Currently, there is no mechanism to calculate actual radiotherapy rates in Victoria. Existing methodology uses an approximation from state-wide data with no direct link to complete patient information. Our study improved on this by calculating actual utilisation of radiotherapy rates using the Victorian Cancer Outcomes Network (VCON) population-based dataset for the BSWRICS.
Primary tumours for newly diagnosed patients (2009) tallied 1,778 including 223 breast, 159 lung, 335 prostate and 98 rectum. Median age was 69yr (IQR 59-79yr) and 58% male. Median distance from home to ALCC was 16km (IQR 5–87km). Radiotherapy utilisation rates were highest for head and neck (63%), oesophagus (63%), lung (52%), breast (56%) and central nervous system (65%). Univariate analysis found a pattern towards those without radiotherapy being older and with greater distance to travel. However, the majority of clinical decisions are based on tumour stage. Prostate, breast, rectum and lung tumour sites were selected for more detailed analysis across tumour stage. The highest rate of radiotherapy was found in Stage III categories for lung, breast and rectal tumours. There was a trend towards an older age group in those without radiotherapy for the breast, lung and rectal tumour streams. Longer distances to travel were found in those without radiotherapy for breast and prostate. However, further links to multidisciplinary meeting outcomes, surgery and chemotherapy data may identify important cofounders.
The use of the population-based dataset has established the link between radiotherapy, tumour stage and demographics with further links planned. The addition of 2010 data would further improve the data quality and increase power of the study.