Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Clin Oncol (R Coll Radiol). 2021 Jul;33(7):e285-e294. doi: 10.1016/j.clon.2021.03.004. Epub 2021 Mar 26.
Cancer incidence varies across England, which affects the local-level demand for treatments. The magnetic resonance-linac (MR-linac) is a new radiotherapy technology that combines imaging and treatment. Here we model the demand and demand variations for the MR-linac across England.
Initial clinical indications were provided by the MR-linac consortium and introduced into the Malthus radiotherapy clinical decision trees. The Malthus model contains Clinical Commissioning Group (CCG) population, cancer incidence and stage presentation data (for lung and prostate) and simulated the demand for the MR-linac for all CCGs and Radiotherapy Operational Delivery Networks (RODN) across England.
Based on the initial target clinical indications, the MR-linac could service 16% of England's fraction burden. The simulated fractions/million population demand/annum varies between 3000 and 10 600 fractions/million at the CCG level. Focussing only on the cancer population, the simulated fractions/1000 cancer cases demand/annum ranges from 1028 to 1195 fractions/1000 cases. If a national average for fractions/million demand was then used, at the RODN level, the variation from actual annual demand ranges from an overestimation of 8400 fractions to an underestimation of 5800 fractions. When using the national average fractions/1000 cases, the RODN demand varies from an overestimation of 3200 fractions to an underestimation of 3000 fractions.
Planning cancer services is complex due to regional variations in cancer burden. The variations in simulated demand of the MR-linac highlight the requirement to use local-level data when planning to introduce a new technology.
英格兰各地的癌症发病率存在差异，这影响了当地治疗需求。磁共振直线加速器（MR-linac）是一种新的放射治疗技术，结合了成像和治疗。本研究对英格兰各地的 MR-linac 需求和需求变化进行了建模。
MR-linac 联盟提供了初步的临床适应证，并将其引入到马尔萨斯放射治疗临床决策树中。马尔萨斯模型包含临床委托组（CCG）人口、癌症发病率和分期数据（肺癌和前列腺癌），并模拟了英格兰所有 CCG 和放射治疗运营交付网络（RODN）的 MR-linac 需求。
根据初始目标临床适应证，MR-linac 可以服务于英格兰 16%的分次负担。在 CCG 层面，模拟的每百万人口需求/年的分次数量在 3000 至 10600 分次之间变化。仅关注癌症人群，模拟的每 1000 例癌症病例需求/年的分次数量范围为 1028 至 1195 分次。如果使用全国平均需求/百万人口的分次数量，则在 RODN 层面，实际年需求的变化范围从高估 8400 分次到低估 5800 分次。当使用全国平均每 1000 例癌症病例的分次数量时，RODN 的需求变化范围从高估 3200 分次到低估 3000 分次。
由于癌症负担的区域性差异，规划癌症服务非常复杂。MR-linac 模拟需求的变化突出了在计划引入新技术时使用本地数据的必要性。
