ESTRO 2024 - Abstract Book

S1631

Clinical - Lung

ESTRO 2024

April 2023 a novel dose limit to this area as the new standard-of-care for all patients with stage I-III lung cancer receiving curative-intent, non-SABR radiotherapy.

The RAPID- RT study is using ‘rapid - learning’ methodology and RWD, to quickly determine the impact of changes in standard-of-care radiotherapy practices on patient outcomes, with the introduction of heart-sparing radiotherapy as a clinical exemplar.

Material/Methods:

The RAPID-RT study was co-designed with patients and other stakeholders, with the aim of maximising inclusivity, transparency, scientific quality and practicality, including:

1. Patients with direct experience of lung cancer and/or radiotherapy, or members of the public with an interest in health research, took part in a two day Citizen’s Jury (n=24) aiming to reach consensus on, a) the most appropriate method for study participants to give consent for the collection of their anonymised routine data, and b) how patients should be informed of the study. 2. Formation of a patient advisory group (n=8). 3. Focus groups with patients (n=6) who have experience of radiotherapy-related toxicity and a national focus group of clinical oncologists (n=7) to ascertain what changes in survival and toxicity levels that may occur as a result of changing base of heart dose-limits are considered acceptable to both patients and the clinical team.

Results:

1. During the Citizens’ Jury, contributors thought the RAPID -RT study was low risk to participants, because enrolment would not alter patients’ standard treatment and data would be anonymised. Regarding consent they voted that simplified ‘opt - out’ processes were appropriate (79% agreement) and that information on RAPID-RT should be provided face-to-face to patients by their medical team, receive a short simple participant information sheet, and have the option of viewing an information video (Figure 1). This advice was adopted for RAPID-RT. 2. All patient-facing material was reviewed by the patient advisory group to ensure participation was inclusive, simple to understand and appealing. 3. Patient and clinicians both voted that any changes in treatment that increased either lung (≤6%) or oesophageal (≤25%) toxicities were acceptable, provided survival increased. Clinicians deemed a ≥5% increase in survival would be clinically meaningful. This informed the statistical design of the study.

Figure 1: RAPID- RT Citizens’ Jury polls