Feasibility and appropriateness of implementing satellite radiotherapy centres equipped with a single linear accelerator

Radiotherapy is an important component of the therapeutic arsenal for cancer. It is estimated that radiotherapy is indicated in slightly more than 50 % of cancer patients at some point during their disease. In Québec, radiotherapy services are presently offered in 12 centres located in 9 of the 16 administrative regions. These services are usually set up in large urban centres. Cancer patients who live in remote areas therefore have to travel long distances from their home and family to be treated with radiotherapy.

To improve access, the Direction générale de cancérologie (DGC) asked to INESSS to examine the appropriateness and feasibility of implementing single-machine satellite radiotherapy centres in certain regions of Québec, specifically, Abitibi-Témiscamingue, the Côte-Nord and the Gaspésie/Îles-de-la-Madeleine.

A review of the literature and of the experience of a few centres established elsewhere in Canada and around the world confirms that the implementation of single-machine radiotherapy centres capable of providing safe, quality treatments is a feasible undertaking. However, this option entails certain difficulties that need to be overcome and certain precautions. The main issues specific to single-machine satellite radiotherapy centres reside in the difficulty ensuring personnel and equipment redundancy to permit the continuity of services.

The success of a satellite radiotherapy centre also depends on several contextual elements, such as patient volume, the existing oncological services at the hospital onto which the centre would be added, the distribution of the population on the territory, and the impact that opening a satellite centre might have on the patient volume at the centres currently treating these patients.

The implementation of satellite radiotherapy centres in the regions could help relieve the significant burden that patients have to bear in order to be treated.