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Introduction: The techniques employed in palliative radiation therapy are highly variable, ranging from basic (2D/3D-conformal) to more advanced (beam modulation and stereotactic techniques), and their relative use has not previously been formally investigated at a national level. The purpose of this work was to assess the current utilisation of palliative techniques and technologies in Australia and New Zealand (ANZ)., Methods: A voluntary, anonymous, internet-based, RANZCR approved survey was offered to all practising radiation oncology (RO) Fellows in ANZ. Participants selected their preferred methods of managing patients in five case studies involving bone, brain, lung metastases and locally advanced lung cancer., Results: From October 2022 to February 2023, 146 of 485 eligible participants (30%) responded. In all, 61% and 81% would treat an uncomplicated breast cancer solitary spinal metastasis with stereotactic body radiation therapy routinely and ideally, respectively; 11% and 32% would treat a solitary lung cancer brain metastasis with dedicated stereotactic radiosurgery routinely and ideally; 36% and 56% would treat multiple low-volume brain metastases with a stereotactic technique routinely and ideally. There was negligible difference in the routine and preferred use of advanced technologies for a solitary bowel cancer lung metastasis; 69% and 77% would treat a locally advanced primary lung cancer with an advanced technique routinely and ideally. Relative to Australia, NZ ROs routinely treat uncomplicated solitary spinal metastases (P < 0.001), solitary brain metastases (P < 0.001), multiple low-volume brain metastases (P < 0.02), and locally advanced primary lung cancer (P < 0.001) more commonly with basic technologies, mainly due to limited local availability of advanced technology and departmental waiting lists., Conclusion: Participants generally favoured treating with advanced techniques and technologies in palliative settings, if available, but there were notable disparities between the two countries. Enhanced local access and clinical training may facilitate optimal utilisation of advanced technologies and improve clinical outcomes., (© 2024 Royal Australian and New Zealand College of Radiologists.)

Introduction: Although hypofractionated radiotherapy (HFRT) has become an accepted option for whole-breast irradiation after breast-conserving surgery, there is limited evidence to support HFRT to the chest wall following mastectomy. We retrospectively analysed post-mastectomy patients treated with HFRT in Christchurch to determine whether HFRT yields acceptable efficacy and toxicity., Methods: The Christchurch oncology database was used to identify breast cancer patients treated with adjuvant HFRT to the chest wall following a mastectomy between 2003 and 2008. Eligible post-mastectomy patients were treated with 40 Gy in 16 daily fractions. Treatment outcomes assessed included local recurrence-free survival, breast cancer survival, overall survival and acute toxicities., Results: One hundred thirty-three patients were identified. The median follow-up period was 5.03 years. Three patients had a local recurrence as a first event, resulting in 5-year local recurrence-free survival of 97.6%. Five-year overall survival and 5-year breast cancer survival were 74.7% and 77.7%, respectively. The prospectively assessed acute toxicities were mostly grade 1. In particular, the incidence of grade 2 skin toxicity was 10.7%, and no patients experienced grade 3 skin toxicity., Conclusion: The high local control rate with HFRT, combined with acceptable toxicity and the practical benefits of a shorter treatment time, supports its ongoing use in the eligible patient group. A randomised controlled trial would be necessary to more completely assess the acute and long-term toxicity of HFRT compared with standard fractionation., (© 2014 The Royal Australian and New Zealand College of Radiologists.)