higher costs at $8048 compared with $4121 with conventional RT for SC-RT.
“Use of LC-RT has important financial implications given higher total spending,” the authors wrote in their report. “Wider adoption of SC-RT may help reduce systemwide costs and optimize personalized RT decision-making.”
Tringale KR, Hubbeling H, Chino F, et al. Trends in use of and Medicare spending on short-course radiotherapy for lymphomas from 2015 to 2019. JAMA Health Forum. 2022;3:e221815. doi: 10.1001/jamahealthforum.2022.1815
This article originally appeared on Hematology Advisor