ESTRO 2025 - Abstract Book

S1813

Clinical – Upper GI

ESTRO 2025

3061

Digital Poster Radiotherapy for oesophagogastric cancers in the UK: volume, variation & quality

Christopher W Bleaney 1,2 , Ganesh Radhakrishna 1,2 , Katharine Aitken 3 , Tom Crosby 4 , Christopher M Jones 5,6 1 Division of Cancer Sciences, Facult of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom. 2 Department of Clinical Oncology, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom. 3 Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, United Kingdom. 4 Department of Clinical Oncology, Velindre University NHS Trust, Cardiff, United Kingdom. 5 Department of Oncology, University of Cambridge, Cambridge, United Kingdom. 6 Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom Purpose/Objective: We characterised variation in quality measures of external beam radiotherapy (EBRT), as well as pre- and post- treatment care, for patients diagnosed with an oesophagogastric cancer for which they received radiotherapy in the United Kingdom (UK). Material/Methods: Data relating to all radiotherapy treatment episodes delivered in the English National Health Service (NHS) for patients with a diagnosis of an oesophagogastric cancer between 2020-2022 were extracted from the routinely collated National Radiotherapy Dataset (RTDS). Broader patterns of care were assessed using a bespoke pre-piloted online survey hosted by SurveyMonkey, which was distributed to all UK NHS radiotherapy centres during July 2024. This was completed by 45 (75%) of the 60 UK centres that currently provide radiotherapy for oesophagogastric cancer. Results: A total of 4471 radical radiotherapy treatment episodes were delivered for an oesophagogastric cancer diagnosis across England during the studied period. The mean time from a decision to treat to the start of radical radiotherapy varied annually between 21-23 days. A majority (90%) of radical treatments used IMRT or rotational arc therapy. Only 28% of centres routinely used IMRT or VMAT for palliative-intent oesophagogastric radiotherapy. Sixty-two percent of centres routinely used 4D planning for lower oesophageal or gastro-oesophageal junction tumours, though 35% did not use any motion management techniques in these cases. Seventy-four percent of centres routinely peer review contours for radical treatments. The use of induction chemotherapy in definitive chemoradiotherapy regimens varies greatly by centre and tumour histology (Table 1). The frequency of planned reviews undertaken for patients receiving radical radiotherapy for an oesophagogastric cancer varies considerably by centre (Figure 1). Eighty-seven percent of centres routinely perform CT and 40% endoscopy and biopsy to assess response to definitive chemoradiotherapy at 3 months post-treatment completion. Palliative treatment approaches for dysphagia differ greatly between centres. Forty-five percent of centres will offer stenting only and 6% will use EBRT after stent insertion. Sixty-six percent of centres lack local access to brachytherapy.