Infrastructure of radiotherapy in Spain: A minimal standard of radiotherapy resources

Escó, R.; Palacios, Amalia; Pardo, J.; Biete, A.; Carceller, J.A.; Veiras, C.; Vázquez, Gumersindo Fernández

doi:10.1016/s0360-3016(02)04580-7

Cited by 48 publications

(35 citation statements)

References 7 publications

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“…The results from the Dutch survey were consistent with the assessment made by the Swedish Council on Technology Assessment in Health Care (SBU) which in 2001 established a radiotherapy utilization rate of 47% in Sweden, 15% higher than in 1992 [11] [15]. Identical approaches with somewhat similar results on radiotherapy utilization rate have been followed in Austria (42%) [16], Italy (41%) [17], and Spain (38%) [13]. External beam radiation sessions; α: Prospective survey in radiotherapy departments; β: Retrospective survey in radiotherapy departments; δ: Governmental report on the use of special medical techniques, including radiotherapy; φ: Decision trees based on evidence-based guidelines and population-based data; γ: Decision trees based on evidence-based guidelines (CCORE model) and estimated population-based data (Globocan 2002); σ: Expert's opinion.…”

Section: Discussionsupporting

confidence: 80%

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Camacho¹,

Neves²,

Piñeros³

et al. 2014

JCT

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Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer specific treatment planned and written in the patients' medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer * Affiliations are as of 1 March 2014. # Corresponding author. R. Camacho et al.990 treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.

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Section: Discussionsupporting

confidence: 80%

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Camacho¹,

Neves²,

Piñeros³

et al. 2014

JCT

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“…Many authors argue that the inevitable reason for increasing WTs is the failure to reconcile RT to its demand, creating a continuous imbalance 1,2,3 . Even developed countries face this problem 25,26,27,28,29 , which may be even more profound in primarily government funded health care systems. In Brazil, despite recent government efforts 19 , the scenario is still worrisome and the growing demand for RT has created an inefficient system where only 65.9% of the demand is met and long WTs are commonplace with a median WT to RT of 113.4 days (almost 4 months) 19,20 , regardless of tumor type.…”

Section: Discussionmentioning

confidence: 99%

Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

Loureiro

Pontes

Callegaro-Filho

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method: Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results: Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT # 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT . 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p , 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion: No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.Keywords: glioblastoma, radiotherapy, waiting time, delay, prognosis, survival. RESUMOObjetivo: Avaliar o efeito do tempo de espera (TE) até radioterapia na sobrevida global de pacientes com glioblastoma como um fator prognóstico confiável. Método: Estudo retrospectivo de 115 pacientes com glioblastoma, que foram submetidos à radioterapia pós-operatória, em dois serviços diferentes no Brasil (um público e outro privado). Resultados: Mediana de TE para radioterapia foi de 6 semanas (variação, 1,3-17,6). A mediana de sobrevida para TE # 6 semanas foi de 13,5 meses (IC95%, 9,1-17,9) e para TE . 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,762; p = 0,470). Na análise multivariada, as variáveis associadas à sobrevida foram perfomance status (p , 0,001), extensão da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). Conclusão: Não se observou impacto prognóstico para TE até a radioterapia na sobrevida. Diante de outros fatores prognósticos, é possível assegurar de que o espaço de tempo até a radioterapia não parece influenciar o controle da doença.Palavras-chave: glioblastoma, radioterapia, tempo de espera, atraso, prognóstico, sobrevida.

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“…The semi-structured interviews with internal leaders and external experts allowed us to synthesize several overarching themes thought to be critical for successful implementation of a distributed model [11][12][13][14] :…”

Section: Themes Identified As Important For Developing a Devolved Radmentioning

confidence: 99%

“…With that backdrop, we focused on determining whether support existed for a smu approach to service delivery in Alberta 14,18 . Most internal respondents felt that having more than 1 unit is always optimal because of greater cost effectiveness, benefits to retention of staff, and mitigation of treatment delays when a single unit has to be taken down for service or repairs.…”

Section: Driver 2: Factors Determining the Size And Location Of Deparmentioning

confidence: 99%

Defining the Elements for Successful Implementation of a Small-City Radiotherapy Department

Craighead

Dunscombe

2011

Current Oncology

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Infrastructure of radiotherapy in Spain: A minimal standard of radiotherapy resources

Cited by 48 publications

References 7 publications

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

Defining the Elements for Successful Implementation of a Small-City Radiotherapy Department

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