• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjects

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    An update to the Malthus model for radiotherapy utilisation in England

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    35835634.pdf
    Size:
    287.0Kb
    Format:
    PDF
    Description:
    Identified with Open Access button
    Download
    Authors
    Heritage, S.
    Sundaram, S.
    Kirkby, Norman
    Kirkby, Karen J|Mee, Thomas
    Jena, R.
    Affiliation
    School of Clinical Medicine, University of Cambridge, Cambridge, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Aims: The Malthus Programme predicts national and local radiotherapy demand by combining cancer incidence data with decision trees detailing the indications, and appropriate dose fractionation, for radiotherapy. Since the last model update in 2017, technological advancements and the COVID-19 pandemic have led to increasing hypofractionation of radiotherapy schedules. Indications for radiotherapy have also evolved, particularly in the context of oligometastatic disease. Here we present a brief update on the model for 2021. We have updated the decision trees for breast, prostate, lung and head and neck cancers, and incorporated recent cancer incidence data into our model, generating a current estimate of fraction demand for these four cancer sites across England. Materials and methods: The decision tree update was based on evidence from practice-changing randomised controlled trials, published guidelines, audit data and expert opinion. Site- and stage-specific incidence data were taken from the National Disease Registration Service. We used the updated model to estimate the proportion of patients who would receive radiotherapy (appropriate rate of radiotherapy) and the fraction demand per million population at a national and Clinical Commissioning Group level in 2021. Results: The total predicted fraction demand has decreased by 11.4% across all four cancer sites in our new model, compared with the 2017 version. This reduction can be explained primarily by greater use of hypofractionated treatments (including stereotactic ablative radiotherapy) and a shift towards earlier stage presentation. The only large change in appropriate rate of radiotherapy was an absolute decrease of 3% for lung cancer. Conclusions: Compared with our previous model, the current version predicts a reduction in fraction demand across England. This is driven principally by hypofractionation of radiotherapy regimens, using technology that requires increasingly complex planning. Treatment complexity and local service factors need to be taken into account when translating fraction burden into linear accelerator demand or throughput.
    Citation
    Heritage S, Sundaram S, Kirkby NF, Kirkby KJ, Mee T, Jena R. An Update to the Malthus Model for Radiotherapy Utilisation in England. Clinical oncology (Royal College of Radiologists (Great Britain)). 2022 Jul 11. PubMed PMID: 35835634. Epub 2022/07/15. eng.
    Journal
    Clinical Oncology
    URI
    http://hdl.handle.net/10541/625428
    DOI
    10.1016/j.clon.2022.06.006
    PubMed ID
    35835634
    Additional Links
    https://dx.doi.org/10.1016/j.clon.2022.06.006
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clon.2022.06.006
    Scopus Count
    Collections
    All Christie Publications

    entitlement

    Related articles

    • Variations in Demand across England for the Magnetic Resonance-Linac Technology, Simulated Utilising Local-level Demographic and Cancer Data in the Malthus Project.
    • Authors: Mee T, Vickers AJ, Jena R, Kirkby KJ, Choudhury A, Kirkby NF
    • Issue date: 2021 Jul
    • Radiotherapy demand and activity in England 2006-2020.
    • Authors: Round CE, Williams MV, Mee T, Kirkby NF, Cooper T, Hoskin P, Jena R
    • Issue date: 2013 Sep
    • Quantifying uncertainty in radiotherapy demand at the local and national level using the Malthus model.
    • Authors: Jena R, Mee T, Kirkby NF, Williams MV
    • Issue date: 2015 Feb
    • Radiotherapy in England in 2007: modelled demand and audited activity.
    • Authors: Williams MV, Drinkwater KJ
    • Issue date: 2009 Oct
    • The Malthus Programme: developing radiotherapy demand models for breast and prostate cancer at the local, regional and national level.
    • Authors: Round C, Mee T, Kirkby NF, Cooper T, Williams MV, Jena R
    • Issue date: 2013 Sep
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.