P1.15-25 Has Lung Cancer Radiotherapy Utilisation Changed over Time in New South Wales, Australia?

Abstract

Evidence based indications suggest that 73% of all Australian lung cancer patients would benefit from radiotherapy at diagnosis. In 2001-2002, the radiotherapy utilisation (RTU) rate in NSW for lung cancer was 39%. Since then a number of new radiation oncology centres have opened and the number of linear accelerators increasing from 29 to 46. There has also been an increase in the number of lung cancer multidisciplinary teams. We aimed to evaluate whether there had been any change in RTU for lung cancer in NSW from 2001-2002 to 2009-2011. All patients diagnosed with lung cancer in NSW between 1/1/2009 and 31/12/2011 were identified from the NSW Central Cancer Registry (NSWCCR). Data linkage with the Admitted Patients Data Collection, Retrospective Radiotherapy Data and Clinical Cancer Registry was performed to ascertain radiotherapy treatment within 1 year of diagnosis. Patients with non-lung cancer pathologies and those who lived closer to interstate radiotherapy centres were excluded. Patients with a clinical diagnosis of lung cancer (no pathological confirmation (NPC)) were included. A total of 10,712 patients were identified through NSWCCR of which 947 patients were excluded leaving 9,765 patients for analysis. The median age was 71 years and 60% were males. Histopathology was NSCLC, SCLC and NPC in 76%, 12% and 13% respectively. Stage was IandII in 12%, III in 12%, IV in 28% and unknown in 47%. The overall RTU for lung cancer was 40%. RTU was 43% for NSCLC, 56% for SCLC and 8% for NPC. RTU by stage compared to previous figures is shown in Table 1.Table 1Radiotherapy utilisation rate by stage of lung cancer, NSW 2001-2002 and 2009-2011HistologyStageRTU N (%) (2001-2002)RTU (%) (2009-2011)NSCLCI76(26)201(27)II35(39)164(41)III170(55)753(72)IV258(49)1,497(66)Unknown17(22)544(18)Total556(43)3,159(43)SCLCI-III39(47)157(80)IV61(32)280(61)Unknown1(17)202(41)Total101(36)639(56)NPCI12(22)12(43)II4(33)3(50)III11(35)17(71)IV20(27)37(60)Unknown5(8)25(2)Total52(23)94(8)OVERALLTotal709(39)3,892(40) Open table in a new tab Increased RTU was seen in some groups of patients including Stage III-IV NSCLC, Stage I-IV SCLC and Stage I-IV NPC. Despite an increase in resources, overall RTU for lung cancer has remained unchanged over the last decade.