What will be the radiotherapy machine capacity required for optimal delivery of radiotherapy in Scotland in 2015?

AIMS: Lack of radiotherapy capacity has been cited as a reason for poor cancer outcomes reported in the United Kingdom. This modelling study was conducted to ensure sufficient capacity in the future and to aid health service planning. METHODS: The predicted changes in the incidence of each cancer type to 2015 were calculated using the age-period-cohort technique. To develop the model the indications for radiotherapy now and in 2015 were established, as were the fractionation schedules for each clinical scenario. The optimal radiotherapy utilisation rates and required radiotherapy capacity were estimated for 2005 and for 2015. RESULTS: Cancer incidence is expected to rise by 18.9% by 2015. In Scotland, the estimated optimal radiotherapy utilisation rate during initial management is 44.2-47.9%. The model suggested that currently for optimal delivery, the capacity for 195,300-256,300 fractions is required. Due to predicted changes in the patient population, it is anticipated that requirements will increase to between 276,400 and 354,200 fractions per annum by 2015. Based on the current working practices, this is a 20-54% increase in current capacity, or from 5 to 6-7.6 machines per million head of population. CONCLUSIONS: In order to meet the current and projected demand, a marked increase in the provision of radiotherapy machine capacity will be required in Scotland by 2015.