Does travel time for SABR treatment, impact upon the management of early-stage inoperable NSCLC?
Brown, S. Mee, Thomas Kirkby, Norman Faivre-Finn, Corinne Kirkby, Karen J
Brown, S.
Mee, Thomas
Kirkby, Norman
Faivre-Finn, Corinne
Kirkby, Karen J
Citations
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Abstract
Introduction: SABR for early lung cancer is the standard of care for
patients unsuitable for surgery. SABR is not commissioned in 30%
of English radiotherapy centres [1]. Compared to the Netherlands,
numbers of patients who receive suboptimal conventional
radiotherapy or no treatment (26% vs 9%) are unacceptably high [2].
This could be related to excess patient travel-time to a SABR centre
[3]. The aim of this study is to simulate demand for lung SABR in
England, based on aspirational Dutch treatment rates, and compare
this to the provision of SABR and the relationship to patient traveltime.
Methods: The Malthus model (a local-level radiotherapy demand
prediction tool) [4] was used to simulate current SABR treatment
at a local-level using 2015–2016 English SABR treatment rates (12%)
[2].This was then repeated based on Dutch treatment rates (41%)
and mapped against English radiotherapy centres identified as SABR
or non-SABR centres. 45min travel-time isochrones based on SABR
centre postcodes were then generated.
Results: There is an imbalance of lung SABR provision. For large
parts of England (e.g. the South West and North West) patients
are located over 45 minutes from a SABR centre (Fig. 1). If England
matched Dutch treatment rates, patient numbers with a travel-time
over 45 minutes would greatly increase. Overall, patient numbers
could increase from ~725 to ~2500 patients/year.
Conclusion: Geographical disparity of lung SABR services exists
in England. This will subject some patients, who are typically
elderly with multiple co-morbidities, to long travel-times. This may
contribute to high rates of suboptimal radiotherapy or no treatment
in England. Improvements in SABR provision and commissioning are
urgently needed to address this.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Brown S, Mee T, Kirkby N, Faivre-Finn C, Kirkby KJ. Does travel time for SABR treatment, impact upon the management of early-stage inoperable NSCLC? Lung Cancer. 2020;139:S33-S4