S1399
Interdisciplinary - Health economics & health services research
ESTRO 2026
[1]Scottish Index of Multiple Deprivation 2020. The Scottish Government. https://www.gov.scot/collections/scottish-index-of- multiple-deprivation-2020/(04/11/2025)[2]Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA. 2004 Jun 9;291(22):2720-6. doi: 10.1001/jama.291.22.2720. PMID: 15187053.[3] Baiu I, Titan AL, Martin LW, Wolf A, Backhus L. The role of gender in non-small cell lung cancer: a narrative review. J Thorac Dis. 2021 Jun;13(6):3816-3826. doi: 10.21037/jtd-20-3128. PMID: 34277072; PMCID: PMC8264700. Keywords: Health Inequalities, Clinical Trials estimating the optimal use of radiotherapy in breast cancer: updated model of utilisation and number of fractions in contemporary practice Anzela Anzela 1,2 , Mei Ling Yap 1,2 , Karen Wong 1,2 , Vikneswary Batumalai 2,3 , Geoff Delaney 1,2 1 Liverpool and Macarthur Cancer Therapy Centre, South Western Local Health District, Liverpool, NSW, Australia. 2 Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute, Liverpool, NSW, Australia. 3 The George Institute for Global Health, UNSW Sydney, Randwick, NSW, Australia Digital Poster 2402 Purpose/Objective: Breast cancer is the most commonly diagnosed malignancy among females, and radiotherapy remains a fundamental component of its management. Recent advances in fractionation schedules, radiotherapy techniques, selective omission, and the evolving role of radiotherapy in oligometastatic disease have reshaped treatment paradigms. Modelling of optimal, evidence-based radiotherapy is important for resource planning and benchmarking [1-3]. The optimal radiotherapy utilisation rate for breast cancer was previously estimated to be 87% with an average of 14.4 fractions per patient [4-6]. This study aims to update the Australian model of optimal radiotherapy utilisation (RTU) and number of fractions (RTF) for first course of radiotherapy in breast cancer to reflect changes in staging and contemporary evidence-based guidelines recommendations. Material/Methods: This study utilised the Collaboration for Cancer Outcomes Research and Evaluation (CCORE) model of optimal radiotherapy utilisation and number of fractions initially developed in 2003 and updated in 2012 and 2015 [4, 5, 7]. An optimal radiotherapy decision tree for breast cancer was constructed based on national and international guidelines published
were narrowly attenuated upon multivariable adjustment (Male vs Female OR=1.32; 95%CI 0.96, 1.83). When cross-tabulated, sex differences were associated with varying subsite presentation and treatment intent (P < 0.001).
There were no associations observed between trial participation and area-based socioeconomic status SIMD-1 vs SIMD-5 (OR=0.94; 95%CI 0.62, 1.42). Similarly, an increased travel time to the cancer centre was not a predictor of trial participation (5-minute travel time increase OR=0.99; 95% CI 0.97, 1.02). These findings largely persisted across the study subgroup analysis.
Conclusion: While patients from the most socioeconomically deprived areas experience a disproportionate HNC burden, this study found no association between trial participation and the socioeconomic deprivation level of the patient’s home residence or cancer centre travel time. Disparities in age between the TC and CC may reflect patient fitness/co-morbidities and is not unexpected. Under representation of women in clinical trial participation has been previously reported and should be further explored and addressed. [2-3] References:
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