Cancer Control in New Zealand

Radiation Treatment

The Ministry of Health collects monthly figures on waiting times for radiotherapy from each of the six cancer centres in New Zealand. The categories measured were recommended by the New Zealand Radiation Oncology Advisory Committee. Radiation treatment waiting times data is provided below:

Radiation treatment waiting times data

Information on treatment booking priorities and procedures, from the report of the New Zealand Radiation Oncology Advisory Committee (1999) and Improving Non-Surgical Cancer Treatment Services in New Zealand (2001), is provided below.

See also information on the Reducing Cancer Waiting Times Health Target in the Health Targets section.

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Radiation treatment waiting times data

* Data reported from 1 July 08 uses a different format to previous years

Radiation treatment booking priorities

Priority Category	Good Practice	Maximum acceptable	Criteria	Examples
A. Urgent		Within 24 hours	Patients with rapidly progressive complications of malignancy that require rapid treatment to prevent or minimise severe morbidity or life threat	Spinal cord compression Superior vena cava obstruction Cord equina compression Major life-threatening haemorrhage not amenable to surgical intervention Major upper airways or bronchial obstruction with stridor
B. Curative		Within 2 weeks	Tumours for which radiation treatment usually results in 20 percent or better survival at five years and there is evidence that delay may compromise chance of cure Patient fit to have radical radiation treatment	Head and neck cancer Bladder cancer Carcinoma oesophagus Paediatric cancer High grade Non Hodgkin’s Lymphoma Hodgkin’s Disease Cervix cancer Pre-operative radiation treatment
C. Palliative and other radical	Palliative treatment within 2 weeks or sooner according to severity of symptoms.	Within 4 weeks	Radical or adjuvant radiation treatment where there is no clear evidence that short delays are likely to affect the outcome	Prostate cancer Post operative breast cancer Post operative endometrial cancer Skin cancer Seminoma testis (stage I) Brain tumours
D. Combined chemotherapy and radiation treatment		Start date booked according to treatment schedule	Patients having combined radiation treatment and chemotherapy where safe, effective sequencing of treatment modalities is required Tumours treated according to clinical trial or documented referenced national/international protocols	Anal cancer Oesophageal cancer Bladder cancer Rectal cancer Paediatric cancer Hodgkin’s disease Non-Hodgkin’s lymphoma Patients in clinical trials

Note: When treatment resources do not allow priority C patients to start within four weeks priorities for A, B and D should not change. Priority C patients should be started as soon as possible but could expect delays longer than the accepted maximum of 4 weeks.

Assignment of booking priorities

Careful clinical assessment and judgement is required in assignment of a priority, particularly to categories B and C. When difficult clinical situations exist, consultation in a joint meeting with other specialist colleagues or multidisciplinary clinics is encouraged. Clinical discretion is required assigning a priority category taking into account fitness of patient for treatment, stage of tumour and other prognostic variables. At the present time it is not considered appropriate to use a scoring system for assignment of priority categories.

Procedures for when treatment capacity is insufficient to maintain booking time priorities.

When there is insufficient treatment capacity the recommended times for priorities A and B should not change. Priority D patients should continue to be booked according to their protocol date. Priority C patients would expect delays longer than the maximum of 4 weeks and be started as soon as possible. When there are delays of longer than 6 weeks arrangements for radiation treatment at other centres should be considered for suitable patients.

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Page last updated: 10 December 2008