Variations in IMRT demand and delivery across England
Mee, Thomas Burnet, Neil G Gray, R. Shelton, J
Mee, Thomas
Burnet, Neil G
Gray, R.
Shelton, J
Citations
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Abstract
Purpose or Objective
Intensity Modulated Radiotherapy (IMRT) is a key
radiotherapy (RT) technique used for radical treatments.
A 2015 report1 from England suggested that 51.8% of
radical RT patients should be treated with IMRT. However,
there are variations in the profile of cancer throughout
England. This will result in variations in the demand for
IMRT and therefore 51.8% may not be applicable at local
level. Delivery of IMRT may also vary between RT centres.
The English Cancer registries record delivered RT data,
including which treatments were IMRT. Here, we compare
the recorded IMRT delivered data to a local-level IMRT
demand simulations.
Material and Methods
The future IMRT predictions from the 2015 report were
encoded into the Malthus Model2 for every IMRT relevant
cancer site. Malthus contains local-level population,
incidence and stage presentation data. Malthus simulated
the IMRT demand for every clinical commissioning group
(CCG) in England. The recorded IMRT delivered data is also
at CCG level and was sourced from Public Health England.
The recorded IMRT data was converted to a percentage of
the simulated demand. A heat map of the results was
created for England in Tableau software3. The postcode
location of every main RT centre in England was obtained
and plotted on the heat map, including information on the
number of linacs registered at the centre. Breast IMRT was
excluded from the analysis, as it could potentially distort
the data, due to current questions around inverse/forward
planned IMRT and service targets1.
Results
There is variation in simulated demand for IMRT across
England, ranging from 44.7% to 56.5% of radical RT
patients. There is also variation in recorded IMRT delivery,
ranging from 21% to 67%. When comparing a CCG’s
recorded IMRT to its simulated demand the results range
from 55% to 164%. Figure 1 shows the results of the
comparison for every CCG in England alongside RT centre
location and size information.
Conclusion
The combination of the future demand figures from the
2015 IMRT report and the Malthus model has produced the
regional variations in IMRT demand. The heat map of the
comparison of recorded IMRT delivery data to the locallevel
demand, highlights regions within England which may
be under providing, or over providing, IMRT. These areas
should be investigated in detail to identify the reasons for
these differences. There may be non-service factors
driving the differences, such as data and recording
inaccuracies, incidence fluctuations or
comorbidities. These are factors which are not currently
included in the Malthus model.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Mee T, Kirkby NF, Burnet NG, Mackay RI, Gray R, Shelton J, et al. PO-1274: Variations in IMRT demand and delivery across England. Radiotherapy and Oncology . 2020 Nov;152:S671–2.