Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Grau, Cai; Defourny, Noémie; Malicki, Julian; Dunscombe, Peter; Borràs, Josep M.; Coffey, Mary; Slotman, Ben J.; Bogusz, Marta; Gasparotto, Chiara; Lievens, Yolande

doi:10.1016/j.radonc.2014.08.029

Cited by 158 publications

(142 citation statements)

References 24 publications

Supporting

Mentioning

135

Contrasting

Unclassified

Order By: Relevance

“…For instance, and using Belgium as an example, the OUP is 53.3%; using its own stage data [3]; a difference of 5.0% from the Australian estimate of 48.3% [2]. This difference represents 3267 additional patients with an indication for radiotherapy (excluding retreatments), implying the need for 7.8 linear accelerators, based on the average throughput of 420 courses of radiotherapy per MV unit in the European countries or 8.5 based on the Belgian average number of patients treated on a linear accelerator [5]. This illustrates how the differences calculated, even if they may seem small, could have a substantial impact on the calculation of the resources needed.…”

Section: Discussionmentioning

confidence: 98%

“…The possible limitation of the OUP having been estimated with stage distributions from only five population based cancer registry data has been discussed above. Analyses, such as the one presented, are inherently limited by the timely and complete collection of data: for the estimates of the gap between actual and optimal utilization, the latter refers to the year 2012 while the data on actual utilization are not [5,6]. Variations in radiotherapy activity are, however, extremely dependent on facilities being opened or renovated and additional personnel being trained, both typically spreading over long time periods.…”

Section: Discussionmentioning

confidence: 99%

“…This number has been compared to the annual courses of radiotherapy delivered from the HERO database (provided by the National Societies, available years ranging from 2009 to 2011; with the corrections of the data included) [5] in order to assess the gap between optimal and actual delivered treatment courses.…”

Section: Methodsmentioning

confidence: 99%

“…To allow comparison between optimal and actual courses, retreatments should be excluded. Therefore, in the countries where retreatments were included, the courses were adjusted by a factor of 0.80 in order to compensate for the increment of 25% typically applied for retreatments [5]. This approach has been taken due to the lack of consistent data across European countries on the retreatments carried out; until now only local analyses have been published [10][11][12], mostly from outside Europe.…”

Section: Methodsmentioning

confidence: 99%

“…Analyses of the resources available in the European countries were recently published [5][6][7]. This paper evaluates the evidence-based country-specific demand for radiotherapy across Europe in order to allow all stakeholders to be able to estimate the capital and human resources required to deliver an appropriate radiotherapy service.…”

mentioning

confidence: 99%

See 4 more Smart Citations

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

Borràs

Lievens

Dunscombe

et al. 2015

Radiotherapy and Oncology

Self Cite

144

View full text Add to dashboard Cite

a b s t r a c tBackground and purpose: The absolute number of new cancer patients that will require at least one course of radiotherapy in each country of Europe was estimated. Material and methods: The incidence and relative frequency of cancer types from the year 2012 European Cancer Observatory estimates were used in combination with the population-based stage at diagnosis from five cancer registries. These data were applied to the decision trees of the evidence-based indications to calculate the Optimal Utilization Proportion (OUP) by tumour site. Results: In the minimum scenario, the OUP ranged from 47.0% in the Russian Federation to 53.2% in Belgium with no clear geographical pattern of the variability among countries. The impact of stage at diagnosis on the OUP by country was rather limited. Within the 24 countries where data on actual use of radiotherapy were available, a gap between optimal and actual use has been observed in most of the countries. Conclusions: The actual utilization of radiotherapy is significantly lower than the optimal use predicted from the evidence based estimates in the literature. This discrepancy poses a major challenge for policy makers when planning the resources at the national level to improve the provision in European countries.Ó 2015 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology xxx (2015) xxx-xxxThe estimated number of new cancer patients that require radiotherapy is a key parameter for planning the resources needed in a specific country in the framework of a cancer control programme. Most commonly, this calculation has been carried out using a specific proportion, typically the 'gold standard' of 50%, of the incident cases that would require radiotherapy at least http://dx

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

Borràs

Lievens

Dunscombe

et al. 2015

Radiotherapy and Oncology

Self Cite

144

View full text Add to dashboard Cite

show abstract

Provision and use of radiotherapy in Europe

2020

Self Cite

View full text Add to dashboard Cite

Radiation therapy is one of the core components of multidisciplinary cancer care. Although~50% of all European cancer patients have an indication for radiotherapy at least once in the course of their disease, more than one out of four cancer patients in Europe do not receive the radiotherapy they need. There are multiple reasons for this underutilisation, with limited availability of the necessary resourcesin terms of both trained personnel and equipmentbeing a major underlying cause of suboptimal access to radiotherapy. Moreover, large variations across European countries are observed, not only in available radiotherapy equipment and personnel per inhabitant or per cancer patient requiring radiotherapy, but also in workload. This variation is in part determined by the country's gross national income. Radiation therapy and technology are advancing quickly; hence, recommendations supporting resource planning and investment should reflect this dynamic environment and account for evolving treatment complexity and fractionation schedules. The forecasted increase in cancer incidence, the rapid introduction of innovative cancer treatments and the more active involvement of patients in the healthcare discussion are all factors that should be taken under consideration. In this continuously changing oncology landscape, reliable data on the actual provision and use of radiotherapy, the optimal evidence-based demand and the future needs are crucial to inform cancer care planning and address and overcome the current inequalities in access to radiotherapy in Europe.

show abstract

Comorbidities, age and period of diagnosis influence treatment and outcomes in early breast cancer

Minicozzi

Eycken²,

Molinié

et al. 2018

Intl Journal of Cancer

View full text Add to dashboard Cite

Survival for breast cancer (BC) is lower in eastern than northern/central Europe, and in older than younger women. We analysed how comorbidities at diagnosis affected whether selected standard treatments (STs) were given, across Europe and over time, also assessing consequences for survival/relapse. We analysed 7581 stage I/IIA cases diagnosed in 9 European countries in 2009-2013, and 4 STs: surgery; breast-conserving surgery plus radiotherapy (BCS + RT); reconstruction after mastectomy; and prompt treatment (≤6 weeks after diagnosis). Covariate-adjusted models estimated odds of receiving STs and risks of death/relapse, according to comorbidities. Pearson's R assessed correlations between odds and risks. The z-test assessed the significance of time-trends. Most women received surgery: 72% BCS; 24% mastectomy. Mastectomied patients were older with more comorbidities than BCS patients (p < 0.001). Women given breast reconstruction (25% of mastectomies) were younger with fewer comorbidities than those without reconstruction (p < 0.001). Women treated promptly (45%) were younger than those treated later (p = 0.001), and more often without comorbidities (p < 0.001). Receiving surgery/BCS + RT correlated strongly (R = −0.9), but prompt treatment weakly (R = −0.01/−0.02), with reduced death/relapse risks. The proportion receiving BCS + RT increased significantly (p < 0.001) with time in most countries. This appears to be the first analysis of the influence of comorbidities on receiving STs, and of consequences for outcomes. Increase in BCS + RT with time is encouraging. Although women without comorbidities usually received STs, elderly patients often received non-standard less prompt treatments, irrespective of comorbidities, with increased risk of mortality/relapse. All women, particularly the elderly, should receive ST wherever possible to maximise the benefits of modern evidence-based treatments.

show abstract

Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Cited by 158 publications

References 24 publications

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

Provision and use of radiotherapy in Europe

Comorbidities, age and period of diagnosis influence treatment and outcomes in early breast cancer

Contact Info

Product

Resources

About