Waiting for Radiotherapy

Schäfer, C.; Nelson, Kristin; Herbst, M.

doi:10.1007/s00066-005-1252-7

Cited by 13 publications

(2 citation statements)

References 44 publications

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“…2 3 4 Waiting lists for radiotherapy are now common in many parts of the world 45 6 7 8 Longer times to radiotherapy are a result of rise in demand—from intensified screening, greater number of diagnoses of cancer in an ageing population, and expanding indications for and increasing technological complexity of treatment—that outstrips the supply of equipment and services.…”

Section: Introductionmentioning

confidence: 99%

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis

Punglia

Saito

Neville

et al. 2010

BMJ

104

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Objectives To determine if the length of interval between breast conserving surgery and start of radiotherapy affects local recurrence and to identify factors that might be associated with delay in older women with breast cancer. Design Retrospective cohort analysis with Cox proportional hazards models to study the association between time to radiotherapy and local recurrence, and propensity score and instrumental variable analyses to confirm findings. Logistic regression investigated factors associated with later start of radiotherapy. Setting Linked database (Surveillance, Epidemiology, and End Results Program-Medicare) in the United States Participants 18 050 women aged over 65 with stage 0-II breast cancer diagnosed in 1991-2002 who received breast conserving surgery and radiotherapy but not chemotherapy. Main outcome measure Local recurrence. Results Median time from surgery to start of radiotherapy was 34 days, with 29.9% (n=5389) of women starting radiotherapy after six weeks. Just over 4% (n=734) of the cohort experienced a local recurrence. After adjustment for clinical and sociodemographic factors, intervals over six weeks were associated with increased likelihood of local recurrence (hazard ratio 1.19, 95% confidence interval 1.01 to 1.39, P=0.033). When the interval was modelled continuously (assessing accumulation of risk by day), the effect was statistically stronger (hazard ratio 1.005 per day, 1.002 to 1.008, P=0.004). Propensity score and instrumental variable analysis confirmed these findings. Instrumental variable analysis showed that intervals over six weeks were associated with a 0.96% increase in recurrence at five years (P=0.026). In multivariable analysis, starting radiotherapy after six weeks was significantly associated with positive nodes, comorbidity, history of low income, Hispanic ethnicity, non-white race, later year of diagnosis, and residence outside the southern states of the US. Conclusions There is a continuous relation between the interval from breast conserving surgery to radiotherapy and local recurrence in older women with breast cancer, suggesting that starting radiotherapy as soon as possible could minimise the risk of local recurrence. There are considerable disparities in time to starting radiotherapy after breast conserving surgery. Regions of the US known to have increased rates of breast conserving surgery had longer intervals before radiotherapy, suggesting limitations in capacity. Given the known negative impact of local recurrence on survival, mechanisms to ameliorate disparities and policies regarding waiting times for treatment might be warranted.

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Section: Introductionmentioning

confidence: 99%

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis

Punglia

Saito

Neville

et al. 2010

BMJ

104

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“…Research suggests that the waiting time is relatively long [2–4]. The admission of patients receiving radiotherapy is an admission scheduling problem (ASP).…”

Section: Introductionmentioning

confidence: 99%

Integer programming for improving radiotherapy treatment efficiency

Kou

et al. 2017

PLoS ONE

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Background and purposePatients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources.Materials and methodsA mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model.ResultsCompared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds.ConclusionsThe integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making.

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Ethical Aspects of Screening and Preventive Diagnosis with Radiological Imaging

Reiter-Theil

Giles

2008

Screening and Preventive Diagnosis With Radiological Imaging

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Waiting for Radiotherapy

Cited by 13 publications

References 44 publications

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis

Integer programming for improving radiotherapy treatment efficiency

Ethical Aspects of Screening and Preventive Diagnosis with Radiological Imaging

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