The clinical, patient experience and resource outcomes in the introduction of a prostate radiotherapy education seminar within the radiotherapy pathway

Abstract

Introduction: Prostate cancer affects 48000 patients per year1, 32% will peruse radiotherapy as their preferred treatment option2. With a survival of 85% at 5/10 years3 emphasis is required in improving long term quality of life(QOL). Common radiotherapy techniques require soft tissue localisation comprising of consistent bladder filling/rectal emptying for effective stabilisation of the target volume and protection of rectum, bowel and bladder; in particular with rectal (QOL) significantly different in patients treated with radiotherapy vs surgery within the first 2 years4. This study evaluates the clinical and experience outcomes following a multidisciplinary group seminar introduction, advising patients regarding bowel/bladder preparation, treatment information, side effect management and supportive services; in contrast to the individual consultations on preparation. Method and Materials: 40 patients were randomly selected 3 months pre/post seminar introduction (20 each) (Table 1.). Exclusions included, patients who received daily Cone beam computerised tomography (none present within the pre-seminar cohort), patients whom met the exclusion criteria (whom received an individual consultation) and those in the initial optimisation/improvement period (6 weeks). Comparison was made in repeat CT appointments, bladder size (volume increase/decrease) against set percentage volume criteria and rectal position affecting organ dose or target volume coverage. All patients who attended the seminar were also provided a qualitative pre/post seminar experience questionnaire rating confidence in bowel/bladder preparation, side effect advice and how well informed they felt. Results: Table 1 shows the clinical results between the patient cohorts. Seminar attending patients saw a 24% increase within ‘acceptable’ criteria and a 37% reduction in repeat CT appointments . Following the seminar patient perceived feeling of confidence in bladder/bowel preparation and side effect knowledge increased by 106% (4.6 points), feeling of being informed by 48% (2.8 points).Tabled 1Table 1:totalBladder/Rectum AcceptableBladder Minor ChangeBladder Major ChangeRectal gas/tissue within PTVPre-Seminar (consultation)17346.82%20.81%14.45%17.92%Post-Seminar (Seminar)15870.89%13.92%6.96%8.23% Open table in a new tab Conclusion: A Prostate Education Seminar within the radiotherapy pathway sees clinical and experience improvements reducing staff resources re and CT appointment slot utilisation. Numerical References [1]Cancerresearchuk.org. (2019). About Cancer | Prostate cancer | Cancer Research UK. [Online] Available at: https://www.cancerresearchuk.org/about-cancer/prostate-cancer/about [Accessed 24 Jul. 2019] [2] Donovan, J, et al. (2016). Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. New England Journal of Medicine 375, pp.1425-1437.[3]Cancerresearchuk.org. (2016). Survival | Prostate cancer | Cancer Research UK. [Online] Available at: https://www.cancerresearchuk.org/about-cancer/prostate-cancer/survival [Accessed 24 Jul. 2019][4]Chen, C. Basak, R and Meyer, A. (2017). Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer. JAMA 317(11), pp.1141-1150.