Health Services Research

PV QA 3 - Poster Viewing Q&A 3

TU_41_3004 - Contemporary fractionation trends within a large United States academic radiation oncology department

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Contemporary fractionation trends within a large United States academic radiation oncology department
S. Schroeder1, H. Wilhelm1, C. Wallace1, K. Rodgers1, M. H. Lin1, A. Pompos1, S. B. Jiang1, D. J. Sher1, R. D. Timmerman1, and H. Choy2; 1Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, 2University of Texas – Southwestern Medical Center, Department of Radiation Oncology, Dallas, TX

Purpose/Objective(s): Recent clinical trials have demonstrated efficacy for hypofractionated external beam treatment, including stereotactic ablative radiotherapy (SABR), across multiple disease sites (i.e. breast, prostate, and lung). While recent trends in fractionation use for individual disease sites have been previously reported, the overall effect of hypofractionation in terms of practice patterns within an individual treatment center has not been described. Here, we report modern fractionation patterns at an academic radiation oncology center providing comprehensive treatment.

Materials/Methods: We reviewed patient procurement data at our institution from 2006 to 2017 including mean number of radiation treatment fractions per treatment course. To assess changes in practice patterns over this period, fractionation trends for individual disease-oriented treatment sites and treatment intent (definitive vs. palliative) were also analyzed.

Results: In 2006, the mean number of fractions per treatment course was 23.0 and progressively decreased to 16.1 fractions in 2017 (Table 1). To determine the impact of treatment intent on treatment course length, definitive and palliative cases were analyzed separately and decreased from 25.7 to 20.6 and 12.5 to 5.9 fractions, respectively. Within individual disease sites (definitive treatment only), the mean number of fractions per course from 2006-2008 compared to 2015-2017 decreased most dramatically for CNS (24.0 to 11.2) and lung (19.1 to 13.5) treatments. Over the same period, the change in mean number of fractions for head and neck treatments was minimal (27.5 to 26.7).

Conclusion: Overall, the average number of fractions per treatment course decreased by 30% from 2006 to 2017; this trend was appreciated for both definitive and palliative treatments. In terms of individual disease sites, fractionation for CNS treatments decreased most dramatically primarily because of increased utilization of stereotactic treatment; lung treatments also decreased substantially. Hypofractionation confers a number of potential advantages compared to conventional fractionation including improved treatment efficacy, increased patient convenience, and decreased treatment cost. Additional research is needed to examine fractionation patterns and implications for patient care on a national level. Table 1:
Mean number of fractions per treatment course: 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
All treatments 23.0 22.7 21.2 21.5 21.2 21.6 19.4 18.9 18.0 16.5 15.8 16.1
Definitive 25.7 25.7 23.7 24.5 24.6 25.3 22.6 23.0 21.9 20.5 19.7 20.6
Palliative 12.5 11.0 10.2 10.1 8.0 10.1 9.1 8.0 8.1 7.5 6.3 5.9

Author Disclosure: S. Schroeder: Employee; Baylor College of Dentistry. H. Wilhelm: None. K. Rodgers: Employee; Medical City Dallas. M. Lin: None. A. Pompos: None. S.B. Jiang: Patent/License Fees/Copyright; Sun Nuclear. R.D. Timmerman: Research Grant; Varian Medical Systems, Accuray, Inc, Elekta Oncology. H. Choy: Research Grant; Celegene. Advisory Board; EMD, Bayer.

Samuel Schroeder, MD

Presentation(s):

Send Email for Samuel Schroeder


Assets

TU_41_3004 - Contemporary fractionation trends within a large United States academic radiation oncology department



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Contemporary fractionation trends within a large United States academic radiation oncology department