The management of interruptions to radiotherapy in head and neck cancer: an audit of the effectiveness of national guidelines.
OBJECTIVE
To re-audit national radiotherapy practice in head and neck cancer to assess the effect of new guidelines.


METHODS
A two-part electronic audit assessing departmental policies and the management of interruptions was carried out from April to June 2005. All patients commencing treatment within this audit period were eligible for assessment. The outcome measures were: frequency and causes of interruptions to therapy; policy and compliance with policy for managing interruptions; prolongation; time between first visit to clinic and start of treatment.


RESULTS
Forty-eight out of 57 centres returned data on 631 patients. Overall, 397/631 (63%) patients had one or more treatment interruptions. The causes of interruptions were generally the same as the 2002 audit. Of interrupted cases, 88% completed treatment within 1 day of the target. This is a major improvement on 62% within 1 day in the 2002 audit. Overall, 92% of all cases completed treatment within 1 day of the target and 95% within 2 days in the 2005 audit. There was also an improvement in waiting times; 52% of patients started treatment within the target of 4 weeks compared with 41% from the 2002 data.


CONCLUSIONS
There has been an improvement in the radiotherapy service for head and neck cancer patients with better management of gaps in treatment. Waiting times for radical radiotherapy have shortened, but remain unacceptable.
Cancer Centre, University Hospital Birmingham Foundation Trust, Edgbaston, Birmingham B15 2TH, UK.
N D
ND
James
M V
MV
Williams
E T
ET
Summers
K
K
Jones
B
B
Cottier
D019583:Dose Fractionation, Radiation; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008485:Medical Audit; D011446:Prospective Studies; D018787:Radiation Oncology / Q000592:standards*; D013997:Time Factors