Radiotherapy treatment patterns in the Netherlands - Insights from the Netherlands Cancer Registry
Jelle Evers is a PhD student in the department Health Technology & Services Research. (Co)Promotors are prof.dr. S. Siesling from the faculty of Behavioural, Management and Social Sciences, dr.ir. M. Aarts, Integraal Kankercentrum Nederland, dr. M. van der Sangen, Catharina Ziekenhuis and prof. H. Struikmans, Leiden University Medical Center.
The thesis provides an overview and tries to explain the nationwide trends and variations of primary radiotherapy use in non-metastatic stages of cancer types often seen at radiotherapeutic facilities: lung cancer – both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), breast cancer – both ductal carcinoma in-situ (DCIS) and invasive breast cancer, prostate cancer, and rectal cancer. The radiotherapy utilization rates were investigated in the broader context of multidisciplinary treatment of these tumor types. Data from the Netherlands Cancer Registry were used to provide these insights.
Changes in treatment driven by novel insights in optimal care were observed; sometimes (rapidly) following treatment guideline adaptions and sometimes preceding guideline adaptions. Other changes in treatment appear mostly driven by technological advancements and developments in healthcare organisation. Furthermore, treatment variations between patients were found, reflecting differences in frailty and probably patient preferences, as well as variations in treatment strategy across the country. Also, treatment variations were associated with hospital-characteristics, which may relate to the available in house-expertise.
Clinicians and policy makers may use these nationwide insights when evaluating treatment patterns involving radiotherapy and finding agreement with each other at a regional or national level. The research was conducted in collaboration with the Netherlands Comprehensive Cancer Organisation (IKNL) and the Dutch Association of Radiation Oncology (NVRO).
