Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria.
Milne, Roger L
J Med Imaging Radiat Oncol
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Fogarty, T., Tacey, M., McCorkell, G., Kok, D., Hornby, C., Milne, R. L., Millar, J., et al. (2022). Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria.. J Med Imaging Radiat Oncol https://doi.org/10.1111/1754-9485.13381
INTRODUCTION: To describe the pattern of the use of advanced radiation therapy (RT) techniques, including intensity-modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body RT (SBRT) for the management of bone metastases (BM), and the associated factors in Victoria. METHODS: We used a population-based cohort of patients from the state-wide Victorian Radiotherapy Minimum Data Set (VRMDS) who received RT for BM between 2012 and 2017. The primary outcome was proportion of RT courses using advanced RT techniques. The Cochran-Armitage test for trend was used to evaluate temporal trend in advanced RT use. Multinomial logistic regression was used to identify factors associated with advanced RT use. RESULTS: A total of 18,158 courses of RT were delivered to 10,956 patients-16,626 (91.6%) courses were 3D conformal RT, 857 (4.7%) IMRT/VMAT and 675 (3.7%) SBRT. There was a sharp increase in IMRT/VMAT use from <1% in 2012-2015, to 10.1% in 2016 and 16.3% in 2017 (P-trend < 0.001). Increase in SBRT use was more gradual, from 1.2% in 2012 to 4.8% in 2016 and 5.5% in 2017 for SBRT (P-trend<0.001). In multivariate analyses, year of RT was the strongest predictor of IMRT/VMAT use (OR = 41; 95%CI = 25-67; P < 0.001, comparing 2012-2013 and 2016-2017). Primary tumour type (prostate cancer) was the strongest predictor of SBRT use (OR = 6.07; 95% CI = 4.19-8.80; P < 0.001). CONCLUSION: Overall, there was increasing trend in the use of advanced RT techniques for BM in Victoria, with a distinct pattern for IMRT/VMAT compared with SBRT - SBRT uptake was more gradual while IMRT/VMAT uptake was abrupt, occurring contemporaneously with Medicare Benefit Scheme funding changes in 2016.
Radiation Oncology‐Original Article, Radiation Oncology‐Original Articles, bone metastases, IMRT, radiation therapy, stereotactic, VMAT
External DOI: https://doi.org/10.1111/1754-9485.13381
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333551