Changes in the use of radiotherapy in Ontario 1984-1995

Purpose: To describe changes in the use of radiotherapy in the management o f cancer in Ontario between January 1, 1984 and December 31, 1995, Methods: A retrospective review of prospectively gathered electronic record s of all radiotherapy for cancer at nine provincial cancer treatment centre s, Results: Over the 12 years of the study, the incidence of cancer increased by 33%, The number of curative and adjuvant courses per incident case incre ased by 39.3% and the number of palliative courses per incident case decrea sed by 15.8%. The mean number of fractions per curative and adjuvant course increased by 13%, and the mean number of fractions per palliative course d ecreased by 22%. The number of curative fractions per incident case increas ed by 63%, and the number of palliative fractions per incident case decreas ed by 32%. The increase in curative workload was mainly due to an increase in the incidence of prostate cancer, to an increase in the number of course s per incident case in breast and prostate cancer, and to an increase in th e number of fractions per curative course in every disease group. The decre ase in palliative workload was due to a decrease in the number of courses p er incident case in most disease groups, and to a decrease in the number of fractions per course in most disease groups. Conclusions: In Ontario, between 1984 and 1995, there was a large shift in workload from palliative radiotherapy to curative radiotherapy. Potential c auses for this phenomenon are discussed. (C) 1999 Elsevier Science Inc.