ESTRO 2022 - Abstract Book

S31

Abstract book

ESTRO 2022

1 Maastro Clinic, Radiotherapy, Maastricht, The Netherlands; 2 University Medical Center Utrecht, Radiotherapy, Utrecht, The Netherlands; 3 Amsterdam University Medical Center, Radiotherapy, Amsterdam, The Netherlands; 4 Erasmus Medical Center, Radiotherapy, Rotterdam, The Netherlands; 5 Catharina Hospital Eindhoven, Radiotherapy, Eindhoven, The Netherlands; 6 Haaglanden Medical Center, Radiotherapy, Den Haag, The Netherlands; 7 Radiotherapiegroep, Radiotherapy, Arnhem, The Netherlands; 8 Radboud University Medical Center, Radiotherapy, Nijmegen, The Netherlands; 9 Radiotherapeutisch Instituut Friesland, Radiotherapy, Leeuwarden, The Netherlands; 10 Haga Ziekenhuis, Radiotherapy, Den Haag, The Netherlands; 11 University Medical Center Groningen, Radiotherapy, Groningen, The Netherlands Purpose or Objective Previous research among Dutch radiotherapy (RT) centers showed that 69% of the planned innovations were simultaneously implemented at 7 or more centers without a structure to share lessons learned about the implementation process. Therefore, a multidisciplinary Taskforce Innovation Implementation was raised aimed at supporting RT centers to continuously improve their implementation efficiency. The aim of this study is to investigate the status of the innovation implementation process in Dutch RT centers and to develop tools to reinforce mutual learning with regard to innovation implementation. Materials and Methods First, we asked the 18 Dutch RT centers to provide us their 10 most valuable innovations that were or will be implemented in the period 2019-2022. Subsequently, we selected the four most mentioned topics on which we performed semi-structured interviews with physicists, radiation oncologists and radiation therapists (RTT) from several centers. The interviews were structured using the Consolidated Framework for Implementation Research making sure all relevant implementation issues were addressed. The interviews were transcribed and coded by using template analysis. Results Based upon the inventory (72% of the RT centers responded to the inventory), we conducted interviews with 23 persons from 12 out of 18 RT centers on projects concerning 1) automation 2) adaptive RT 3) tracking and image guided RT and 4) patient participation. Most innovations were implemented with a delay, mainly due to: shortage of time from personnel (n=9 centers), prioritization of projects (n=8 centers), collaboration with external parties (n=6 centers) and resistance to or acceptance of the innovation (n=5 centers). These barriers were quite similar between the centers, especially on similar topics. E.g., centers implementing surface tracking often mentioned that they encountered some form of resistance in the RTT group. Although consultation of other centers before starting the implementation process was often done, this mainly focused on the content of the innovation and only to a small extent on the implementation process or the challenges that were encountered during implementation. The presence of complete implementation plans was scarce; shorter versions were available in 9 centers and 3 centers did not have an implementation plan. Formal evaluation of the implementation process and changes in workflow, e.g., to discover challenges and delaying factors, was rarely performed. Conclusion This study showed that most centers experience comparable challenges when implementing innovations. By sharing data on the implementation process, and developing an evidence-based implementation plan to face challenges, centers can learn from each other. We are currently developing a web-based platform to share knowledge and experience about implementation processes in RT centers, to improve implementation efficiency. M. Renouf 1 , K. Zhou 2 , G. Perrocheau 2 , N. Magné 3 , G. De Brisson de la Roche 3 , I. Latorzeff 4 , P. Pommier 5 , G. Créhange 6 , A. Paumier 7 , G. Bera 8 , C. Catton 9 , M. Bellanger 2 , S. Supiot 1 1 Institut de Cancérologie de l'Ouest René Gauducheau, Radiation Oncology, Nantes, France; 2 Institut de Cancérologie de l'Ouest René Gauducheau, Human and Social Sciences, Nantes, France; 3 Institut de Cancérologie Lucien Neuwirth, Radiation Oncology, Saint Priest en Jarez, France; 4 Clinique Pasteur, Radiation Oncology, Toulouse, France; 5 Centre Léon Bérard, Radiation Oncology, Lyon, France; 6 Institut Curie, Radiation Oncology, Paris, France; 7 Institut de Cancérologie de l'Ouest Paul Papin, Radiation Oncology, Angers, France; 8 Hôpital du Scorff, Groupe Hospitalier Bretagne Sud, Radiation Oncology, Lorient, France; 9 Princess Margaret Hospital, University of Toronto, Radiation Oncology, Toronto, Canada Purpose or Objective Hypofractionated Radiation therapy (RT) is considered a safe and efficient treatment option for localized prostate cancer. The international PROstate Fractionated Irradiation Trial (PROFIT) found moderate hypofractionation to be non-inferior to standard dose-escalated RT for intermediate-risk prostate cancer. The aim of this study is to evaluate the cost- effectiveness of moderate hypofractionation compared to conventional RT for treatment of intermediate-risk prostate cancer. Materials and Methods A randomized prospective multicenter ancillary study of the PROFIT trial was conducted in France in six centers. Costs were determined from the National Health Insurance System (NHIS) reimbursement rates. We conducted a cost- effectiveness analysis from the NHIS payer’s perspective, with a time horizon of 48 months. To estimate total costs per patient, we assigned unit costs to resource use for transportation, medical exams, visits and inpatient stays for adverse events. Results from EPIC questionnaires at baseline, M24 and M48 were mapped to obtain EuroQol five-dimensional questionnaire (EQ-5D) equivalent to generate Quality Adjusted Life Years (QALY). Total costs were combined with QALY to estimate the Incremental Cost-effectiveness ratio (ICER) over the 48-month follow-up. Results Between December 8, 2011, and January 25, 2016, 231 patients were included: 116 received conventional fractionated RT and 106 had hypofractionated RT. Median follow-up was 5.4 years (4.4-6.3 years). Total costs per patient were higher in MO-0058 Cost-effectiveness of hypofractionated radiotherapy in intermediate-risk prostate cancer.