The Use of Radiotherapy in the Cure of Different Cancers - Further Results From the FORTY (Favourable Outcomes From RadioTherapY) Project

Abstract

Aims

Overall, almost 40% of patients surviving 5 years are estimated to have received radiotherapy (RT). The utilisation of RT for individual tumour types in 5-year survivors was examined.

Materials and methods

Patient-level data on RT utilisation in cancer patients in England were analysed. Patient, tumour, and treatment event data were obtained for the 5-year period 2009–2013, together with 5-year individual patient survival (to 2018 ie pre Covid-19 pandemic). All tumour sites (excluding C44) and ages were included. 5-year survivors (n = 537,970) were divided into 22 tumour sites, plus a category of ‘Other’ (5% of patients) where tumour site was unknown, leaving 508,753 with known tumour site diagnosis.

Results

Overall cancer-specific 5-year survival was 52%. Of the 5-year survivors with definite tumour site diagnosis, 200,269 (39%) received RT. Breast cancer accounted for 50% of RT patients, prostate 24%. 75% of breast cancer 5-year survivors received RT, 65% of head and neck patients, 49% of rectum, 49% of central nervous system (CNS), and 43% of prostate patients. 25% of lymphoma 5-year survivors received RT. Only 29% of lung cancer 5-year survivors received RT. In 6 tumour sites (pancreas, leukaemia, kidney, colon, ovary, and melanoma), <5% of patients (n = 3981, 2%) received RT. Excluding these, 50% of 5-year survivors received RT.

Conclusions

RT contributes significantly to 5-year survival. RT was delivered to 50% of 5-year survivors in tumour sites where RT is utilised for ≥5% of patients. Including the additional tumour sites where RT is used rarely, RT was delivered to almost 40% of patients. We recommend that this exercise is repeated regularly. This 50% figure emphasises the importance of RT. It is critical for service planning and public health messaging. It should be noted for the development of the new cancer plan.