ESTRO 2023 - Abstract Book

S622

Monday 15 May 2023

ESTRO 2023

important that chronological age alone does not limit treatment recommendations. Assessment of medical comorbidities is an important component for the assessment of treatment suitability. These have not been considered in previous optimal RTU models. We aimed to develop an age- and comorbidity- adjusted optimal RTU model for patients, with a particular focus on those aged 80+ years, with lung, rectal cancer, prostate and cervical cancer, and compare them to actual RTU rates. Materials and Methods New South Wales (NSW) Cancer Registry data (2010-2014) linked to radiotherapy data (2010-2015) and hospitalisation data (2008-2015) were used to determine the number of patients diagnosed with lung, rectal, prostate and cervical cancer. The Cancer Specific C3 ‘all sites’ comorbidity index was calculated from hospital diagnosis data for each patient to determine suitability for radiotherapy. The index was then incorporated into a tumour site-specific decision tree model. The actual RTU was also calculated using the linked datasets. Results 14696 patients were diagnosed with non-small cell lung cancer (NSCLC), 1839 with small cell lung cancer (SCLC), 5551 with rectal cancer, 30935 with prostate cancer and 1216 with cervical cancer in New South Wales from 2010-2014. The proportion of patients aged 80+ years at cancer diagnosis was 25% (3603 patients), 15% (279 patients), 17% (943 patients), 12% (3745 patients), and 7% (88 patients) respectively. The age- and comorbidity- adjusted optimal RTU rates for patients aged 80+ years using the C3 index were 49% (NSCLC), 49% (SCLC), 43% (rectal), 51% (prostate) and 40% (cervical). The corresponding actual RTU rates for patients aged 80+ years were 25%, 32%, 27%, 16%, and 56%. Conclusion Even after adjusting for age and comorbidities, the actual radiotherapy utilisation rates were lower than optimal radiotherapy utilisation rates in patients aged 80+ years except for patients with cervical cancer. This warrants further assessment and research into reasons and solutions. OC-0756 A first step towards value-based healthcare in radiation oncology: classification of innovations. M. Vandemaele 1 , A. Aggarwal 2,3 , Y. Lievens 4 1 Ghent University Hospital, Radiation Oncology Department, Ghent, Belgium; 2 London School of Hygiene and Tropical Medicine, London, UK, Faculty of Public Health and Policy, London, United Kingdom; 3 Guy’s & St Thomas’ NHS Trust, Department of Clinical Oncology, London, United Kingdom; 4 Ghent University Hospital, Radiation Oncology Department, Gent, Belgium Purpose or Objective The concept of ‘value’ in healthcare has been proposed to evaluate the impact of new intervention, taking into account both the outcomes (that matter most to patients) and the cost spent over the total cycle of care. The Health Economics in Radiation Oncology program of the European Society for Radiotherapy and Oncology (ESTRO-HERO) engaged in building a value-based framework, with a focus on radiation oncology (RO) interventions. As a first step, a systematic literature review was done to investigate existing definitions and classification methods for RO innovations, the latter being the focus of this report. Materials and Methods A systematic literature search was carried out in Pubmed and Embase, following the PRISMA reporting guidelines (Fig 1). Only articles with a definition or classification system for innovation, applicable to RO, were withheld. Data extraction, using a pre-defined data collection form, identified the characteristics and any additional information (e.g. type of outcome, quantitative indicators) of each system.

Fig 1: PRISMA

Results Data extraction is shown in the PRISMA chart (Fig 1). In 25 papers, 15 original reports of classification systems were identified. Iterative appraisal difference between categories, additional data extraction and consensus between authors divided the classification systems into two groups.