A National Audit of Radiotherapy in Head and Neck Cancer

James, Nicholas D.; Robertson, Gerry; Squire, C.J.; Forbes, Helen; Jones, Kate; Cottier, B.

doi:10.1053/clon.2002.0198

Cited by 31 publications

(26 citation statements)

References 10 publications

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“…Similar time intervals have been reported from another region in Sweden [16] and also internationally [21]. The importance of immediate start of treatment has been identified [17,22] and in UK the NHS has stipulated that all cancer treatment programmes must start within 4 weeks after diagnosis before 2005 [23]. Upper limits for waiting periods have not yet been stipulated in standards or protocols in Sweden.…”

Section: Discussionmentioning

confidence: 55%

Quality assessment of a multidisciplinary tumour meeting for patients with head and neck cancer

Stalfors

Lundberg

Westin

2007

Acta Oto-Laryngologica

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Head and neck oncology MDT meetings are held in our region to establish a correct diagnosis and an appropriate treatment plan for each reviewed patient. The quality of these MDT meetings was assessed based on the following factors: How often can a diagnosis, a TNM-classification and a treatment plan be successfully established from the workup presented at the patient's first MDT meeting? And what are the reasons for failure? Further, how often are the TNM-classification altered at treatment start? All patients (n=329) presented at MDT meetings during one year were included prospectively and data were collected in a protocol. As telemedicine recently was introduced to reduce travel, any eventual impact on quality on decisions with regard to telemedicine were also studied. A diagnosis and a treatment plan could be established for 236 (73%) of 324 patients at the first MDT meeting. TNM classification was revised in four patients (1.4%) before treatment. In conclusion, the validity of decisions made at the MDT meeting is satisfactory, but improvements regarding the quality of workups are possible. The mode of presentation of patients at the MDT meeting was not decisive for the quality of decisions regarding diagnosis and treatment plans.

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Section: Discussionmentioning

confidence: 55%

Quality assessment of a multidisciplinary tumour meeting for patients with head and neck cancer

Stalfors

Lundberg

Westin

2007

Acta Oto-Laryngologica

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“…An audit by Royal College of Radiologists of radical radiotherapy for head and neck cancer showed 81% of treatment interruptions were due to machine breakdown or servicing. 20 Fraction size may influence local control rates. Many studies have demonstrated better local control rates if fraction size is > 2 Gy.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated Radiotherapy in the Treatment of Early Glottic Carcinoma

Hussain¹,

Jamshed²,

Majeed³

et al. 2011

International Journal of Head and Neck Surgery

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Introduction: Given the high probability of cure, the aims of treatment are cure, laryngeal preservation and good voice quality while making effective use of available resources. In this study we analyze locoregional control (LRC) and survival following hypofractionated radiotherapy in early stage glottic squamous cell carcinoma treated at patients with early glottic squamous cell carcinoma were treated with hypofractionated radiotherapy. All patients were included in the study (M: 94%; F:6%). Median age was 60 years (range: 21-81 years). Sixty-six percent of patients were smokers. AJCC stage was T1 in 95% and T2 in 5% of the patients. Radiotherapy dose was 55 Gy in 20 fractions over 4 weeks. All patients were treated on cobalt-60. Median radiotherapy treatment time was 28 days (range: 23-35 days). Results:The LRC rate after primary radiotherapy at 5 years was 91% (95% CI: 88-94%). The 5 years overall and disease-specific survival was 86% (95% CI: 81 and 91%) and 97% (CI 95%: 95 and 99%) respectively. Patients with T1a and T1b disease had LRC rates of 95 and 88% (p = 0.32). The LRC rates for patients with and without anterior commissure involvement at 5 years were 80 and 96% (p = 0.02) respectively.Conclusion: Hypofractionated radiotherapy 55 Gy in 20 fractions is comparable to conventional fractionation schedules in terms of locoregional control and survival while offering potential for optimizing resources usage.

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“…49,50 Both these studies cite similar reasons to those given by Ash 47 for these delays and demonstrate that such delays have an adverse impact on tumour control and treatment outcomes. 54 More recently, Dodwell and Crellin have argued that, despite investments, staff shortages mean many radiotherapy centres are unable to cope with increasing workloads. 51 In response to calls for a UK hadron facility, 26 Dodwell and Crellin caution that such investment will merely divert scarce resources from tackling this larger problem of increased waiting times, thereby further adversely affecting outcomes.…”

Section: Are We Being Seduced By the Research? Back To Realitymentioning

confidence: 99%

Research or reality: Within the context of UK radiotherapy and cancer services, where should research and investment be focused to best improve UK treatment outcomes?

O'Connell¹

2007

J Radiother Pract

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Purpose: It is now six years since the publication of the NHS Cancer Plan. During this time, there has been considerable investment and research within UK cancer services. Some progress has been made towards improving treatment outcomes, but obstacles persist. This article explores some recent advances in cancer treatment and considers whether UK cancer treatment outcomes will best improve through the clinical advances being made in cancer research or whether improvement now needs to be more explicitly driven via a strategic approach. Methodology: The article explores this question from two differing perspectives. First, from a research perspective, it reviews briefly the evidence for a selection of clinical advancements in cancer therapy that have all been cited as providing breakthroughs in treatment outcomes. Second, it considers the investment in cancer research within a more strategic context, focusing on the reality of managing an improvement programme in UK cancer services. Here, some of the practical obstacles to improving treatment outcomes are highlighted. Findings: Significant progress has been made over the past six years towards improving UK treatment outcomes. Much of this is a direct result of international advances in clinical research. Further progress, however, is required. This article argues that progress will best be achieved by focusing resources and research investment on tackling some of the endemic strategic obstacles, highlighted in this article, that are the present reality within UK cancer services.

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A National Audit of Radiotherapy in Head and Neck Cancer

Cited by 31 publications

References 10 publications

Quality assessment of a multidisciplinary tumour meeting for patients with head and neck cancer

Quality assessment of a multidisciplinary tumour meeting for patients with head and neck cancer

Hypofractionated Radiotherapy in the Treatment of Early Glottic Carcinoma

Research or reality: Within the context of UK radiotherapy and cancer services, where should research and investment be focused to best improve UK treatment outcomes?

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