Racial and social-economic inequalities in systemic chemotherapy use among adult glioblastoma patients following surgery and radiotherapy

• Published in: Scientific reports Vol. 14; no. 1; pp. 19079 - 9
• Main Authors: Xu, Fei, Hua, Xin, Wang, Mengdi, Cao, Weiguo, Wang, Shubei, Xu, Cheng, Chen, Jiayi, Gao, Yunsheng, Chen, Linlin, Ni, Weiqiong
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.08.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67/1922; 692/700/3934; Adjuvants; Adult; Age; Aged; Aged, 80 and over; Beam radiotherapy; Biopsy; Brain cancer; Brain Neoplasms - epidemiology; Brain Neoplasms - therapy; Brain research; Brain stem; Brain tumors; Cancer therapies; Cerebellum; Chemotherapy; Classification; Diagnosis; Epidemiology; Ethics; Family income; Female; GBM; Glioblastoma; Glioblastoma - surgery; Glioblastoma - therapy; Glioma; Global health; Healthcare Disparities; Households; Humanities and Social Sciences; Humans; Male; Medical prognosis; Middle Aged; multidisciplinary; Oncology; Patients; Post-surgery; Race; Radiation therapy; Regression analysis; Science; Science (multidisciplinary); SEER Program; Socioeconomic Factors; Software; Statistical analysis; Surgery; Surveillance; Systemic chemotherapy; Toxicity; Tumors; Global health; GBM; Post-surgery; Beam radiotherapy; Systemic chemotherapy
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-68962-y

Not all patients with glioblastoma multiforme (GBM) eligible for systemic chemotherapy after upfront surgery and radiotherapy finally receive it. The information on patients with GBM was retrieved from the surveillance, epidemiology, and end results database. Patients who underwent upfront surgery or biopsy and external beam radiotherapy between 2010 and 2019 were eligible for systemic chemotherapy. The available patient and tumor characteristics were assessed using multivariable logistic regression and chi-squared test. Out of the 16,682 patients eligible, 92.1% underwent systemic chemotherapy. The characteristics linked to the lowest systemic chemotherapy utilization included tumors of the brain stem/cerebellum ( P  = 0.01), former years of diagnosis ( P  = 0.001), ≥ 80 years of age ( P  < 0.001), Hispanic, Non-Hispanic Asian, Pacific Islander, or Black race ( P  < 0.001), non-partnered status ( P  < 0.001), and low median household income ( P  = 0.006). Primary tumor site, year of diagnosis, age, race, partnered status, and median household income correlated with the omission of systemic chemotherapy in GBM in adult patients.