Trommer Maike, Gillett Piers, Franchini Fanny, Trapani Karen, Hornby Colin, Abraham Skye, Herath Dishan, Gough Karla, Donohoe Keith, Tran Phillip, Foroudi Farshad, IJzerman Maarten, Khor Richard
Austin Health, Department of Radiation Oncology, Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia.
Faculty of Medicine and University Hospital Bonn, Department of Radiation Oncology, University of Bonn, Bonn, Germany.
Strahlenther Onkol. 2025 Aug 22. doi: 10.1007/s00066-025-02418-8.
Palliative radiotherapy (PRT) is crucial for improving quality of life in patients with advanced-staged cancer. This large data analysis investigates the travel distances and potential disparities in PRT access especially focusing on the burden of excess travel for palliative cancer patients in Victoria, Australia.
Using a state-wide linked dataset from the PRedicting the health economic IMPact of new and current Cancer Treatments (PRIMCAT) research program, we analysed the estimated road travel distance (ERTD) and potential excess travel distance (PETD) as well as received radiotherapy fractions for 29,807 PRT patients being treated from 2010-2019. We examined disparities by socioeconomic status (SEIFA) and remoteness (RA) of the residential area of PRT patients, and receiving treatment at a public or private centre.
The average one-way ERTD for all PRT patients was 43 km, with variations based on SEIFA and RA. Patients in the lowest SEIFA quintile and those living in outer regional areas had the longest ERTD. Approximately 50% did not receive treatment at the closest facility, with a mean PETD of 27.9 km for private and 24.3 km for public facility patients. Fractionation patterns showed no significant reduction in the number of fractions with increased travel distance. Patients at private facilities received more fractions on average (8.49) compared to those at public facilities (5.91).
This study highlights potential disparities in PRT access in Victoria, with patients living in socioeconomically disadvantaged and remote regions facing longer travel distances and excess travel. These findings underscore the need for strategic referral practices and further research to optimise equitable access to PRT.
姑息性放疗（PRT）对于改善晚期癌症患者的生活质量至关重要。这项大型数据分析调查了PRT治疗的出行距离以及获取PRT治疗方面可能存在的差异，尤其关注澳大利亚维多利亚州姑息性癌症患者的额外出行负担。
利用来自“预测新的和现有癌症治疗的健康经济影响”（PRIMCAT）研究项目的全州关联数据集，我们分析了2010年至2019年期间接受治疗的29807名PRT患者的估计道路出行距离（ERTD）、潜在额外出行距离（PETD）以及接受的放疗分次情况。我们按PRT患者居住地区的社会经济地位（SEIFA）和偏远程度（RA）以及在公立或私立中心接受治疗的情况来研究差异。
所有PRT患者的平均单程ERTD为43公里，因SEIFA和RA而异。社会经济地位最低五分位组的患者以及居住在偏远地区的患者ERTD最长。约50%的患者未在最近的机构接受治疗，私立机构患者的平均PETD为27.9公里，公立机构患者为24.3公里。分次模式显示，出行距离增加时，分次数量没有显著减少。私立机构的患者平均接受的分次（8.49次）比公立机构的患者（5.91次）更多。
本研究突出了维多利亚州在获取PRT治疗方面可能存在的差异，社会经济处于不利地位和偏远地区的患者面临更长的出行距离和额外出行。这些发现强调了需要采取战略性转诊措施并开展进一步研究，以优化PRT治疗的公平可及性。
