Clinical and Translational Oncology

, Volume 19, Issue 2, pp 204–210 | Cite as

Demand for radiotherapy in Spain

  • A. RodríguezEmail author
  • J. M. Borrás
  • J. López-Torrecilla
  • M. Algara
  • A. Palacios-Eito
  • A. Gómez-Caamaño
  • L. Olay
  • P. C. Lara
Research Article



Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it.

Material and methods

We used data from the European Cancer Observatory on the estimated incidence of cancer in Spain in 2012, along with the evidence-based indications for radiotherapy developed by the Australian CCORE project, to obtain an optimal radiotherapy utilisation proportion (OUP) for each tumour.


About 50.5 % of new cancers in Spain require radiotherapy at least once over the course of the disease. Additional demand for these services comes from reradiation therapy and non-melanoma skin cancer. Approximately, 25–30 % of cancer patients with an indication for radiotherapy do not receive it due to factors that include access, patient preference, familiarity with the treatment among physicians, and especially resource shortages, all of which contribute to its underutilisation.


Radiotherapy is underused in Spain. The increasing incidence of cancer expected over the next decade and the greater frequency of reradiations necessitate the incorporation of radiotherapy demand into need-based calculations for cancer services planning.


Radiotherapy-demand Optimal utilization Evidence-based practice Planning Spain 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.


  1. 1.
    Lievens Y, Borras JM, Grau C. Cost calculation: a necessary step towards widespread adoption of advanced radiotherapy technology. Acta Oncol. 2015;54:1275–84.CrossRefPubMedGoogle Scholar
  2. 2.
    Norlund A. Cost of radiotherapy. Acta Oncol. 2003;42:411–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Borras JM, Lievens Y, Grau C. The need for radiotherapy in Europe in 2020: not only data but also a cancer plan. Acta Oncol. 2015;54:1268–74.CrossRefPubMedGoogle Scholar
  4. 4.
    Delaney G, Jacob S, Featherstone C, Barton MB. The role of radiotherapy in cáncer treatment. Estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer. 2005;104:1129–37.CrossRefPubMedGoogle Scholar
  5. 5.
    Bentzen SM, Heeren G, Cottier B, Slotman B, Glimelius B, et al. Towards evidence-based guidelines for radiotherapy infrastructure and staffing needs in Europe: the ESTRO QUARTS project. Radiother Oncol. 2005;75:355–65.CrossRefPubMedGoogle Scholar
  6. 6.
    Barton MB, Jacob S, Shafiq J, Wong K, Thompson SR, Hanna TP, Delaney G. Estimating the demand for radiotherapy from the evidence: a review of changes from 2003 to 2012. Radiother Oncol. 2014;112:140–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Grau C, Dofourney N, Malicki J, Dunscombe P, Borras JM, Coffey M, et al. Radiotherapy equipment and departments in the European countries: final results from the ESTRO-HERO survey. Radiother Oncol. 2014;112:155–64.CrossRefPubMedGoogle Scholar
  8. 8.
    Lievens Y, Defourny N, Coffey M, Borras JM, Dunscombe P, Slotman B, et al. Radiotherapy staffing in the European countries: final results from the ESTRO-HERO survey. Radiother Oncol. 2014;112:178–86.CrossRefPubMedGoogle Scholar
  9. 9.
    Borras JM, Lievens Y, Dunscombe P, et al. The optimal utilization proportion of external beam radiotherapy in European countries: an ESTRO HERO analysis. Radiother Oncol. 2015;116:38–44.CrossRefPubMedGoogle Scholar
  10. 10.
    Poortmans P, Valentini V, Lievens Y. Expanding Global access to radiotherapy: the European Society for Radiotherapy and Oncology perspective. Lancet Oncol. 2015;16:1149.CrossRefGoogle Scholar
  11. 11.
    Steliarova-Foucher E, O’Callaghan M, Ferlay J, Massuyer E, Rosso S, Forman D, et al. The European cancer observatory: a new data resource. Eur J Cancer. 2015;51:1131–43.CrossRefPubMedGoogle Scholar
  12. 12. Accessed 8 May 2016.
  13. 13. Accessed 8 May 2016.
  14. 14.
    Borras JM, et al. How many new cancer patients in Europe will require radiotherapy by 2025? an ESTRO-HERO analysis. Radiother oncol. 2016;119(1):5–11. doi: 10.1016/j.radonc.2016.02.016 [Epub 2016 Feb 24].CrossRefPubMedGoogle Scholar
  15. 15.
    Tyldesley S, Boyd C, Schulze K, Walter H, Mackillop W. Estimating the need for radiotherapy for lung cancer: an evidence-based epidemiological approach. Int J Radiat Oncol Biol Phys. 2001;49:973–85.CrossRefPubMedGoogle Scholar
  16. 16.
    Jena R, Round C, Mee T, Kirkby NF, Cooper T, Hoskin P, Jena R. The Malthus model: a new tool for estimating radiotherapy demand at local level. Clin Oncol. 2012;23:1–3.CrossRefGoogle Scholar
  17. 17.
    Wong K, Delaney G, Barton MB. Evidence-based optimal number of radiotherapy fractions for cancer: a useful tool to estimate radiotherapy demand. Radiother Oncol. 2015;116(2):174–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Ingham Institute for Applied Medical Research (IIAMR)- Collaboration for Cancer Outcomes Research and Evaluation (CCORE). Review of optimal radiotherapy utilisation rates. CCORE report; 2013. Available from: (accessed 26-11-2014).Google Scholar
  19. 19.
    Van de Werf E, Verstraete J, Lievens Y. The cost of radiotherapy in a decade of technology evolution. Radiother Oncol. 2012;102:148–53.CrossRefPubMedGoogle Scholar
  20. 20.
    Slotman B, Vos P. Planning of radiotherapy capacity and productivity. Radiother Oncol. 2013;106:266–70.CrossRefPubMedGoogle Scholar
  21. 21.
    Barton MB, Allen S, Delaney GP, et al. Patterns of retreatment by radiotherapy. Clinical Oncol. 2014;26:611–8.CrossRefGoogle Scholar
  22. 22.
    Popovic M, den Hartog M, Zhang L, et al. Review of international patterns of practice for the treatment of painful bone metastases with palliative radiotherapy from 1993 to 2013. Radiother Oncol. 2014;111:11–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Esco R, Palacios A, Pardo J, et al. Infrastructure of radiotherapy in Spain: a minimal standard of radiotherapy resources. Int J Radiat Oncol Biol Phys. 2003;56(2):319–27.CrossRefPubMedGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2016

Authors and Affiliations

  1. 1.Department of Radiation OncologyHospital Ruber InternacionalMadridSpain
  2. 2.Universidad de Barcelona, IDIBELLBarcelonaSpain
  3. 3.Department of Radiation OncologyERESA Hospital General UniversitarioValenciaSpain
  4. 4.Department of Radiation OncologyHospital de la EsperanzaBarcelonaSpain
  5. 5.Universitat Pompeu FabraBarcelonaSpain
  6. 6.Department of Radiation OncologyHospital Universitario Reina SofíaCórdobaSpain
  7. 7.Department of Radiation OncologyHospital Clínico Universitario Santiago de CompostelaSantiago de Compostela, La CoruñaSpain
  8. 8.Department of Radiation OncologyHospital Universitario Central de Asturias (HUCA)OviedoSpain
  9. 9.Department of Radiation OncologyHospital Universitario Dr NegrínLas PalmasSpain
  10. 10.Clinical Oncology, Universidad de Las PalmasLas PalmasSpain

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