“…This is consistent with a previous Surveillance, Epidemiology, and End Results–based study which found this rate to be 39.9%. 27 The practice patterns were variable, with differences noted across different sociodemographic cohorts and different types of hospitals and regions of the country. It is possible that academic institutions have greater access to advanced endoscopic procedures 28 to palliate symptoms and therefore use radiation less often, although the regional differences could represent different levels of clinician and patient enthusiasm for radiation as a palliative approach in different parts of the country.…”