Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria

Fogarty, T; Tacey, M; McCorkell, G; Kok, D; Hornby, C; Milne, RL; Millar, J; Foroudi, F; Ong, WL

Author(s): Fogarty, T; Tacey, M; McCorkell, G; Kok, D; Hornby, C; Milne, RL; Millar, J; Foroudi, F; Ong, WL;
Details: Publication Year 2022-08,Volume 66,Issue #5,Page 678-687
Journal Title: Journal of Medical Imaging and Radiation Oncology
Publication Type: Research article
Abstract: INTRODUCTION: To describe the pattern of the use of advanced radiation therapy (RT) techniques, including intensity-modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body RT (SBRT) for the management of bone metastases (BM), and the associated factors in Victoria. METHODS: We used a population-based cohort of patients from the state-wide Victorian Radiotherapy Minimum Data Set (VRMDS) who received RT for BM between 2012 and 2017. The primary outcome was proportion of RT courses using advanced RT techniques. The Cochran-Armitage test for trend was used to evaluate temporal trend in advanced RT use. Multinomial logistic regression was used to identify factors associated with advanced RT use. RESULTS: A total of 18,158 courses of RT were delivered to 10,956 patients-16,626 (91.6%) courses were 3D conformal RT, 857 (4.7%) IMRT/VMAT and 675 (3.7%) SBRT. There was a sharp increase in IMRT/VMAT use from <1% in 2012-2015, to 10.1% in 2016 and 16.3% in 2017 (P-trend < 0.001). Increase in SBRT use was more gradual, from 1.2% in 2012 to 4.8% in 2016 and 5.5% in 2017 for SBRT (P-trend<0.001). In multivariate analyses, year of RT was the strongest predictor of IMRT/VMAT use (OR = 41; 95%CI = 25-67; P < 0.001, comparing 2012-2013 and 2016-2017). Primary tumour type (prostate cancer) was the strongest predictor of SBRT use (OR = 6.07; 95% CI = 4.19-8.80; P < 0.001). CONCLUSION: Overall, there was increasing trend in the use of advanced RT techniques for BM in Victoria, with a distinct pattern for IMRT/VMAT compared with SBRT - SBRT uptake was more gradual while IMRT/VMAT uptake was abrupt, occurring contemporaneously with Medicare Benefit Scheme funding changes in 2016.
Keywords: Aged; Humans; Male; Medicare; *Radiosurgery/methods; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted/methods; *Radiotherapy, Intensity-Modulated/methods; *Spinal Neoplasms/radiotherapy; United States; Imrt; Vmat; bone metastases; radiation therapy; stereotactic
Department(s): Radiation Oncology
PubMed ID: 35106919
Publisher's Version: https://doi.org/10.1111/1754-9485.13381
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-24 06:56:10

Last Modified: 2024-10-24 06:56:36