ESTRO 2020 Abstract Book

S332 ESTRO 2020

Team, London, United Kingdom ; 4 Odense University Hospital, Department of Radiotherapy Physics, Odense, Denmark ; 5 Institute of Cancer Research, Department of Radiotherapy and Imaging, London, United Kingdom ; 6 Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom ; 7 Institute of Cancer Research, Clinical Academic Radiotherapy Team, London, United Kingdom Purpose or Objective This work aimed to assess common operative issues which arose in two multicentre PoD trials: HYBRID (CRUK/12/055) and RAIDER (CRUK/14/016). The purpose was to assemble the lessons learnt from managing these operative issues. Material and Methods Centres were issued radiotherapy planning and delivery guidelines before implementing PoD. Pre-trial and on-trial DICOM data, QA reviews and centre variables were collated from both trials, Figure 1.

The most common operative issues were: • OARs were incorrectly outlined •

Larger volumes and plans did not include excursions of smaller volumes and plans Smaller plans were less optimised than larger plans

•

• • •

Incorrect nomenclature

Non-compliant PoD selections

Centres were unable to schedule treatment and imaging for PoD

There was no difference between issues within groups versus centre variables in all tests except PoD selection. In the PoD selection analysis, the PoD selection compliance decreased from pre-trial to on-trial ( P <.001), Table 1. Therefore additional training including an interactive workshop was introduced. Conclusion The main lessons learnt were: Issues arise in all aspects of PoD and there was no improvement from the pre-trial to on-trial process. Thus, training is recommended before implementing PoD and monitoring its implementation is essential. Many issues can be avoided with checklists and improving guidance. Interactive sessions, i.e. workshops were successful for ongoing systematic issues across multiple centres; collaborating and improving compliance, e.g. in PoD selections. The concept of PoD needs to be realised e.g. if larger plans don’t encompass smaller plans or smaller plans are not optimised, the heavy workload to undertake PoD may be ineffective. The most common operative issues in two multicentre PoD trials have been outlined. In the era of adopting, adapting and advancing the lessons learnt suggest that simple processes can optimise the introduction of advanced techniques for all patients. OC-0591 Achieving expert consensus for IGRT training and assessment for radiation therapists: A Delphi T. Barnes 1 , S. Palmer 2 1 musgrove park hospital taunton, radiotherapy, taunton, United Kingdom ; 2 University of the West of England, Faculty of Health and Applied Sciences-, Bristol-, United Kingdom Purpose or Objective The aim of this Delphi study was to elicit expert radiation therapist (RTT) views related to image guided radiotherapy (IGRT) training and to gain consensus on

Common PoD issues were assessed by the following: 1. Issues were classified into outlining, planning, PoD selection and process groups. 2. An inductive approach was used to develop the common operative issues that arose during PoD implementation. 3. The practical considerations and actions recommended to centres were recorded, to generate the lessons learnt. 4. A secondary analysis was undertaken to test for associations between issues and centre variables. Descriptive statistics were used to characterise the data. Chi-square, Mann-Whitney U and Kruskal Wallis were used to test for associations. Results Pre-trial and on-trial data from 35 centres were reviewed, including 226 outline submissions, 528 plans from 176 submissions, 8,286 PoD selections from 1,339 submissions and 43 process documents.160 operative issues were reported in outlining, 95 in planning, 989 in PoD selections and 51 in the PoD process. Issues were categorised; Table 1.