Background:The Alan Walker Cancer Care Centre, Darwin (AWCCC) has provided chemo-radiotherapy services for the Northern Territory since 2010. Its remoteness presents unique challenges in coordinating and completing treatment within a satisfactory time period, where multi-disciplinary and interstate care is needed. A comparable paper of note - Management Pathway for Patients with Cervical Cancer in the Auckland Region 2003–2007, Capelle et al. 2011.
Aim: This audit examined cervical and endometrial cancer care in a service where visiting gynaecological surgeons, brachytherapists and positron emission tomography (PET) is required with reference to National Comprehensive Cancer Guidelines version 2.2013, 2012, which recommends completing radiotherapy for cervical cancer within 56 days.
Methods:An audit was undertaken of all patients with cervical or uterine cancer who received curative intent external beam radiotherapy (EBRT) at the AWCCC between 2010 and 2012. Clinico-pathological data was collected with timeline milestones. The mean time between diagnosis and treatment milestones was calculated.
Results:13 cervical and 7 uterine cases were identified. Mean time from biopsy to PET = 14.8 days. Mean times are from: biopsy to multidisciplinary team meeting (MDT) = 39.3 days; MDT to starting EBRT = 40.7 days; biopsy to radiotherapy completion = 127.2 days; starting EBRT to brachytherapy completion = 63.8 days and starting EBRT to brachytherapy completion for cervical cancer alone = 60 days [range: 33 to 92 days]. Mean EBRT duration 41.2 days. Median time from start EBRT to completion of all radiotherapy for all cases and cervical group alone = 54 days
Conclusions: AWCCC has overcome challenges of remoteness to complete radiotherapy protocols for gynaecological cancer and, more specifically for cervical cancer within a satisfactory time. It has succeeded in coordinating interstate multidisciplinary care between EBRT in Darwin and, interstate visiting surgeons, brachytherapists and PET. Quality care can be successfully provided in remote cancer centres.