Estimating the Need for Palliative Radiation Therapy: A Benchmarking Approach

Area of Science:

• Oncology
• Radiation Oncology
• Health Services Research

Background:

• Palliative radiation therapy (PRT) is crucial for managing symptoms in patients with incurable cancer.
• The actual utilization rate of PRT remains largely unquantified, hindering optimal resource allocation and patient care planning.

Purpose of the Study:

• To estimate the appropriate utilization rate of palliative radiation therapy (PRT) in Ontario.
• To establish benchmarks for PRT use based on patient populations with optimal access.

Main Methods:

• Utilized the Ontario Cancer Registry (2006-2010) and linked comprehensive radiation therapy (RT) records.
• Employed multivariate analysis to identify factors influencing PRT use and defined a benchmark population with unimpeded access.
• Measured PRT rates (lifetime, last 2 years of life, courses per 1000 deaths) in the benchmark population and standardized them.

Main Results:

• Hospital-based RT availability was the primary determinant of PRT use, overshadowing socioeconomic status and distance.
• The standardized benchmark for lifetime PRT use was 33.9%, with a province-wide rate of 28.5%.
• Benchmarks for PRT in the last two years of life (32.4% vs. 27.0%) and courses per 1000 deaths (652 vs. 542) also showed a deficit in actual use.

Conclusions:

• An estimated one-third of patients dying from cancer in Ontario have a need for PRT.
• Current PRT utilization rates fall short of established benchmarks, indicating a significant unmet need.
• Improving access to PRT for eligible patients is essential for enhancing palliative cancer care.