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Killing time: The consequences of delays in radiotherapy

2007; Elsevier BV; Volume: 84; Issue: 1 Linguagem: Inglês

10.1016/j.radonc.2007.05.006

1879-0887

William J. Mackillop,

Lung Cancer Diagnosis and Treatment

Over the last 20 years, waiting lists for radiotherapy (RT) have become common in publicly funded health systems in many parts of the world [ 1 Mackillop W.J. Fu H. Quirt C.F. Dixon P. Brundage M. Zhou Y. Waiting for radiotherapy in Ontario. Int J Radiat Oncol Biol Phys. 1994; 30: 221-228 Abstract Full Text PDF PubMed Scopus (134) Google Scholar , 2 Schäfer C. Nelson K. Herbst M. Warten auf eine Strahlentherapie. Eine Aufforderung, einen nationalen Diskurs über Wartelisten in der Radiotherapie zu führen: Ergebnisse einer Befragung. Strahlentherapie und Onkologie. 2005; 181: 9-19 Crossref PubMed Scopus (18) Google Scholar , 3 Lim K. Vinod S.K. Bull C. O'Brien P. Kenny L. Prioritization of radiotherapy in Australia and New Zealand. Australas Radiol. 2005; 49: 485-488 Crossref PubMed Scopus (18) Google Scholar , 4 O'Rourke N. Edwards R. Lung cancer treatment waiting times and tumour growth. Clin Oncol. 2000; 12: 141-144 Abstract Full Text PDF PubMed Scopus (189) Google Scholar ]. The principal cause of this problem is an imbalance between supply and demand for RT. The demand for RT has increased dramatically, not only because of the rising incidence of cancer in the aging populations of the developed world, but also because of the discovery of new indications for RT [ [5] Mackillop W.J. Zhou S. Groome P. Dixon P. Cummings B.J. Hayter C. et al. Changes in the use of radiotherapy in Ontario 1984–1995. Int J Radiat Oncol Biol Phys V. 1999; 22: 355-362 Abstract Full Text Full Text PDF Scopus (48) Google Scholar ]. The supply of RT has often failed to keep pace with demand, either because of constraints in health care funding or because of poor forward planning. The increasing complexity of pretreatment evaluation may also contribute to the problem. Sequential short delays in pretreatment imaging and/or consultations with other specialists may add significantly to overall waiting times for RT.