Background: Access to equitable and timely oncology care is a challenge faced by many rural Australian communities. To overcome these issues, The Townsville Cancer Centre (Queensland, Australia) utilises shared care (Townsville tele-oncology model) to deliver oncology services to rural communities. The Mount Isa Hospital is the largest of these remote sites and has used tele-oncology since 2006.
Aim: Assess the safety of remotely supervised chemotherapy delivery at Mount Isa Hospital using the Townsville tele-oncology model.
Methods: A retrospective review was conducted on all referrals to the Mount Isa oncology unit between September 2006 and May 2012. Patients not receiving chemotherapy or those supervised by other units were excluded.
Results: A total of 83 patients received 1076 cycles of chemotherapy. Treatment intent was either adjuvant (37%) or palliative (63%). The median age was 57 years (range 33-79) and 26% of patients were Indigenous. The most common malignancies were breast (26%), lung (24%) and colorectal (19%). Adverse effects (AE) of any grade were recorded in 90 cycles (8%). Of these, half were grade 3 or 4 and included: haematological (61%), neuropathic (7%) and gastrointestinal (5%). There was one death, two months after completion of gemcitabine for metastatic pancreatic cancer. There were 41 hospitalisations (4%). Reasons included: febrile neutropenia (25%), progression or palliation (22%) and grade 3 or 4 AE (18%). The median dose intensity achieved for adjuvant treatment was 100% for breast, 93% for colorectal and 89% for other malignancies. The full intended dose was delivered in 87% of cycles (n= 940).
Conclusions: The rate of AE and dose intensities achieved in this cohort was similar to that seen in the literature. These findings suggest that the Townsville tele-oncology model is a safe and effective way to provide oncology services to rural Australian communities.