Introduction
Radiotherapy is an integral tool in the treatment of approximately half of all cancers, in both the curative and palliative setting. The Victorian Cancer Plan (2020-2024)1 prioritises access, safety and quality for all Victorian radiotherapy patients, optimising safe delivery, and where appropriate, treatment close to home. Ongoing expansion of treatment facilities, combined with pre-existing referral pathways, are key enablers to meeting this need. At the height of the 2020 pandemic, restrictions imposed significant barriers on movement in and out of regional areas into metropolitan Melbourne- often a necessity to meet complex radiotherapy needs. The aim of this review was to investigate recent Victorian patient treatment locations and determine the impact (if any) of pandemic restrictions on the site of radiotherapy.
Methods
All radiotherapy courses treated in Victoria between January 2018 and April 2021 were included in this analysis. Patient residence (postcode) and treatment location (postcode) categorised radiotherapy courses into geographic rings from the Victorian radiotherapy department where care was delivered. Proportion of courses treated within 10km, 25km, 50km, 75km, 100km, 150+km radii were reported.
Results
67,579 radiotherapy courses were delivered in Victoria between 1/1/2018 and 30/4/2021. Treatment <50km of home occurred on 79.7%(2018), 80.2%(2019) and 82.7%(2020) of occasions. Concurrently, treatment >150km from home was seen in 6.8%(2018), 6.3%(2019) and 5.1%(2020) of courses. In metropolitan radiotherapy departments, treatment >150km from home decreased from 7.0%(2018) and 6.3%(2019), to 4.7%(2020)- a decrease of >350 courses from 2018 to 2020. Comparatively, courses for regional patients travelling >150km for radiotherapy remained relatively stable (2018-6.4%; 2019-6.1%; 2020-6.2%).
Conclusions
Pandemic restrictions had varying impacts on Victorian radiotherapy patients accessing treatment. Further investigation is required to understand the decreased travel to metropolitan radiotherapy hubs from regional Victoria, and whether altered pathways are sustained long term to enable care closer to home, where possible, without compromising optimal care.