Radiation Therapy Fields of Dreams: We Built Them-But Did They Come?

Radiation therapy (RT) has been underused in cancer treatment. One possible reason is the long distances some patients must travel for treatment. We performed this study to investigate whether the introduction of RT treatment facilities in regional locations in Queensland influenced RT utility.

The Cancer Alliance Queensland database which links individual patient data to population based and treatment data was used to identify new cancer diagnoses from 2011 to 2020. Cases were grouped according to Local Government Authority (LGA) of residence at the time of diagnosis. Annual use of RT within 12 months of diagnosis (RTU12) for each LGA was calculated. Four regional RT facilities commenced treatment at various points during this time. Variation in year-to-year RTU12 for these LGAs was examined before and after opening and compared to comparable figures for Queensland as well as Brisbane, Townsville and Toowoomba (LGAs with long established centres).

Mean RTU12 for Queensland was 24.6%, with minimal year-to-year variation. Brisbane, Toowoomba and Townsville LGAs showed stable RTU12 close to the Queensland average. All four regional LGAs without centres in 2010 had lower RTU12 prior to services commencing which improved after installation. For these centres mean RTU12 was 22.1%-95% confidence interval (95% CI) 20.9%-23.3%-before service availability compared to 24.8%-95% CI 24.0% -25.7% (p = 0.03)-after service availability.

The installation of regional radiation therapy centers in Queensland appears to be associated with an increase in RT use for patients resident in those LGAs.