Y Lievens1, H De Schutter2, K Stellamans3, M Rosskamp2, L Van Eycken2. 1. Radiation Oncology Department, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: yolande.lievens@uzgent.be. 2. Belgian Cancer Registry, Koningsstraat/Rue Royale 215 Box 7, 1210 Brussels, Belgium. 3. Radiation Oncology Department, AZ Groeninge, President Kennedylaan 4, 8500 Kortrijk, Belgium.
Abstract
INTRODUCTION: Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. MATERIALS AND METHODS: AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. RESULTS: The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. CONCLUSION: Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy.
INTRODUCTION: Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. MATERIALS AND METHODS: AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. RESULTS: The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. CONCLUSION: Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy.
Authors: Giorgio Calleris; Giancarlo Marra; Ettore Dalmasso; Marco Falcone; Robert Jeffrey Karnes; Alessandro Morlacco; Marco Oderda; Rafael Sanchez-Salas; Francesco Soria; Paolo Gontero Journal: World J Urol Date: 2019-04-06 Impact factor: 4.226
Authors: Wei Liu; Alissa Liu; Jessica Chan; R Gabriel Boldt; Pablo Munoz-Schuffenegger; Alexander V Louie Journal: Transl Lung Cancer Res Date: 2019-09
Authors: Wee Loon Ong; Norah Finn; Luc Te Marvelde; Colin Hornby; Roger L Milne; Gerard G Hanna; Graham Pitson; Hany Elsaleh; Jeremy L Millar; Farshad Foroudi Journal: J Med Imaging Radiat Oncol Date: 2022-03-31 Impact factor: 1.667
Authors: Francisco Carrasco-Peña; Eloisa Bayo-Lozano; Miguel Rodríguez-Barranco; Dafina Petrova; Rafael Marcos-Gragera; Maria Carmen Carmona-Garcia; Josep Maria Borras; Maria-José Sánchez Journal: Int J Environ Res Public Health Date: 2020-09-14 Impact factor: 3.390