Distance to Radiotherapy and Demand – Projection of the Effects of Establishing New Radiotherapy Facilities in Poland by 2025

Adam Michał Czerwiński

doi:10.2478/ceej-2018-0002

Figures & Tables

Linear accelerator locations in 2012 and 2016 and planned locations in 2025

Observed overall EBRT utilisation rate (a), and fitted values of the best overall EBRT utilisation spatial model (standard(1),power*) in 2012 with trend and signal (b), in 2012 with trend (c) and in 2025 with trend (d)

Fitted EBRT utilisation rates of the best overall and cancer-specific models in relation to their respective distance measures

Projected change of expected EBRT utilisation rates for counties between 2012 (trend) and 2025 according to the best overall spatial model

Results of the cancer-specific models with the best fit according to the AIC

EBRT utilisation rate		Central nervous System	Lower gastrointestinal tract	Female genital organs	Head and neck	Breast	Trachea, bronchus and lung	Prostate	Other

Distance Functional measure form		standard(3) power	standard(1) exponential*	gravitational(3) exponential	gravitational(3) exponential	standard(1) exponential	standard(2) exponential*	standard(1) power	gravitational(1) exponential
ß0	Coefficient	0.710	0.269	0.438	0.681	0.618	0.466	0.620	0.258
	Cl(95%)	(0.521,0.900)	(0.244,0.285)	(0.388,0.487)	(0.617,0.745)	(0.583,0.652)	(0.415,0.517)	(0.543,0.697)	(0.232,0.284)
	p-value (Wald)	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
y1	Coefficient	-0.073	-0.0008	-0.005	-0.008	-0.0011	-0.0011	-0.020	-0.004
	CI(95%)	(-0.117, -0.030)	(-0.0011,-0.0003)	(-0.008,-0.001)	(-0.012,-0.003)	(-0.0017,-0.0004)	(-0.0017,-0.0003)	(-0.040, -0.0003)	(-0.006, -0.002)
	p-value (Wald)	0.001	<0.001	0.005	<0.001	<0.001	0.003	0.046	<0.001
*ind*	Coefficient	-	-0.037	-	-	-	0.056	-	-
	CI (95%)	-	(-0.072,-0.001)	-	-	-	(0.017,0.095)	-	-
	p-value (Wald)		0.044	-	-	-	0.005		-
A	Coefficient	-0.132	0.356	0.321	0.270	0.373	0.560	0.486	0.682
	Cl (95%)	(-0.288, 0.022)	(0.227,0.485)	(0.189,0.452)	(0.134,0.405)	(0.245,0.500)	(0.452,0.666)	(0.370,0.601)	(0.593,0.772)
	p-value (Wald)	0.104	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
AIC		-186.87	-822.05	-536.84	-297.09	-487.41	-670.97	-193.55	-980.25
AlC(linear)		-186.26	-796.21	-517.20	-248.70	-456.69	-579.02	-141.71	-822.23
SRMSE		0.474	0.347	0.315	0.281	0.218	0.238	0.327	0.281

Prognosis results for 2025

Model	Base-case utilisation	Prognosis utilisation	Utilisation change (%)
Overall	0.453	0.466	+3.05
Cancer-specific	0.464	0.479	+3.15
Central nervous system	0.510	0.542	+6.30
Lower gastrointestinal tract	0.268	0.273	+1.95
Female genital organs	0.461	0.479	+3.88
Head and neck	0.813	0.828	+1.88
Breast	0.801	0.819	+1.33
Trachea, bronchus and lung	0.523	0.561	+7.30
Prostate	0.770	0.774	+0.46
Other	0.261	0.270	+3.74

Malignant neoplasm groups defined for the purpose of cancer-specific utilisation rates

	Cancer group	ICD-10*	Utilisation rate in 2012	Counties with 0 courses in 2012
1.	Central nervous system	C70-C72	0.493	18
2.	Melanoma of skin	C43	0.260	108
3.	Head and neck	C00-C14, C30-C32	0.799	2
4.	Trachea, bronchus and lung	C33, C34	0.520	0
5.	Breast	C50, D05	0.787	0
6.	Lower gastrointestinal tract	C18-C21	0.264	2
7.	Upper gastrointestinal tract	C15, C16, C22-26	0.138	41
8.	Prostate	C61	0.717	3
9.	Female genital organs	C53, C54, C56, C57	0.458	3
10.	Kidney	C64-C66	0.159	83
11.	Bladder	C67	0.157	78
12.	Thyroid	C73	0.870	210
13.	Testicle	C62	0.136	211
14.	Other	C17, C37-C41, C45-C49, C51, C52, C55, C58, C60, C63, C68, C69, C74-C80, C97	0.547	1

Comparison of the results of the SEM and OLS overall EBRT utilisation models with the best fit according to the AIC criterion

Distance measure Functional form Model version			standard(1) power*
		SEM	OLS
β₀	Coefficient	0.452	0.501
	CI( 95%)	(0.405, 0.498)	(0.461, 0.540)
	p-value (Wald)	<0.001	<0.001
γ₁	Coefficient	-0.024	-0.038
	CI( 95%)	(-0.035, -0.012)	(-0.048, -0.027)
	p-value (Wald)	<0.001	<0.001
*ind*	Coefficient	-0.046	-0.086
	CI( 95%)	(-0.085, -0.008)	(-0.132, -0.040)
	p-value (Wald)	0.018	<0.001
λ	Coefficient	0.710	-
	CI(95%)	(0.625, 0.795)	-
	p-value (Wald)	<0.001	-
AIC		−1,247.33	−1,062.53
SRMSE		0.120	0.163
Projected utilisation rate (2025)		0.466	0.473

Distance to Radiotherapy and Demand – Projection of the Effects of Establishing New Radiotherapy Facilities in Poland by 2025

Figures & Tables

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Results of the cancer-specific models with the best fit according to the AIC

Prognosis results for 2025

Malignant neoplasm groups defined for the purpose of cancer-specific utilisation rates

Comparison of the results of the SEM and OLS overall EBRT utilisation models with the best fit according to the AIC criterion

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