Radiotherapy underutilisation and its impact on local control and survival in New South Wales, Australia

Merie, Roya; Gabriel, Gabriel; Shafiq, Jesmin; Vinod, Shalini; Bartoň, Michael; Delaney, Geoff P.

doi:10.1016/j.radonc.2019.09.012

Cited by 18 publications

(26 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The shortfall in overall RTU appears to occur in all major tumour sites, including lung, breast, rectal and prostate cancer. There is evidence that an inappropriate reduction in RTU (non-treatment where evidence suggests benefit) results in decreased local control and overall survival [8] , [9] , [10] , [11] . The factors contributing to the reduction in RTU in older cancer patients have not yet been examined.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia

Mackenzie

Vajdic

Delaney

et al. 2020

Technical Innovations & Patient Support in Radiation Oncolo

Self Cite

View full text Add to dashboard Cite

Background and Purpose: Large non-age-specific radiotherapy utilisation rate (RTU) studies have demonstrated that actual RTU is below the optimal recommended utilisation rate for both curative and palliative intent radiotherapy indications. The optimal utilisation rate for the geriatric oncology cohort of patients has not yet been determined. The purpose of this research was to examine the actual RTU for patients treated in New South Wales (NSW), Australia as a function of increasing age, and the relationship between RTU and tumour site, travelling distance and socioeconomic status. Materials & Methods: NSW Central Cancer Registry data (2009-2011) were linked to the NSW Radiotherapy Dataset (2009-2012). RTU was calculated for patients aged <80 years and 80 years. RTU was defined as the proportion of patients receiving at least a single course of radiotherapy within 12 months of a cancer diagnosis. Results: 110,645 patients were diagnosed with cancer, of whom 27,721 received at least one course of radiotherapy. The overall RTU was 25%. RTU for patients aged <80 years was 28% compared to 14% for patients aged 80+ years (p < 0.001). On both univariate and multivariate analysis, increasing age, residential address in disadvantaged socioeconomic areas and increasing distance to the nearest radiotherapy department were associated with a reduction in RTU. Conclusion: Geriatric oncology patients are less likely to receive radiotherapy than their younger counterparts. Some of the reduction in RTU may be justifiable on the basis of limited life expectancy and comorbidity. Further research is required to determine the co-morbidity adjusted optimal RTU in older patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia

Mackenzie

Vajdic

Delaney

et al. 2020

Technical Innovations & Patient Support in Radiation Oncolo

Self Cite

View full text Add to dashboard Cite

show abstract

“…Underutilisation of radiotherapy for breast cancer has detrimental impact on patient’s survival 17,41,44 . For patients who had breast‐conserving surgery and patients who had mastectomy and have node positive disease (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Underutilisation of radiotherapy for breast cancer has detrimental impact on patient's survival. 17,41,44 For patients who had breast-conserving surgery and patients who had mastectomy and have node positive disease (i.e. regional disease spread), radiotherapy is routinely indicated given the strong evidence of its benefit for these patients.…”

Section: Survival Ratesmentioning

confidence: 99%

Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction This study aims to report on the surgical and radiotherapy patterns of breast cancer care in New South Wales (NSW) and Australian Capital Territory (ACT) in Australia, to identify factors that impact on utilisation of evidence‐based treatment and to report on the overall survival (OS) rate and the influencing factors on OS. Methods Cancer registry data linked to hospital records for all patients with breast cancer diagnosis in NSW and ACT between 2009 and 2014 were used to calculate rates of breast conserving surgery (BCS), mastectomy, sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND) and radiotherapy. Multivariate analysis used to identify factors that led to variations in care. 5‐year OS was calculated and cox regression model assessed factors that influenced survival. Results Data for 30,337 patients were analysed. BCS and mastectomy rates were 64% and 36%, respectively. The SLNB, ALND and ALND after SLNB rates were 61.5%, 32.1% and 6.4%, respectively. Radiotherapy was utilised in 63%. Younger age, socio‐economic disadvantage, longer distance to a radiotherapy facility and overseas place of birth were factors that predicted for increased rates of mastectomy and ALND. Radiotherapy was more likely to be utilised in later years of diagnosis, patients between 40‐69 years old, and those who lived in major cities and closer to a radiotherapy facility. 5‐year OS was 80.5%. Older patients, the socioeconomically disadvantaged and those advanced tumours had worse survival. Conclusion Variations in breast cancer care continue to exist in certain patient groups that we identified. Targeted strategic planning and further research to identify other drivers of existing disparities remain a priority.

show abstract

“…There have been important developments in the management of bladder cancer where radiation is often under‐utilised and can be suboptimally delivered. It has been established that a deficit in radiation therapy use has a significant adverse impact on patient outcomes 27 …”

Section: Discussionmentioning

confidence: 99%

“…It has been established that a deficit in radiation therapy use has a significant adverse impact on patient outcomes. 27 Despite the evidence existing for BCT as an alternative treatment modality for patients with MIBC, a multidisciplinary approach to treatment decision-making is often overlooked. A population-based study from Canada showed that only 10%of patients treated with a RC had a pre-operative radiation oncology consultation 28 and this is similar to the low perceived rates of referral prior to a RC that our survey identified.…”

Section: Guideline 1: Multidisciplinary Managementmentioning

confidence: 99%

FROGG patterns of practice survey and consensus recommendations on radiation therapy for MIBC

et al. 2020

View full text Add to dashboard Cite

Radiotherapy underutilisation and its impact on local control and survival in New South Wales, Australia

Cited by 18 publications

References 41 publications

Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia

Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia

Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia

FROGG patterns of practice survey and consensus recommendations on radiation therapy for MIBC

Contact Info

Product

Resources

About