S1402
Interdisciplinary - Health economics & health services research
ESTRO 2026
patients for whom radiotherapy is indicated. The overall optimal number of fractions was determined by weighting each fractionation schedule according to the frequency of specific clinical scenarios. Sensitivity analyses were performed to assess impact of uncertainties on model estimates. Results: The optimal radiotherapy utilisation in prostate cancer was estimated to be 48.7% (range 46.6% - 52.1%) with an estimated optimal number of fractions per patient of 10.8 (range 6.7-17.2), based on the updated evidence-based guidelines (Figures 1 and 2). When stratified by NCCN risk category, radiotherapy would be recommended in 2.2% of low-risk, 48.5% of intermediate-risk, 73.4% of high-risk, 87.5% of regional nodal, and 36.7% of metastatic patients, with estimated optimal number of fractions per patient of 0.3, 11.1, 17.1, 16.9 and 8.81, respectively.
75(3): p. 355-65.3.Scottish Executive Health Department and Radiotherapy, Activity Planning Group. Radiotherapy activity planning for Scotland 2001–2015.4.Barton, M.B., et al . Radiother Oncol, 2014. 112(1): p. 140-4.5.Wong, K., G.P. Delaney, and M.B. Barton. Radiother Oncol, 2016. 119(1): p. 145- 9.6.Delaney, G., et al. Cancer, 2005. 104(6): p. 1129-37. Keywords: Radiotherapy, Optimal, Colorectal Cancer
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estimating the optimal use of radiotherapy in prostate cancer: updated model of utilisation and number of fractions in contemporary practice Anzela Anzela 1,2 , Karen Wong 1,2 , Mei Ling Yap 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 Purpose/Objective: Prostate cancer is the most commonly diagnosed cancer in men and the most prevalent cancer overall in Australia. The landscape of prostate cancer radiotherapy has rapidly evolved with the adoption of novel fractionation schedules, expanded role of stereotactic radiotherapy in oligometastatic disease and the availability of robust long-term clinical data. Modelling of optimal, evidence-based radiotherapy is important for resource planning and benchmarking [1- 3]. The optimal radiotherapy utilisation rate for prostate cancer was previously estimated to be 58.4% with an average of 16.3 fractions per patient [4, 5]. This study aims to update the Australian model of optimal radiotherapy utilisation (RTU) and number of fractions (RTF) for the first course of radiotherapy in prostate cancer to incorporate contemporary staging and evidence-based guideline 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 [4-6]. An optimal radiotherapy decision tree for prostate cancer was constructed based on national and international guidelines published between 2020 and 2025. Proportion of patients with indications for radiotherapy were derived primarily from Australian population-based data. Guideline- recommended fractionation schedules were assigned to each indication. The optimal radiotherapy utilisation rate was determined by calculating the proportion of
Conclusion: The estimated optimal radiotherapy utilisation and number of fractions per patient in prostate cancer are lower compared to the previous modelling. This study provides an updated benchmark for the optimal use of radiotherapy in prostate cancer to support efficient resource planning. The model can be adapted to different populations to evaluate access, efficiency, and cost-effectiveness, helping guide equitable and evidence-based radiation oncology care. References: 1. Barton MB, F.M., Olver I, Cox X, et al, A cancer services framework for Victoria and future directions for the Peter MacCallum Cancer Institute. A report from a consortium led by the Collaboration for Cancer Outcomes Research and Evaluation (CCORE).2. Bentzen, S.M., et al. Radiother Oncol, 2005. 75(3): p. 355-65.3. Scottish Executive Health Department and
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