ESTRO 2025 - Abstract Book

S2259

Interdisciplinary – Health economics & health services research

ESTRO 2025

Keywords: cervical cancer, patient decision aid

References: Bacorro W et al. Patient decision aid for chemotherapy or exclusion in cisplatin-intolerant patients with locally advanced cervical cancer (CECIL): protocol for development, validation and clinical testing. J Hosp Manag Health Policy. 2023 Sep;7:12–12. Bacorro W et al. Outcomes with definitive radiotherapy among patients with locally advanced cervical cancer with relative or absolute contraindications to cisplatin: A systematic review and meta-analysis. Gynecol Oncol. 2022 Sep;166(3):614-630. Bacorro W et al. Patient Decision Aid for Chemotherapy or Exclusion in Cisplatin-Intolerant Patients With Locally Advanced Cervical Cancer: Development, Alpha Testing, and Peer Validation. JCO Global Oncol. 2023; Sep;9:e2300096

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Digital Poster Assessing the use of respiratory motion management as a standard of care in India Vrushab Rao, Soumya Singh, Niraj Dhawale, Bhooshan Zade Department of CyberKnife Radiosurgery and Radiation Oncology, Ruby Hall Clinic, Pune, India

Purpose/Objective: The dynamic nature of breathing movements makes it difficult to maintain precision and consistency during radiotherapy, spurring the development of new techniques and technology to overcome these issues. As technology progresses and our understanding of cancer biology grows, the topic of respiratory motion regulation in radiation has seen substantial progress. In this study, we aim to understand the landscape of respiratory motion management (RMM) modalities and their usage as a standard of care in India. Material/Methods: A 5-point questionnaire was sent to radiation oncology institutes across India. The questions included whether RMM was used routinely in practice, the modality used, its indications, and the reasons for not using it routinely. Responses were recorded, tabulated and analyzed. Fisher's exact test was used to compare the usage of motion management in tier I versus tier II and III cities. Results: 107 responses from radiation oncologists across 23 states and union territories in India were recorded. 82.1% of the responses indicated that RMM facilities were available at their institution, however, 79.2% of radiation oncologists use these facilities routinely. 87% of oncologists used abdominal compression as a modality, while deep-inspiratory breath hold using real-time position management (RPM) respiratory gating and active breathing coordinator were used by 78.2% of all responses. 13 oncologists reported that no RMM modality was available at their institution. Breast, lung, liver and thoracic malignancies were the most common indications of using RMM. The key reasons for not using motion management were patient inability or poor compliance (59.4%), and unavailability or breakdown of machinery (21.8% and 15.8% respectively). 15.8% of radiation oncologists avoid RMM based on their clinical judgment that the patient will not benefit even if it not used. 12% use RMM routinely. Fisher's exact test to compare usage of RMM between tier I (n=55) and tier II-IV (n=52) cities was statistically not significant (two-tailed p=1). Conclusion: Respiratory motion management is used as a standard of care in India. The broad application of this approach emphasizes its crucial role in enhancing the delivery of radiation therapy. The absence of disparity between