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)
AffiliationRadiotherapy Related Research, The Christie Hospital, Manchester
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AbstractIntroduction: 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.
CitationBrown 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.
TypeMeetings and Proceedings