ESTRO 2024 - Abstract Book

S5661

RTT - Patient experience and quality of life

ESTRO 2024

Participants in the breast group were aged 37-69 (mean=53) with Body Mass Index (BMI) values of 23.1-41.4 (mean=28.8). Participants in the prostate group were aged 61-83 (mean=73) with BMI values of 22.4-41.8 (mean=29.0). A separate online patient survey was disseminated via cancer support-groups and radiotherapy advocacy organisations. For this aspect, a video explaining the concept of upright radiotherapy was followed by brief questions.73 individuals responded to this survey, self-certifying that they had received radiotherapy (for any clinical indication).

Results:

A key theme that emerged from the in-person discussions was “everyone has a different journey”. Patients start their radiotherapy having already experienced individualised cancer treatment pathways (e.g. surgery, chemotherapy, brachytherapy), with/without co-morbidities (e.g. limited mobility, blood pressure issues, obesity). Consequently, it is unsurprising that patient perspectives on body positioning for radiotherapy are heterogeneous. Lying down for treatment was difficult for a subset of participants. Figures 1&2 show some individual views, as captured by the live artist. For many participants, overall body positioning wasn't a major issue. For a small subset, the opportunity to lie down and “tune out” was welcomed. Approximately two-thirds of participants diagnosed with breast cancer, and one-third of participants diagnosed with prostate cancer, reported feeling emotionally vulnerable during radiotherapy. Within the breast cohort, radiotherapy arm positioning (post-surgery) and emotional vulnerability were identified as two key barriers to comfort. Across both cohorts, participants consistently indicated that they'd feel a better social connection if RTTs positioned them upright, compared to lying down. 36% of the prostate cohort reported that they had difficulties lying down or getting up from the supine treatment position. 82% of the cohort indicated that it would be easier to get in/out of position upright (18% thought it would be easier supine). However, independent of body positioning, the requirement to have a full bladder was highlighted as the principal barrier to comfort for prostate radiotherapy, and it was widely expressed that androgen deprivation therapy (typically provided neoadjuvantly/concurrently with prostate radiotherapy) had major impacts upon quality of life. When asked “Which radiotherapy treatment position do you think you would have preferred overall?”, 55% of the prostate cohort selected “upright”, 27% were “not sure” and 18% selected “lying down” (n=11). Complete questionnaire follow-up data was recorded for 7/10 participants who received breast radiotherapy: 86% selected upright and 14% selected “lying down”. In the online survey (n=73), when asked “what is your reaction to the possibility of upright radiotherapy, compared to conventional, lying down treatments?”, 41% of respondents answered “Excited, upright treatments sound like they’d be more comfortable”; 41% answered “I’m not sure; I’d need to try the chair” and 18% answered “No thanks, I’d prefer to lie down”. In-person and online, many patients emphasised that clinical treatment quality, rather than body positioning, was their primary concern. Some patients indicated that the following upright radiotherapy research topics would be important to them: possible claustrophobia from upright CT scanners; patient tolerance of rotation; the potential use of modesty coverings, upright.