title: Variations in radiotherapy delivery in England - evidence from the national radiotherapy dataset.
abstract: Data in the national radiotherapy dataset for England for 2009-2011 is based upon downloads of activity from every linear accelerator in the country through its oncology management system linked to the local patient administration system to give a full overview of each patient episode.
  
  
  RESULTS
  An analysis of this dataset shows that there is still a considerable variation in radiotherapy activity across the country, with a two-fold variation between the most and least active networks. Lower activity is seen in London and the southeast compared with the rest of the country, but when the data are split between the north and south of the country, no such variation is seen. Activity is higher in smaller centres and non-teaching centres. About half of all treatment is palliative and this proportion does not vary with geography, although there is considerable variation between individual centres in the proportion of radical radiotherapy given. There is a trend towards less use of radiotherapy, both radical and palliative, in the more deprived population groups, although no change in the relative use of palliative and radical treatment.
  
  
  CONCLUSIONS
  It is important to emphasise that these data currently reflect activity patterns only and do not reflect quality of care or treatment outcomes, which will be achieved by linkage with cancer registry data in the future.
authors.affiliation: Mount Vernon Cancer Centre, Northwood, UK. peterhoskin@nhs.net
authors.forename: P J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: H
authors.initials: H
authors.lastname: Forbes
authors.forename: C
authors.initials: C
authors.lastname: Ball
authors.forename: D
authors.initials: D
authors.lastname: Riley
authors.forename: T
authors.initials: T
authors.lastname: Cooper
authors.forename: D
authors.initials: D
authors.lastname: Tait
authors.forename: K
authors.initials: K
authors.lastname: Duxbury
authors.forename: K
authors.initials: K
authors.lastname: Lloyd
authors.forename: S
authors.initials: S
authors.lastname: Tozer-Loft
authors.forename: A
authors.initials: A
authors.lastname: Murphy
authors.forename: P
authors.initials: P
authors.lastname: Kirkbride
authors.forename: T
authors.initials: T
authors.lastname: Murphy
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Francis
authors.forename: I
authors.initials: I
authors.lastname: Locke
authors.forename: K
authors.initials: K
authors.lastname: Fell
authors.forename: T
authors.initials: T
authors.lastname: Parker
authors.forename: C
authors.initials: C
authors.lastname: Beardmore
mesh_terms: D004739:England; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators; D011878:Radiotherapy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Deprivation; England; linear accelerator; population; radiotherapy; regions