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Hypofractionation Utilisation in Radiation Therapy: A Regional Department Evaluation
Cyrena Tabet1,2, Amy Brown3, Catriona Hargrave1,2
1School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
Journal of Medical Radiation Sciences
|February 26, 2025
Summary
Hypofractionation radiotherapy is increasingly used worldwide, especially for breast and prostate cancers. This trend shows a shift towards more complex, value-based treatments, unaffected by patient social factors.
Area of Science:
- Radiation Oncology
- Medical Physics
- Clinical Oncology
Background:
- Global trend towards hypofractionation radiotherapy (HRT) schedules (>2.45 Gy/fraction) over the past decade.
- HRT offers potential for increased efficiency and improved patient outcomes.
- Assessing HRT adoption in regional Queensland provides insight into practice variations.
Purpose of the Study:
- Evaluate changes in radiotherapy fractionation schedules in regional Queensland over 10 years.
- Analyze the influence of cancer site, treatment intent, and patient social factors on HRT adoption.
- Identify current gaps and trends in radiotherapy practice.
Main Methods:
- Retrospective clinical audit of patients undergoing radiotherapy in 2012, 2019, and 2022.
- Data collection included demographics and treatment information.
- Descriptive statistics were used for analysis, including a 10-year trend and COVID-19 impact assessment.
Main Results:
- Significant shift towards hypofractionation for breast and prostate cancers.
- Breast cancer: conventional fractionation decreased from 62.7% (2012) to 2.4% (2022); hypofractionation increased from 37.3% to 92.1%.
- Prostate cancer: conventional fractionation decreased from 99.4% (2012) to 23.2% (2022); hypofractionation increased from 0.6% to 74.1%.
- Palliative intent treatments (lung, brain, bone metastases) increasingly used hypofractionated and ultra-hypofractionated radiotherapy (>5 Gy/fraction).
- Adoption of advanced techniques like stereotactic radiotherapy and VMAT coincided with HRT increase.
- Hypofractionation adoption was not influenced by patient social factors (Indigenous status, age, distance to treatment).
Conclusions:
- Validated increase in hypofractionated treatments across various cancer sites and intents.
- Increased treatment complexity and adoption of advanced radiotherapy techniques.
- HRT impacts departmental resources and promotes value-based, patient-centered care.
Keywords:
Aboriginal and Torres Strait islanderbreasthypofractionated radiotherapymodalityout‐of‐townpalliativeprostateregionalruralultrafractionated radiotherapy
