PATTERNS OF RADIOTHERAPY FOR CANCER-PATIENTS IN SOUTH-EASTERN NETHERLANDS, 1975-1989

Radiotherapy patterns were determined in all 34487 cancer patients dia gnosed between 1975 and 1989 in south-eastern Netherlands, a densely p opulated and prosperous area with a greying population of almost 1 mil lion inhabitants. Specialised care was available in 10 community hospi tals with expanding staffs and in a non-academic radiotherapy centre, the distance never exceeding 50 km. With respect to western Europe the cancer incidence rates for this area were relatively high for males a nd average for females during this period. We computed overall and tum our-specific percentages of patients receiving radiotherapy as primary treatment (RTla) and estimated this for initial treatment of recurren ce or metastasis (RTlb). The total number of patients receiving RTla i ncreased by about 2% per year, but age-adjusted figures remained stabl e at 36% for females and increased from 28% to 32% for males. Since 19 86 about 40% of all new cases receive RTla and RTlb and about 40% of a ll RTla undergo secondary radiotherapy for recurrence or metastasis. O f all male and female patients 70% and 50%, respectively, were over 60 . Diverse underlying tumour-specific trends in RTla were observed: chi ldren and adolescents with cancer received RTla less often (25% vs. 40 %) as did patients with cervical (55% vs. 80%), ovarian (9% vs. 17%), small cell lung (25% vs. 55%) and non-melanoma skin cancer (5% vs. 55% ); patients with stage 1 breast (70% vs. 45%), rectal (30% vs. 10%) an d prostate cancer (31% vs 13%) and adenocarcinoma of the lung (40%, vs . 20%) received RTla more often. Despite easy access to specialised ca re, waiting lists for radiotherapy (until 1987) and more diverse refer ral and treatment policies in the non-academic setting may have led to a modest application of radiotherapy.