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Cross T, McPhail S. Prostate Cancer: Diagnosis and Treatment (Supplement): An Assessment of Need [Internet]. Cardiff (UK): National Collaborating Centre for Cancer (UK); 2008 Feb. (NICE Clinical Guidelines, No. 58S.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Prostate Cancer: Diagnosis and Treatment (Supplement)

Prostate Cancer: Diagnosis and Treatment (Supplement): An Assessment of Need [Internet].

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7Radiotherapy

Recording of radiotherapy (RT) is poor on central systems. By collecting usage data from accelerators it is possible to estimate a lower bound on the number of external beam RT procedures. (Figure 7.1). However, some procedures will be missed due to poor recording of the tumour site and/or patient demographics.

Figure 7.1. Number of patients undergoing prostatectomy or at least one external beam Radiotherapy procedure within a year of diagnosis.

Figure 7.1

Number of patients undergoing prostatectomy or at least one external beam Radiotherapy procedure within a year of diagnosis. Patients resident within the SW Government office Region, Hampshire and the Isle of Wight diagnosed 2003–04 only. “NK” (more...)

7.1. Radiotherapy by patient grade

Radical and palliative RT procedures are not distinguished. However the large number of RT procedures carried out on patients with Gleason score 6 and 7 tumours suggests that radical RT is a more common treatment than prostatectomy.

7.2. Variation in dose and fractions in external beam radiotherapy

Tables 7.1 and 7.2 show the variation in prescribed dose and number of fractions in external beam radiotherapy treatment of prostate cancers in a sample of five NHS trusts in the South West Government office Region. Treatment occurred in 2003 or 2004. Caution should be used in interpreting this data as there is likely to be significant under-ascertainment. However the trusts do show clear differences in the patterns of dose and fractionation, indicating a variation in practice.

Table 7.1. Dose (Grays) administered per course of external beam radiotherapy for a sample of prostate cancer treatments in five NHS trusts in the South West Government office Region, 2003–2004.

Table 7.1

Dose (Grays) administered per course of external beam radiotherapy for a sample of prostate cancer treatments in five NHS trusts in the South West Government office Region, 2003–2004.

Table 7.2. Number of fractions per course of external beam radiotherapy for a sample of prostate cancer treatments in five NHS trusts in the South West Government office Region, 2003–2004.

Table 7.2

Number of fractions per course of external beam radiotherapy for a sample of prostate cancer treatments in five NHS trusts in the South West Government office Region, 2003–2004.

A patient’s treatment may be delivered in multiple courses. Figure 7.2 shows the total dose delivered to patients in the five trusts between 2003 and 2004. 61% received a total dose between 0 and 49 Grays, 35% a dose between 50 and 79 Grays, and 4% a total dose in excess of 80 Grays over the two years. Lack of recording of patient demographic data may prevent the total for each patient from being correctly recorded, leading to a bias in favour of lower total doses. However the variation in the total for doses over 50 Gray indicates a variation in practice for radical radiotherapy.

Figure 7.2. Total dose delivered to prostate cancer patients in five NHS trusts, 2003–2004.

Figure 7.2

Total dose delivered to prostate cancer patients in five NHS trusts, 2003–2004. Data source: RES data provided by NATCanSAT

Copyright © 2008, National Collaborating Centre for Cancer.
Bookshelf ID: NBK49415

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