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A survey of the practice of stereotactic ablative radiotherapy for lung cancer in the UK on behalf of the Advanced Radiotherapy Technologies Network (ART-NET)
Brown, S. Beasley, M. McNair, H. Henry, A.
Brown, S.
Beasley, M.
McNair, H.
Henry, A.
Citations
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Abstract
Introduction: Stereotactic ablative radiotherapy (SABR) has become
the standard of care for patients with either medically inoperable
early stage non-small cell lung cancer or for patients refusing
surgical resection. The delivery of large doses of radiotherapy is
associated with potentially serious toxicity. Therefore, strict image
guidance (IG) workflows are required to ensure its safe delivery.
This survey was conducted on behalf of the Advanced Radiotherapy
Technologies Network (ART-NET) to build a comprehensive picture
of UK SABR practice with a focus on IG and the management of
anatomical changes. This will inform the development of adaptive
protocols for novel treatment platforms e.g. magnetic resonance
image-guided radiotherapy (MR-linac). This will also highlight
variation in practice and areas where current guidance requires
updating.
Methods: An online survey was disseminated to the radiotherapy
managers of all UK NHS centres.
Results: 100% of centres responded to the survey. 36/67 UK centres
deliver lung SABR. Of these, 6 English centres provide SABR despite
not being commissioned to do so. Most SABR centres (56%) treat 20-
100 patients per year, 19% treat less than 20. Lack of commissioning
was cited as the most common barrier to implementation by non-
SABR centres (86%). Of these, all will refer patients to a SABR centre,
however, 62% also provide conventionally fractionated radiotherapy
as a local alternative. Most variation was seen in the frequency of
cone-beam computed-tomography (CBCT), 8 different variations
of CBCT workflows were reported. Only 52% of centres have a
protocol for addressing the impact of anatomical changes. 67% of
centres expecting to develop a service in the next year believe IG
protocols require updating. The most commonly suggested topic
was frequency of IG.
Conclusion: Eligible patients may face difficulty accessing SABR
due to a lack of commissioning and may receive conventional
radiotherapy instead. There is a clear need to update existing IG
protocols.
Description
Date
2019
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Brown S, Beasley M, McNair H, Faivre-Finn C, Henry A, Van-Herk M. A survey of the practice of stereotactic ablative radiotherapy for lung cancer in the UK on behalf of the Advanced Radiotherapy Technologies Network (ART-NET). Lung Cancer. 2019;127:S76-S.