ESTRO 2025 - Abstract Book

S2322

Interdisciplinary – Health economics & health services research

ESTRO 2025

Conclusion: Wearables may be utilised routinely in future clinical practice for health monitoring. However, observation from two studies suggest that participant age and device preference is a significant factor to consider when implementing such technology into health services research or routine clinical care to ensure research and clinical care are equitable and inclusive to all participants.

Keywords: Digital divide, digital health devices, equity

3573

Proffered Paper The impact of proton versus photon therapy on health-related quality of life for patients with lung cancer. Bradley M Sugden 1,2 , Willem Witlox 1 , Bram Ramaekers 1 , Francesco Cortiula 2 , Djoya Hattu 2 , Manuela Joore 1 , Dirk De Ruysscher 2 1 Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, Netherlands. 2 Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Centre+, Maastricht, Netherlands Purpose/Objective: Radiotherapy with protons offers the potential for improved patient health-related quality of life (HRQoL) through reducing radiation-induced toxicities, compared with photon therapy. This study assesses the impact of proton versus photon therapy on HRQoL in lung cancer patients considered for proton therapy. Material/Methods: Consecutive lung cancer patients from a single centre considered for proton therapy and subsequently treated with protons or photons were included. Proton eligibility was determined through the model-based approach. HRQoL was measured using the generic EuroQoL-5D-5L (EQ-5D-5L) and disease-specific EORTC QLQ-C30 instruments at baseline, during radiotherapy, 3, 6, and 12 months, and every 12 months thereafter up to 5 years. Generalised linear mixed effects (GLM) models were developed in R to assess the impact of proton versus photon therapy on EQ-5D-5L utility and EORTC-QLQ-C30 global health status (GHS). Missing data were handled using multiple imputation. Multiple candidate fixed effects (covariates) were considered and selected through backward elimination (Wald test). Radiation modality was forced into the models. Minimal important difference cut-offs utilised were 0.03 for EQ-5D-5L and 0.05 for GHS. Results: In total, 311 and 133 patients were treated with protons and photons, respectively, with mean (median) follow-up of 8 (6) months. Baseline mean HRQoL scores were lower for patients treated with protons (EQ-5D-5L=0.79; GHS=0.71), compared with photons (EQ-5D-5L=0.83; GHS=0.73). EQ-5D-5L and GHS scores over time are visualised in Figure 1. Disease was predominantly stage III (proton: 74%; photon: 80%) and NSCLC (proton: 94%; photon: 83%) with mean radiation dose received being 58 Gy for protons and 57 Gy for photons. Most patients received chemotherapy (protons: 57% concurrent, 24% sequential; photons: 66% concurrent, 32% sequential) with 49% of proton patients and 42% of photon patients receiving adjuvant durvalumab. Following backward elimination, radiation modality, WHO performance status, and baseline EQ-5D-5L/GHS were included as fixed effects in the final GLM models. Generic and disease-specific HRQoL were lower for proton therapy compared to photon therapy (EQ-5D-5L: -0.017 (se: 0.023); GHS: -0.025 (se: 0.024)). However, these differences were not deemed clinically relevant provided the minimal important difference cut-offs, nor statistically significant (p=0.454 and p=0.296, respectively). Figure 1. EQ-5D-5L utility and GHS scores for proton and photon groups. Open dots represent averages over time.