Disparities in Consent to Adjuvant Radiotherapy in Primary Glioblastoma: a population-based study

Despite adjuvant external beam radiation therapy (EBRT) has long been the standard treatment for glioblastoma (GBM), a significant subset of patients chooses to refuse it. We aimed to investigate the factors influencing EBRT refusal in GBM. Patients with GBM were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Both univariable and multivariable logistic regression analyses were employed to evaluate the adjusted odds ratios (aOR) for the refusal of EBRT in relation to various clinical and demographic characteristics. Among the 29,994 patients analyzed, 675 (2.3%) opted to refuse adjuvant EBRT. Patients aged ≥55 years (55-64: aOR 1.63, 95% CI 1.04-2.61, <i>p</i> = 0.03; 65-74: aOR 1.80, 95% CI 1.17-2.87, <i>p</i> = 0.009; 75+: aOR 2.01, 95% CI 1.28-3.24, <i>p</i> = 0.002), being single (aOR 1.68, 95% CI 1.19-2.35, <i>p</i> = 0.002), with a household income of $55,000 to $64,999 (aOR 1.94, 95% CI 1.24-3.07, <i>p</i> = 0.004), and not undergoing chemotherapy (aOR 114, 95% CI 80.2-170.2, <i>p</i> &lt; 0.001) had significantly higher odds of refusing adjuvant EBRT. This study underscores the necessity for targeted communication strategies by physicians regarding the benefits of adjuvant EBRT.