National practice patterns of proton versus photon therapy in the treatment of adult patients with primary brain tumors in the United States

Abstract

Objectives: To examine patterns of care associated with the administration of proton versus photon therapy for adult patients with primary brain tumors in a large national cohort from the United States. Methods: The National Cancer Database (NCDB) was queried for newly diagnosed primary brain tumors (2004–2014) in adult patients aged 18 and older receiving proton or photon radiotherapy. Clinical features, patient demographics and treatment parameters were extracted. Differences between groups were assessed using multivariable logistic regression analysis. Results: In total, 73,073 patients were analyzed (n = 72,635 [99.4%] photon therapy, n = 438 [0.6%] proton therapy). On multivariable analysis of photon versus proton therapy, several factors predicted for receipt of proton therapy, including younger age (p =.041), highest income quartile (p =.007), treatment at academic institutions (p