Abstract

Abstract BACKGROUND Since the pivotal trial, showing a near 5-month survival advantage with the addition of Optune to standard treatment for glioblastoma (GBM), Optune has been introduced into clinical practice in many countries. In Sweden, the device is prescribed by physicians, while the service of equipment and control of its use occur in the patients’ home by staff from the private company providing the device, this potentially creating a conflict of interest. Also, the daily use of the device necessitates the help of a next of kin. These are unique arrangements for Swedish healthcare, leading to the need of a complex and possibly challenging collaboration, and also raising potential ethical dilemmas.This study investigates Optune treatment for patients with GBM, regarding experiences of those involved in the treatment, namely: patients, next of kin, physicians and staff from the private company providing the device. MATERIAL AND METHODS The aim is to include 20 or more participants in each group (patients and next of kin, respectively). They are individually interviewed. The interviews are transcribed and analyzed using quantitative content analysis. Electronic questionnaires were sent during 2021-2022 to all physicians prescribing Optune at Departments of Oncology or Neurology in Sweden. The questionnaires included quantitative as well as open ended questions. Staff working for the company and visiting the patients and next of kin have also received electronic questionnaires focusing on experiences from their work. RESULTS Challenges were identified by the physicians, but they had varying opinions on the magnitude of the ethical problems. To date, 10 patients and 9 next of kin have been interviewed. Possible categories already identified are: “Information from the healthcare” and “Patient - company staff collaboration”. The questionnaires to the staff have been answered. The results of the interviews with patients and next of kin, as well as the results of the questionnaires to staff, will be presented. CONCLUSION The INTRODUCTION of Optune as a treatment of patients with GBM constitutes a new concept and a need for new solutions for tackling medical, practical and ethical issues. SUPPORT The Medical Research Council of Southeast Sweden (FORSS), and an ALF grant from Region Östergötland.

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