Mauro F Palazzi1, Carlo Soatti2, Barbara A Jereczek-Fossa3, Luigi F Cazzaniga4, Paolo Antognoni5, Gianstefano Gardani6, Marcello Amadori7, Ambrogia Baio8, Giancarlo Beltramo9, Mario Bignardi10, Stefano Bracelli11, Alberto Buffoli12, Simona Castiglioni13, Gianpiero Catalano14, Nadia Di Muzio15, Carlo Fallai16, Laura Fariselli17, Paolo Frata18, Alberto Gramaglia19, Corrado Italia20, Giovanni Ivaldi21, Fabrizio Lombardi22, Stefano M Magrini23, Simonetta Nava24, Enrico Sarti25, Luciano Scandolaro26, Marta Scorsetti27, Francesco Stiglich28, Roberto Tortini29, Riccardo Valdagni30, Francesca Valvo31, Vittorio Vavassori32, Elena L Sbicego33, Sandro Tonoli34, Roberto Orecchia35. 1. 1 Radiation Oncology Center, Grande Ospedale Metropolitano Niguarda Milan, Italy. 2. 2 Radiation Oncology Center, Ospedale Manzoni, Lecco, Italy. 3. 3 Department of Oncology and Hemato‑oncology, University of Milan, and Division of Radiotherapy, European Institute of Oncology, Milan, Italy. 4. 4 Radiation Oncology Center, Ospedale Papa Giovanni XXIII, Bergamo, Italy. 5. 5 Radiation Oncology Center, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy. 6. 6 Radiation Oncology Center, Ospedale San Gerardo, Monza, Italy. 7. 7 Radiation Oncology Center, Ospedale C. Poma, Mantova, Italy. 8. 8 Radiation Oncology Center, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. 9. 9 Radiation Oncology Center, Centro Diagnostico Italiano (CDI), Milan, Italy. 10. 10 Radiation Oncology Center, Fondazione Poliambulanza, Brescia, Italy. 11. 11 Radiation Oncology Center, Ospedale, Busto Arsizio, Italy. 12. 12 Radiation Oncology Center, Istituto Clinico S. Anna, Brescia, Italy. 13. 13 Radiation Oncology Center, S. Pio X-Humanitas, Milano, Italy. 14. 14 Radiation Oncology Center, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy. 15. 15 Radiation Oncology Center, IRCCS Ospedale S. Raffaele, Milano, Italy. 16. 16 Radiation Oncology Center, Istituto Nazionale Tumori, Milan, Italy. 17. 17 Radiation Oncology Center, Fondazione Istituto Neurologico Besta, Milan, Italy. 18. 18 Radiation Oncology Center, Ospedale di Esine, ASST di Valcamonica, Esine, Italy. 19. 19 Radiation Oncology Center, Policlinico, Monza, Italy. 20. 20 Radiation Oncology Center, Istituti Ospedalieri Bergamaschi, Ponte S. Pietro, Zingonia (BG), Italy. 21. 21 Radiation Oncology Center, Istituti Clinici Scientifici Maugeri, Pavia, Italy. 22. 22 Radiation Oncology Center, Ospedale San Donato, San Donato Milanese, Italy. 23. 23 Radiation Oncology Center, Brescia University Radiation Oncology Department, O. Alberti Radium Institute, Spedali Civili Hospital, Brescia, Italy. 24. 24 Radiation Oncology Center, Istituti Clinici di Pavia e Vigevano, Vigevano, Italy. 25. 25 Radiation Oncology Center, Ospedale, Treviglio, Italy. 26. 26 Radiation Oncology Center, Ospedale Sant'Anna, ASST Lariana, Como, Italy. 27. 27 Radiation Oncology Center, Humanitas Clinical and Research Center and Humanitas University, Milano-Rozzano, Italy. 28. 28 Radiation Oncology Center, Ospedale, Sondrio, Italy. 29. 29 Radiation Oncology Center, Presidio di Casalpusterlengo, ASST Lodi, Italy. 30. 30 Radiation Oncology Center, Istituto Nazionale Tumori and Università degli Studi di Milano, Milan, Italy. 31. 31 Radiation Oncology Center, CNAO, Pavia, Italy. 32. 32 Radiation Oncology Center, Cliniche Humanitas Gavazzeni, Bergamo, Italy. 33. 33 Radiation Oncology Center, Istituto Clinico S. Ambrogio, Milan, Italy. 34. 34 Radiation Oncology Center, Ospedale, Cremona, Italy. 35. 35 Radiation Oncology Center, IEO Scientific Direction, Milan, Italy.
Abstract
INTRODUCTION: : Several efforts are being implemented at the European level to measure provision of up-to-date radiation treatments across the continent. METHODS: : A snapshot survey involving all radiation oncology centers within Lombardy, Italy, was performed in 2012 and repeated in 2014 and 2016, in cooperation with regional governmental officers. Centers were asked to provide detailed information concerning all individual patients being treated on the index day, and to report data on available local resources. RESULTS: : We observed an increase in the number of centers and of megavoltage units (MVU) (from 76 to 87, i.e., 8.7 MVU per million inhabitants in 2016). Mean number of MVU per center was 2.5. Average age of MVU increased from 5.3 to 7.5 years and patients on the waiting list also increased. Conformal 3D radiotherapy (RT) treatments decreased from 56% to 42% and were progressively replaced by intensity-modulated RT treatments (from 39% to 49%). Waiting times were overall satisfactory. Radiation oncologists treated on average 152 and radiation therapists 100 RT courses per year. Average reimbursement per course was €4,879 (range €2,476-€8,014). CONCLUSIONS: : The methodology of snapshot survey proved feasible and provided valuable information about radiation oncology provision and accessibility in Lombardy.
INTRODUCTION: : Several efforts are being implemented at the European level to measure provision of up-to-date radiation treatments across the continent. METHODS: : A snapshot survey involving all radiation oncology centers within Lombardy, Italy, was performed in 2012 and repeated in 2014 and 2016, in cooperation with regional governmental officers. Centers were asked to provide detailed information concerning all individual patients being treated on the index day, and to report data on available local resources. RESULTS: : We observed an increase in the number of centers and of megavoltage units (MVU) (from 76 to 87, i.e., 8.7 MVU per million inhabitants in 2016). Mean number of MVU per center was 2.5. Average age of MVU increased from 5.3 to 7.5 years and patients on the waiting list also increased. Conformal 3D radiotherapy (RT) treatments decreased from 56% to 42% and were progressively replaced by intensity-modulated RT treatments (from 39% to 49%). Waiting times were overall satisfactory. Radiation oncologists treated on average 152 and radiation therapists 100 RT courses per year. Average reimbursement per course was €4,879 (range €2,476-€8,014). CONCLUSIONS: : The methodology of snapshot survey proved feasible and provided valuable information about radiation oncology provision and accessibility in Lombardy.
Authors: Barbara Alicja Jereczek-Fossa; Barbara Bortolato; Marianna Alessandra Gerardi; Samantha Dicuonzo; Virginia Maria Arienti; Stefania Berlinghieri; Stefano Bracelli; Michela Buglione; Mariangela Caputo; Gianpiero Catalano; Luigi Franco Cazzaniga; Luigi De Cicco; Nadia Di Muzio; Francesco Romeo Filippone; Andrei Fodor; Davide Franceschini; Paolo Frata; Stefania Gottardo; Giovanni Battista Ivaldi; Antonio Laudati; Stefano Maria Magrini; Elisa Mantero; Ilaria Meaglia; Sara Morlino; Mauro Palazzi; Fabio Piccoli; Paola Romanelli; Marta Scorsetti; Flavia Serafini; Luciano Scandolaro; Riccardo Valdagni; Roberto Orecchia; Paolo Antognoni Journal: Radiol Med Date: 2018-12-15 Impact factor: 3.469