S1403
Interdisciplinary - Health economics & health services research
ESTRO 2026
breast, melanoma, lung, and colorectal) were constructed based on national and international guidelines published between 2020 and 2025. Proportions of patients with an indication 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 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 major cancers was estimated at 46.8% with an estimated optimal number of fractions per patient of 7.5, based on the updated evidence-based guidelines (Table 1). Radiotherapy indications were highest in breast cancer (80.4%) followed by lung (65.3%), prostate (48.7%), colorectal (16%) and melanoma (13.6%). Breast and prostate cancers had the highest average number of fractions per patient. Conclusion: This study provides an updated benchmark for optimal radiotherapy use in major cancers in Australia. Evolving indications, systemic therapies, and radiotherapy techniques have influenced radiotherapy utilisation and number of fractions. The model can be adapted to different populations to evaluate access, efficiency, and cost-effectiveness, supporting 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 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: Optimal, radiotherapy, fractions, cancer
Radiotherapy, Activity Planning Group. Radiotherapy activity planning for Scotland 2001–2015.4. Wong, K., G.P. Delaney, and M.B. Barton. Radiother Oncol, 2016. 119(1): p. 145-9.5. Barton, M.B., et al. Radiother Oncol, 2014. 112(1): p. 140-4.6. Delaney, G., et al. Cancer, 2005. 104(6): p. 1129-37. Keywords: Optimal, radiotherapy, prostate cancer
Digital Poster Highlight 2440
optimal radiotherapy use in top five cancers: updated models of utilisation and fraction numbers in the era of stereotactic and molecular oncology 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: Cancer is the second leading cause of death worldwide. The most common cancers include prostate, breast, melanoma, lung and colorectal cancer, which account for almost half of the cancer diagnoses in Australia and other Western countries. Radiotherapy remains a cornerstone in cancer care despite population-based screening and improvements in precision medicine and targeted therapies. Advances in radiotherapy including image- guidance, stereotactic body radiotherapy, and dose escalation have improved accuracy, safety, and expanded its therapeutic role, especially in early-stage lung cancer and select oligometastatic disease, transforming treatment paradigms. Accurate estimates of radiotherapy demand are essential for service planning [1-3]. The overall optimal radiotherapy utilisation rate was previously estimated at 48.3%, with an average of 9.4 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 for major cancers incorporating modern 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]. Optimal radiotherapy decision trees for the five most common cancers (prostate,
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