ESTRO 2020 Abstract book

S719 ESTRO 2020

PO-1274 Variations in IMRT demand and delivery across England T. Mee 1,2 , N.F. Kirkby 1,2 , N.G. Burnet 1,2 , R.I. Mackay 3 , R. Gray 4 , J. Shelton 4 , K.J. Kirkby 1,2 1 University Of Manchester, Division of Cancer Sciences, Manchester, United Kingdom ; 2 The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom ; 3 The Christie NHS Foundation Trust, Christie Medical Physics and Engineering, Manchester, United Kingdom ; 4 Cancer Research UK, Policy Department, London, United Kingdom Purpose or Objective Intensity Modulated Radiotherapy (IMRT) is a key radiotherapy (RT) technique used for radical treatments. A 2015 report 1 from England suggested that 51.8% of radical RT patients should be treated with IMRT. However, there are variations in the profile of cancer throughout England. This will result in variations in the demand for IMRT and therefore 51.8% may not be applicable at local level. Delivery of IMRT may also vary between RT centres. The English Cancer registries record delivered RT data, including which treatments were IMRT. Here, we compare the recorded IMRT delivered data to a local-level IMRT The future IMRT predictions from the 2015 report were encoded into the Malthus Model 2 for every IMRT relevant cancer site. Malthus contains local-level population, incidence and stage presentation data. Malthus simulated the IMRT demand for every clinical commissioning group (CCG) in England. The recorded IMRT delivered data is also at CCG level and was sourced from Public Health England. The recorded IMRT data was converted to a percentage of the simulated demand. A heat map of the results was created for England in Tableau software 3 . The postcode location of every main RT centre in England was obtained and plotted on the heat map, including information on the number of linacs registered at the centre. Breast IMRT was excluded from the analysis, as it could potentially distort the data, due to current questions around inverse/forward planned IMRT and service targets 1 . Results There is variation in simulated demand for IMRT across England, ranging from 44.7% to 56.5% of radical RT patients. There is also variation in recorded IMRT delivery, ranging from 21% to 67%. When comparing a CCG’s recorded IMRT to its simulated demand the results range from 55% to 164%. Figure 1 shows the results of the comparison for every CCG in England alongside RT centre location and size information. demand simulations. Material and Methods

Conclusion The trend towards a reduced number of patients per radiation oncologist and physicist has been observed in previous reports and might be driven by the growing complexity of modern RT, which demands highly skilled, well-trained personnel. The same holds true for the application of imaging systems, such as PET/CT or MRI, in RT departments. On the other hand, the reduction of treatment fractions per patient by the introduction of hypofractionation for breast and prostate and of SBRT and SRS may explain the decrease of the number of RTTs per patient treated.