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Article ; Online: Radiation Therapy Caseload Treatment Volume: Does It Matter?

Thompson, Stephen R / Delaney, Geoff P

International journal of radiation oncology, biology, physics

2023 Volume 117, Issue 5, Page(s) 1087–1089

MeSH term(s)	Humans ; Workload ; Radiation Oncology
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Editorial
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2023.08.008
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Article ; Online: Great expectations or waiting for Godot? Time for development of a near real-time national reporting system of radiotherapy utilisation.

Delaney, Geoff P / Barton, Michael B

Journal of medical imaging and radiation oncology

2022 Volume 66, Issue 6, Page(s) 826–829

MeSH term(s)	Humans ; Motivation ; Radiation Oncology
Language	English
Publishing date	2022-05-24
Publishing country	Australia
Document type	Editorial ; Comment
ZDB-ID	2389687-5
ISSN	1754-9485 ; 1440-1673 ; 1754-9477 ; 0004-8461
ISSN (online)	1754-9485 ; 1440-1673
ISSN	1754-9477 ; 0004-8461
DOI	10.1111/1754-9485.13437
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Article ; Online: The importance of quality and safety in radiotherapy delivery.

Coffey, Mary / Delaney, Geoff

Technical innovations & patient support in radiation oncology

2020 Volume 14, Page(s) 30–31

Language	English
Publishing date	2020-05-28
Publishing country	England
Document type	Editorial
ISSN	2405-6324
ISSN (online)	2405-6324
DOI	10.1016/j.tipsro.2020.05.001
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Article ; Online: Experience of patients considering or using checkpoint inhibitors in cancer treatment: a systematic review of qualitative research.

Yip, Raphael / Arnolda, Gaston / Lamprell, Klay / Nic Giolla Easpaig, Bróna / Chittajallu, Renuka / Delaney, Geoff / Olver, Ian / Liauw, Winston / Braithwaite, Jeffrey

Journal for immunotherapy of cancer

2024 Volume 12, Issue 1

Abstract: Increasing numbers of patients with cancer are considering or undergoing immunotherapy, however, little is known about patients' perspectives on this treatment. We undertook a systematic review for use by clinicians and researchers, consolidating ... ...

Abstract	Increasing numbers of patients with cancer are considering or undergoing immunotherapy, however, little is known about patients' perspectives on this treatment. We undertook a systematic review for use by clinicians and researchers, consolidating published qualitative research studies on patient experience of checkpoint inhibitor therapy. A search of Medline, Embase, and PsycINFO was carried out for publications in English to 30 June 2022. Publications were selected if they reported a qualitative study of patient experience with checkpoint inhibitor therapy for cancer, either by patients or their families or carers. Quality was appraised using the Johanna Briggs Institute quality assessment tool for qualitative studies. A thematic synthesis was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard was followed. We identified 17 eligible studies published between 2017 and 2022, 9 using mixed methods, and 8 solely using qualitative methods. Most studies reported on the experiences of patients with advanced stage melanoma and were using the earliest approved checkpoint inhibitors for cancer therapy. Studies met most formal quality criteria but varied in the extent of their qualitative explorations of data; some mixed methods studies had limited reporting of qualitative results. Through thematic synthesis, we categorized study findings into four domains: (1) treatment decision-making; (2) success with immunotherapy; (3) treatment-related adverse events (AEs); and (4) quality of life on immunotherapy. Our review identified several areas with potential for improving the care system. These include, for example: routinely linking patients to peers who have experienced this therapy; improving the capacity of patients and carers to identify and report AEs faster; and supporting patients and carers to live with changed circumstances after successful treatment. Most studies focused on patients who had successful treatment, effectively excluding those who do not respond or who discontinue due to serious side effects; future research targets are suggested.
MeSH term(s)	Humans ; Immunotherapy/methods ; Qualitative Research ; Immune Checkpoint Inhibitors/therapeutic use ; Neoplasms/drug therapy
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2719863-7
ISSN	2051-1426 ; 2051-1426
ISSN (online)	2051-1426
ISSN	2051-1426
DOI	10.1136/jitc-2023-007555
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Article ; Online: Development of an age- and comorbidity- adjusted optimal radiotherapy utilisation rate for lung, rectal, prostate and cervical cancers.

Mackenzie, Penny / Vajdic, Claire / Delaney, Geoff / Comans, Tracy / Agar, Meera / Gabriel, Gabriel / Barton, Michael

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2023 Volume 188, Page(s) 109862

Abstract: Introduction: Optimal radiotherapy utilisation (RTU) modelling estimates the proportion of people with cancer who would benefit from radiotherapy. Assessment of comorbidities is an important component of the assessment of suitability for radiotherapy in ...

Abstract	Introduction: Optimal radiotherapy utilisation (RTU) modelling estimates the proportion of people with cancer who would benefit from radiotherapy. Assessment of comorbidities is an important component of the assessment of suitability for radiotherapy in addition to chronological age and life expectancy. Comorbidities have not been considered in previous optimal RTU models. We aimed to develop an age- and comorbidity- adjusted optimal RTU model for patients with lung, rectal, prostate, and cervical cancer, and compare them to actual RTU rates, with a particular focus on those aged 80+ years, 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: 14,696 patients were diagnosed with non-small cell lung cancer (NSCLC), 1839 with small cell lung cancer (SCLC), 5551 with rectal cancer, 30,935 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.
Language	English
Publishing date	2023-08-22
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2023.109862
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Article ; Online: Surgical and radiotherapy patterns of care in the management of breast cancer in NSW and ACT Australia.

Merie, Roya / Shafiq, Jesmin / Soon, Patsy S / Delaney, Geoff P

Journal of medical imaging and radiation oncology

2021 Volume 66, Issue 3, Page(s) 442–454

Abstract: Introduction: This study aims to report on the surgical and radiotherapy patterns of breast cancer care in New South Wales (NSW) and Australian Capital Territory (ACT) in Australia, to identify factors that impact on utilisation of evidence-based ... ...

Abstract	Introduction: This study aims to report on the surgical and radiotherapy patterns of breast cancer care in New South Wales (NSW) and Australian Capital Territory (ACT) in Australia, to identify factors that impact on utilisation of evidence-based treatment and to report on the overall survival (OS) rate and the influencing factors on OS. Methods: Cancer registry data linked to hospital records for all patients with breast cancer diagnosis in NSW and ACT between 2009 and 2014 were used to calculate rates of breast conserving surgery (BCS), mastectomy, sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND) and radiotherapy. Multivariate analysis used to identify factors that led to variations in care. 5-year OS was calculated and cox regression model assessed factors that influenced survival. Results: Data for 30,337 patients were analysed. BCS and mastectomy rates were 64% and 36%, respectively. The SLNB, ALND and ALND after SLNB rates were 61.5%, 32.1% and 6.4%, respectively. Radiotherapy was utilised in 63%. Younger age, socio-economic disadvantage, longer distance to a radiotherapy facility and overseas place of birth were factors that predicted for increased rates of mastectomy and ALND. Radiotherapy was more likely to be utilised in later years of diagnosis, patients between 40-69 years old, and those who lived in major cities and closer to a radiotherapy facility. 5-year OS was 80.5%. Older patients, the socioeconomically disadvantaged and those advanced tumours had worse survival. Conclusion: Variations in breast cancer care continue to exist in certain patient groups that we identified. Targeted strategic planning and further research to identify other drivers of existing disparities remain a priority.
MeSH term(s)	Adult ; Aged ; Australia ; Axilla/pathology ; Breast Neoplasms/radiotherapy ; Breast Neoplasms/surgery ; Female ; Humans ; Lymph Node Excision ; Mastectomy ; Middle Aged ; New South Wales/epidemiology ; Sentinel Lymph Node Biopsy
Language	English
Publishing date	2021-11-30
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2389687-5
ISSN	1754-9485 ; 1440-1673 ; 1754-9477 ; 0004-8461
ISSN (online)	1754-9485 ; 1440-1673
ISSN	1754-9477 ; 0004-8461
DOI	10.1111/1754-9485.13357
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Zs.B 66: Show issues

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Article ; Online: Development of an age- and comorbidity adjusted- optimal radiotherapy utilisation rate for women with breast cancer.

Mackenzie, Penny / Vajdic, Claire / Delaney, Geoff / Comans, Tracy / Agar, Meera / Gabriel, Gabriel / Barton, Michael

Journal of geriatric oncology

2022 Volume 13, Issue 6, Page(s) 844–849

Abstract: Introduction: Optimal radiotherapy utilisation (RTU) modelling estimates the proportion of people with cancer who would benefit from radiotherapy. Older adults with cancer may have comorbidities that can impact physiological reserve and affect ... ...

Abstract	Introduction: Optimal radiotherapy utilisation (RTU) modelling estimates the proportion of people with cancer who would benefit from radiotherapy. Older adults with cancer may have comorbidities that can impact physiological reserve and affect radiotherapy recommendations. These have not been considered in previous models. We aimed to develop an age- and comorbidity-adjusted optimal RTU model for breast cancer. Methods: New South Wales (NSW) Cancer Registry data (2010-2014) linked to radiotherapy data (2010-2015) and hospitalisation data (2008-2015) was used to determine the number of women diagnosed with invasive breast cancer in four pre-specified age groups. The Charlson Comorbidity Index (CCI), Cancer-Specific C3 'all sites' index and the Hospital Frailty Risk Score (HFRS) were derived for each woman from diagnostic codes in hospital records. Women were deemed unfit, and thus unsuitable candidates for radiotherapy, if the comorbidity indices were as follows: CCI ≥2; C3 score ≥ 3; and HFRS ≥5. The proportions of women suitable for radiotherapy in each age group were then incorporated into a breast cancer decision tree model. The actual RTU was also calculated using the linked datasets. Results: 23,601 women were diagnosed with breast cancer in NSW from 2010 to 2014 and 2526 were aged 80+ years. The overall comorbidity adjusted- RTU for women of all ages was 85·9% (CCI), 83·7% (C3) and 81·9% (HFRS). The optimal comorbidity adjusted- RTU for women aged 80+ was 76·1% (CCI), 70·1% (C3) and 61·8% (HFRS). The actual RTU for women aged 80+ years was 24.7%. Conclusion: The vast majority of older Australian women with breast cancer are fit for radiotherapy. The overall optimal RTU is only slightly reduced when adjusted for age and comorbidities and was similar using each of the three indices examined. Our data suggest radiotherapy is markedly underutilised for older women with breast cancer.
MeSH term(s)	Aged ; Australia ; Breast Neoplasms/epidemiology ; Breast Neoplasms/radiotherapy ; Comorbidity ; Female ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Radiation Oncology
Language	English
Publishing date	2022-05-02
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2022.04.003
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Article: Age-related experiences of colorectal cancer diagnosis: a secondary analysis of the English National Cancer Patient Experience Survey.

Owais, Syeda Somyyah / Arnolda, Gaston / Lamprell, Klay / Liauw, Winston / Delaney, Geoff P / Olver, Ian / Karnon, Jonathan / Braithwaite, Jeffrey

BMJ open gastroenterology

2023 Volume 10, Issue 1

Abstract: Objective: The incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand ... ...

Abstract	Objective: The incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand the diagnostic experiences of patients with CRC and explore age-related differences in the proportion with positive experiences. Method: A secondary analysis of the English National Cancer Patient Experience Survey (CPES) 2017 was conducted on the responses of patients with CRC, restricted to those likely to have been diagnosed in the preceding 12 months via pathways other than routine screening. Ten diagnosis-related experience questions were identified, with responses to them categorised as positive, negative or uninformative. Age group-related difference in positive experiences were described and ORs estimated, both raw and adjusted for selected characteristics. Sensitivity analysis was performed by weighting survey responses to 2017 cancer registrations by strata defined by age group, sex and cancer site, to assess whether differential response patterns by these characteristics affected the estimated proportion of positive experiences. Results: The reported experiences of 3889 patients with CRC were analysed. There was a significant linear trend (p<0.0001) for 9 of 10 experience items, with older patients consistently displaying higher rates of positive experiences and patients aged 55-64 showing rates of positive experience intermediate between younger and older age groups. This was unaffected by differences in patient characteristics or CPES response rates. Conclusion: The highest rates of positive diagnosis-related experiences were reported by patients aged 65-74 or 75 years and older, and this is robust.
MeSH term(s)	Aged ; Humans ; Colorectal Neoplasms ; Patient Outcome Assessment ; Age Factors ; Middle Aged
Language	English
Publishing date	2023-03-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2054-4774
ISSN	2054-4774
DOI	10.1136/bmjgast-2022-001066
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Article ; Online: Patterns of curative treatment for non-small cell lung cancer in New South Wales, Australia.

Batumalai, Vikneswary / Descallar, Joseph / Gabriel, Gabriel / Delaney, Geoff P / Oar, Andrew / Barton, Michael B / Vinod, Shalini K

Asia-Pacific journal of clinical oncology

2022 Volume 19, Issue 2, Page(s) e149–e159

Abstract: Introduction: There is a lack of large population-based studies examining patterns of curative treatment for non-small cell lung cancer (NSCLC) in Australia. This study aimed to evaluate the utilization of curative treatment for NCSLC at a population ... ...

Abstract	Introduction: There is a lack of large population-based studies examining patterns of curative treatment for non-small cell lung cancer (NSCLC) in Australia. This study aimed to evaluate the utilization of curative treatment for NCSLC at a population level and identify factors associated with its use in New South Wales (NSW), Australia. Methods: Patients diagnosed with localized or locoregional NSCLC between 2009 and 2014 were identified from the NSW Central Cancer Registry. Curative treatment was defined as surgery or radiotherapy with a 45 Gy minimum dose. Univariate and multivariable analyses were performed to investigate factors associated with the receipt of curative treatment. A Cox proportional-hazards regression model was used to analyze the factors associated with 2-year overall survival (OS). Results: Of the 5722 patients diagnosed with NSCLC in the study period, 3355 (59%) patients received curative treatment and 2367 (41%) patients did not receive curative treatment. The receipt of curative treatment was significantly associated with younger patients, female gender, localized disease, and Charlson Comorbidity Index (CCI) = 0. The use of curative treatment increased significantly over time from 2009 (55%) to 2014 (63%) and varied significantly from 24% to 70% between local health districts (LHDs) of residence. Younger age, female gender, localized disease, CCI = 0, and overseas country of birth were significantly associated with 2-year OS. The 2-year OS significantly improved from 70% in 2009 to 77% in 2014 for patients who received curative treatment. Conclusion: The use of curative treatment for patients with potentially curable NSCLC was low at 59%. However, the use of curative treatment and survival have increased over time. Significant variation was noted in the use of curative treatment between LHDs.
MeSH term(s)	Humans ; Female ; Carcinoma, Non-Small-Cell Lung/pathology ; Lung Neoplasms/drug therapy ; New South Wales/epidemiology ; Australia ; Proportional Hazards Models ; Neoplasm Staging
Language	English
Publishing date	2022-07-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2187409-8
ISSN	1743-7563 ; 1743-7555
ISSN (online)	1743-7563
ISSN	1743-7555
DOI	10.1111/ajco.13811
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Article ; Online: Radiotherapy utilisation rates for patients with cancer as a function of age: A systematic review.

Mackenzie, Penny / Vajdic, Claire / Delaney, Geoff / Comans, Tracy / Morris, Lucinda / Agar, Meera / Gabriel, Gabriel / Barton, Michael

Journal of geriatric oncology

2022 Volume 14, Issue 3, Page(s) 101387

Abstract: Introduction: There is an increasing incidence of cancer in older people, but limited data on radiotherapy uptake, and in particular, radiotherapy utilisation (RTU) rates. The RTU rate for older adults with cancer may be lower than recommended due to ... ...

Abstract	Introduction: There is an increasing incidence of cancer in older people, but limited data on radiotherapy uptake, and in particular, radiotherapy utilisation (RTU) rates. The RTU rate for older adults with cancer may be lower than recommended due to lower tolerance for radiotherapy as well as additional comorbidities, reduced life expectancy and travel for treatment. Radiotherapy use must be aligned with best available, age-specific evidence to ensure older adults with cancer receive optimal benefit without harms. Materials and methods: A systematic review was conducted to synthesise the published data on the actual RTU rate for patients with cancer as a function of age. MEDLINE and EMBASE were systematically searched to identify relevant population-based and hospital-based cohort studies on radiotherapy utilisation for all age groups, published in English, from 1 January 1990 to 1 July 2020. We focused on the following common cancers in older adults for which radiotherapy is recommended: breast, prostate, lung, rectal cancer, glioblastoma multiforme (GBM), and cervical cancer. Age-specific radiotherapy utilisation data were extracted and analysed as a narrative synthesis. Results: From 2606 studies screened, 75 cohort and population-based studies were identified with age-specific radiotherapy utilisation data. The total number of patients in the 75 studies was 4,792,138. The RTU rate decreased with increasing age for all tumour sites analysed, except for patients receiving curative radiotherapy as definitive treatment for prostate or cervical cancer. This reduction with increasing age was demonstrated in both palliative and curative settings. Discussion: There is a global reduction in radiotherapy utilisation with increasing age for most tumour sites. The reduction in delivery of radiotherapy warrants further examination and evidence-based guidelines specific to this population.
MeSH term(s)	Male ; Female ; Humans ; Aged ; Uterine Cervical Neoplasms ; Radiation Oncology ; Rectal Neoplasms ; Life Expectancy
Language	English
Publishing date	2022-10-20
Publishing country	Netherlands
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2022.10.002
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