ESTRO 2023 - Abstract Book

S841

Tuesday 16 May 2023

ESTRO 2023

Unlike traditional methods of PRO collecting, digital intelligence tools offer unique advantages such as real time data capture, objective and subjective measurements captured simultaneously, reduced transportation cost for the patient, less burden on the caregiver’s time and reliance on patients’ recall. Studies have found that clinical trial follow-up rates for palliative RT were much higher when return visits to clinic for follow up were not required. Prior PRO collection initiatives have not been able to capture patient experiences and outcomes in real-time. There is now widespread capability to collect PROs via online questionnaires external to the medical chart, for example our institution is transitioning away from paper-based ESAS documentation in consultation to an online app. This app allows patients to input ESAS scores, provide a brief history of their current symptoms and list their medications, reducing time spent on this in consultation. The app will allow the RTT to electronically track the side effects of treatment and facilitate communication between the patient and the health care team. Increasingly novel ‘smart’ technology can also be used to collect patient wellness information in real time. One example of this would be ‘wearable’ devices. This could be as simple as a Fitbit or as complicated as a ‘smart shirt’. A study of this technology is currently underway, utilizing digital patient reporting and real time objective measurements of patients’ symptoms and side effects from palliative RT over the course of a year. This digital outcome measures depends less on active patient or provider participation, which may allow for greater collection consistency, frequency and accuracy. Patients are fitted with wearable technology (HexoSkinTM Smart Shirt) which is capable of measuring vital signs. The patients are given a cell phone with an app to enter symptoms and side effects. The app prompts them to complete quality of life, patient satisfaction and subjective symptom surveys. The RTT involved in the palliative RT team provides follow up of these patients at 30, 90 and 365 days after the last treatment. The RTT is able to monitor the symptoms reported on the app by the patient and follow up with the patients’ health care team as necessary. PROs are an important means to track symptoms patients are experiencing, evaluate patient outcomes (including treatment efficacy and side effects), and improve the patient experience. On a broader scale, PROs can be used to study population based informatics such as comparing efficacy of various techniques or evaluating the quality of care when aggregated together in cohort analysis. Although there are challenges to initiating RTT-led PRO assessments and follow ups (including delegating time away from clinical duties and training), studies have shown that these assessments can drastically impact the QOL for patients receiving cancer therapy. The increasing use of novel digital intelligence technology may lead to easier real-time monitoring of patients’ symptoms and improved patient experiences while on treatment.

Debate: This house believes that tumour-specific radiosensitisation is an unachievable radiobiological fantasy

SP-1025 For the motion A. Chalmers 1 1 University of Glagow, School of Cancer Sciences, Glasgow, United Kingdom

Abstract Text Having dedicated the past 23 years of my career to the topic of tumour-specific radiosensitisation, you may wonder why I am speaking about this being an unachievable radiobiological fantasy. The answer is that I’m similarly bewildered to find myself in this position. However, I like a challenge and am looking forward to a lively discussion with my fellow debaters on this important topic, and hoping for some robust contributions from the audience. What I will say at this very early stage in the proceedings is that every biological intervention has consequences, and too often we only look for the ones we want to see. See you in Vienna!

SP-1026 Against the motion C. Vens United Kingdom

Abstract not available Symposium: Shared decision-making in radiotherapy

SP-1030 Shared decision-making - Why and how to? A. Pieterse 1 1 Leiden University Medical Center, Biomedical Data Sciences, Leiden, The Netherlands

Abstract Text Shared decision making (SDM) is a clinical decision model that is highly recommended when more than one possible treatment option could fit an individual patient best. This is very often the case when making cancer treatment decisions, including decisions about radiotherapy. Choice between two or more medically reasonable options, e.g., undergoing or foregoing (neo-)adjuvant radiotherapy means uncertainty. Dealing with and resolving this uncertainty requires creating choice awareness in the patient and then, ideally, going through a decision process in which the patient is truly involved in order to combine the best scientific, medical, and clinical evidence, and what is important in this patient’s life. SDM is a means, in other words, to achieve evidence-based medicine as it was originally conceived. Extent to which patients are involved in treatment decisions depends on the perspective that is taken (perspective of the physician, patient, or an independent observer), and may depend on the exact definition that is used – many definitions exist, yet they share key elements. Regardless of perspective and definition, true patient involvement or shared decision making is still uncommon in clinical practice. This is also the case in radiotherapy treatment. Various barriers have been identified for why shared decision making has not been widely implemented yet, and a fundamental barrier may relate to the vulnerable position in which patients find themselves with respect to clinicians, and to time. Interventions to promote the adoption of shared decision making among clinicians often include skills training and have shown to be feasible, well-received, and improve clinicians’ knowledge and skills. Interventions targeting patients more often include the provision of tools such as patient decision aids, which have repeatedly been shown to improve