title: Patterns of retreatment with radiotherapy in a large academic centre.
abstract: OBJECTIVE
  To characterise retreatment rates with radiotherapy at a large multifacility academic radiotherapy centre and assess the effect of distance on retreatment rate.
  
  
  METHODS
  Electronic administrative records were reviewed for patients receiving radiotherapy between 1998 and 2010 at regional and metropolitan facilities. Course-level data were reconstructed from electronic administrative databases. Intent of therapy, treatment dates and diagnosis were available for analysis. Retreatment characteristics were derived, including proportion of patients receiving retreatment, proportion of total radiotherapy prescriptions dedicated to retreatment and retreatment per treating facility. Travel distance for each patient to their treatment centre was estimated, and retreatment rates were reported as a function of increasing distance.
  
  
  RESULTS
  A total of 48 200 patients were treated with 66 277 treatment courses during the study period. Retreatment courses constituted 25.2% of all courses prescribed. During the study period, 20.4% of all patients received at least one treatment course. Of these, the average number of retreatment courses prescribed was 1.84. Patients treated with radical intent had a retreatment rate of 13% compared with 45% for those treated initially with palliative intent. Retreatment rates in individual tumour sites ranged from 1.3 to 44.4%. The retreatment rate for those living less than 100 km from treatment facility was 24.8%, and 20.5% for those living more than 100 km from treatment centre (P < 0.001) CONCLUSION: Retreatment accounted for over one quarter of radiotherapy courses, with the rate influenced by casemix and follow-up duration. With increasing distance from treatment centre, a decrease in retreatment rate was observed.
authors.affiliation: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Khor
authors.forename: Mathias
authors.initials: M
authors.lastname: Bressel
authors.forename: Keen Hun
authors.initials: KH
authors.lastname: Tai
authors.forename: David
authors.initials: D
authors.lastname: Ball
authors.forename: Gillian
authors.initials: G
authors.lastname: Duchesne
authors.forename: William
authors.initials: W
authors.lastname: Rose
authors.forename: Jo
authors.initials: J
authors.lastname: Tedesco
authors.forename: Suki
authors.initials: S
authors.lastname: Gill
authors.forename: Claire
authors.initials: C
authors.lastname: Fitzpatrick
authors.forename: Farshad
authors.initials: F
authors.lastname: Foroudi
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology
keywords: access; health service; radiotherapy; retreatment; utilisation