ESTRO 2022 - Abstract Book

S604

Abstract book

ESTRO 2022

PD-0670 Minimising radical radiotherapy commencement time for lung cancer to improve clinical outcomes

M. Padden-Modi 1 , J. Cheng 1 , R. Kirby 1 , N. Twyman 1 , S. Aslam 1 , V.R. Bulusu 1 , D. Gilligan 1 , A. Martin 1 , N. Pipalia 1 , A.M. Shiarli 1 , H. Yang 1 , K. Thippu Jayaprakash 1

1 Cambridge University Hospitals NHS Foundation Trust, Clinical Oncology, Cambridge, United Kingdom

Purpose or Objective The UK National Optimal Lung Cancer Pathway (NOLCP) provides guidance to improve and streamline the treatment pathway for lung cancer 1 . An increased time to treatment is independently associated with poorer survival in non-small cell lung cancer 2 (and also likely in small cell lung cancer). This work reviews radical radiotherapy (RT) commencement times in a tertiary UK referral centre, identifying opportunities to shorten the pathway for patients with lung cancer. Materials and Methods Patients treated with radical (chemo-) RT from April-October 2020 were identified. Data on various time points between referral and treatment were collected from electronic patient records and analysed. LEAN methodology was applied for root-cause analysis to identify patients receiving delayed treatment and to consider actions to improve treatment start times. Results n = 77 (SABR - 22, concurrent chemo-RT - 20, RT alone/sequential chemo-RT - 26). Overall median time from referral to treatment (in days): all patients - 27; SABR - 27; concurrent chemo-RT - 32; RT alone/sequential chemo-RT - 26. Individual median time-frames (in days) for all patients: RT referral to CT (7); CT to contouring [image segmentation] (6); contouring to physics planning (2); physics planning to checking (3); physics checking to delivery quality assurance [DQA] (1); DQA to commencement of RT (5). Respective time frames for the different treatment subgroups are shown below (Figure 1). Root-cause analysis identified areas for improvement including organisation of planning CT, contouring and DQA, and the following solutions were agreed (Figure 2) . ● A clinician-specific timetable for referral to contouring with a target of ≤ 7 days. ● Dedicated planning CT slots for radical lung RT patients. ● Ensuring clinician availability by arranging cross cover for contouring within the lung RT team.

● RT to start on Monday and Wednesday for non-SABR and any day for SABR. ● Optimise chemotherapy regimens to ensure on time delivery of chemo-RT.