ESTRO 2024 - Abstract Book

S5814

RTT - Education, training, advanced practice and role developments

ESTRO 2024

The implementation of a RTT led survivorship clinic for patients with oesophageal cancer

Liza Sarris 1 , Marina Khan 1 , Kasia Owczarczyk 2 , Asad Qureshi 2 , Paula Treasure 1

1 Guy's & St Thomas' NHS Trust, Radiotherapy, London, United Kingdom. 2 Guy's & St Thomas' NHS Trust, Clinical Oncology, London, United Kingdom

Purpose/Objective:

Chronic gastrointestinal symptoms following treatments for oesophageal cancers are acknowledged for their enduring influence on patients' quality of life [1]. Many existing follow-up services lack the capacity and resources necessary for a focused investigations clinic to effectively assess and manage complications arising from treatments such as chemo-radiation. In response to this gap, our initiative aimed to establish a radiation therapist-led survivorship clinic, operating concurrently with consultants' outpatient clinics. The primary objective of this clinic is to systematically identify and interpret symptoms, facilitating timely referrals for further investigations when warranted. Additionally, the clinic employs a comprehensive multidisciplinary team (MDT) approach to enhance patient care. Research underscores the advantages of employing an MDT approach in managing potential long-term toxicities of gastrointestinal cancer [2]. It emphasises the imperative to explore a spectrum of available investigations and treatments for patients. Beyond the positive impact on patient care, this clinic affords the opportunity for the development of advanced practice roles within the radiography scope. Delegating responsibilities traditionally undertaken by consultants to radiographers not only enables the demonstration of best practices but also supports career progression and widespread promotion of the service.

Material/Methods:

A dedicated RTT led survivorship clinic was created in January 2021, for patients with oesophageal cancer who have completed a course of definitive chemo-radiation.

A post treatment pathway (Figure 1) was established to help determine the criteria for admission into the survivorship clinic. Initially, patients are seen by their clinical oncology consultants, until they have completed their response CT chest abdomen pelvis (CAP) and endoscopy, approximately 12 weeks after the completion of treatment. If investigations show a complete or partial response to treatment, these patients proceed to continue their follow up in the RTT led survivorship clinic. Patients are seen at regular pre-defined intervals for a total of 5 years, or 10 years if they have relapsed following initial treatment. If at this point they remain disease-free, as confirmed by a final surveillance CT CAP and endoscopy, patients are discharged back to their general practitioner (GP). A design-led tool was created by the consultant clinical oncologist in collaboration with the advanced practitioner RTT to ensure standardised patient care within the scope of practice. This tool acts as a clear and practical guide for reported symptoms, detailing the time frame for appropriate referral to other teams and/or diagnostic investigations.

Local departmental governance was obtained prior to opening the clinic in order to provide accountable, efficient and transparent direction to the running of the service. The skill set requirements for the Advanced Practitioner RTT