9.3 - Triage Of Radiotherapy Patients

How are patients prioritised to start treatment?

Triage of radiotherapy patients is an important topic, particularly when waiting lists are long.

In general:

  • Curative treatment takes priority over palliative treatments in most cases, as if curative treatment is delayed for too long the patient may become incurable!
    • Curative treatments are triaged according to urgency. Head and neck tumours, and other rapidly progressing malignancies should be prioritised to start over less aggressive tumours such as prostate cancer.
    • Some palliative treatments, such as for spinal cord compression or superior vena cava obstruction, are performed more urgently than curative treatments due to the severe consequences that arise if treatment is not commenced immediately
  • Palliative treatments are triaged according to the symptoms of the patient and urgency of intervention.

At my department we have four triage levels:

  • Urgent cases must begin treatment within 24 hours (spinal cord compression, haemorrhage)
  • Semi-urgent cases must begin treatment within 2 weeks (palliative treatments for pain, curative treatment of rapidly progressive tumours)
  • Category A cases must begin within one month. This typically includes breast cancer and other moderately aggressive tumours.
  • Category B cases must begin within two months. This category is mostly prostate cancer patients, or non-malignant conditions.