ESTRO 2024 - Abstract Book

S2818

Interdisciplinary - Health economics & health services research

ESTRO 2024

Figure

1:

Total

average

weekly

radiotherapy

courses

between

all

4

years.

Between Years 1 and 2, radiotherapy delivery between radical and palliative treatment courses showed a greater reduction in radical treatments (4472 versus 3900 courses) than palliative treatments (2496 versus 2340 courses). For Years 3 and 4, total radiotherapy courses showed an overall increase in radical treatments (5470 versus 5912) and a decrease in palliative treatments (2429 versus 2206). Between Year 1 and Year 2, the effect of COVID-19 saw relative reductions in courses; anal (34%), breast (28%), head and neck (8.5%), lung (16.5%), prostate (18%) and colorectal (5%) cancers. Years 3 and 4 saw a variable recovery across all the tumour sites. Notable increases were found for breast, cervical, rectal, and skin cancer sites. Interestingly, lung cancer numbers showed a significant decrease. Radiotherapy courses were also analysed by gender and age, with a threshold of <65 or ≥65. Between Year 1 and Year 2, a significant reduction was found for women (-15%) compared to men (-8%). The recovery in Year 3 and 4 showed a significant increase for women receiving radiotherapy, with the average weekly RT courses increasing by 28-53%. The recovery for males has been slow and steady, with increases of 9 to 15% between Year 2 and Years 3 and 4. Radiotherapy activity was found to have significantly decreased during the first 12 months of the COVID-19 pandemic, when compared to the 12 months prior. The significant fall in new-start radiotherapy treatments can likely be attributed to the initial suspension of cancer diagnostic services and interventional surgeries together. We also found a rapid increase in the use of hypo-fractionated treatment regimens across several treatment sites. Whereas, an increase in other tumour sites can likely be attributed to the reduction or cancellation of surgical interventions being replaced by radiotherapy treatments. Now that the pandemic has been declared over, and health services have returned to normal, we have found a 35% increase in the total number of patients attending for radiotherapy treatments compared to the year of the pandemic. This rise can likely be attributed to routine diagnostic services and screening programmes being reinitiated as well as all restrictions and social mitigations being lifted. Work is currently ongoing to assess the effect of stage migration and cancer-specific outcomes. Conclusion:

Keywords: COVID-19, Radiotherapy, Scotland