10127-COT-15 REGIONAL MEDICAL DISPARITIES AND RESPONSES TO THE INCREASING COMPLEXITY OF GLIOBLASTOMA TREATMENT

Abstract

Glioblastoma remains a poor prognosis, but with the approval of bevacizumab (BEV) and the alternating tumor treating fields therapy (TTF), combined treatment can now be expected to expand patients' ADL and extend prognosis. However, the shortening of the intervals between patient visits and the unipolarization of treatment are worryingly increasing the unevenness of treatment opportunities, depending on the social circumstances of the patients. In rural areas in particular, it is possible that the disparity in medical care by place of residence is becoming more serious, as transportation conditions make it more difficult for patients to receive regular medical examinations. In this study, we analyzed differences in treatment and prognosis by patient's area of residence, and examined the effects of unipolarization of multidisciplinary medical care in rural areas. Based on the results, we examined what measures should be taken to correct regional disparities. Method: Of 129 consecutive glioblastoma patients initially treated at the hospital between 2010 and 2021, 75 patients who continued treatment after recurrence were included in the study, and were divided into two groups according to their place of residence: a group in the neighborhood of the hospital (59 patients) and a remote group (16 patients). The relationship between overall survival, duration of maintenance therapy visits, and BEV use was also examined. Result: Although no significant differences were found, there was an increase of about 3 months in both median survival and duration of maintenance therapy visits in the neighboring areas. Conclusion: Compared to patients living in the proximity of our facility, patients living in remote areas tended to have shorter maintenance therapy visits and poorer survival. We must strive to be close to such patients and provide them with the best possible quality and appropriate medical care.