Making the Most of a Crisis: A Proposal for Network-Based Palliative Radiation Therapy to Reduce Travel Toxicity

Abstract

A multipronged model is proposed to improve the delivery of palliative radiotherapy by increasing access to care and reducing travel burden for patients.

A pilot study of same-day MRI-only simulation and treatment with MR-guided adaptive palliative radiotherapy (MAP-RT)

“…This was performed with tolerable toxicity comparable to prior studies [19] , [20] , [21] , as there were only seven events of grades 1–2 toxicity, and no grades 3–5 toxicity. This low toxicity was maintained while providing rapid same day simulation and treatment, which suggests that this paradigm can improve treatment efficiency in a vulnerable patient population in which reducing patient travel time and time in department is critical for patient convenience and quality of life [22] , [23] , [24] .…”

Impact of outpatient radiotherapy on direct non-medical cost in patients in the Central Macro Region of Peru 2021

“…This is reflected in the results where there is a correlation between distance, with weekly expenditure and the start time for SIS patients, who represent the population with lower financial income, and it also shows consequent poor treatment outcomes with greater distance ( Table 2 ). Given that travel distance is a known barrier to radiotherapy [ 15 ], the COVID pandemic provided an additional impetus in developed countries to improve patient-centred care by co-ordinating access to radiotherapy closer to home or in less endemic regions, since delays in care can lead to worse outcomes [ 16 ] and could be mitigated through the establishment of an accredited referral network of community practice physicians who offer high-quality radiotherapy [ 17 ]. Likewise, Cosway et al [ 18 ] in a sample in the United Kingdom, where patients had to travel 78.8 miles in order to receive intensity-modulated radiation therapy, considered the travel distance as the main reason for not travelling to receive treatment via that modality, and limiting themselves to only 22.7 miles in order to receive it via the conformal technique.…”

Evaluation of results and costs of high precision radiotherapy (VMAT) compared with conventional radiotherapy (3D) in the treatment of cancer patients with spinal cord compression of metastatic origin

“…Moreover, 5 x 4 Gy sessions administered with a conventional 3D technique are equivalent to a 23.3Gy dose (EQD2) for an alpha/beta of 10. Furthermore, we must consider that the dose that can be administered with VMAT using the "5 x 5 Gy" scheme is similar to a classic 30 Gy scheme in 2 weeks, but administered in half the time (one week instead of two), with the consequent benefit for patients [10] and a shorter hospital stay (in the case of patients who require it because of motor deficit).…”