Author
Listed:
- Owen J. Nicholas
(South West Wales Cancer Centre, Singleton Hospital
Swansea University Medical School)
- Olivier Joseph
(Manchester University NHS Trust)
- Annie Keane
(Manchester University NHS Trust)
- Kate Cleary
(Cardiff University)
- Sue H. Campbell
(Patient Representative)
- Sarah H. Gwynne
(South West Wales Cancer Centre, Singleton Hospital)
- Tom Crosby
(Velindre University NHS Trust)
- Ganesh Radhakrishna
(The Christie NHS Foundation Trust)
- Maria A. Hawkins
(University of Oxford)
Abstract
Background Neoadjuvant chemoradiotherapy for oesophageal cancer significantly improves overall survival but is associated with severe post-operative complications. Proton beam therapy may reduce these toxicities by sparing normal tissues compared with standard radiotherapy. ProtOeus is a proposed randomised phase II study of neoadjuvant chemoradiotherapy in oesophageal cancer that compares proton beam therapy to standard radiotherapy techniques. As proton beam therapy services are often centralised in academic centres in major cities, proton beam therapy trials raise distinct challenges including patient acceptance of travelling for proton beam therapy, coordination of treatments with local centres and ensuring equity of access for patients. Methods Focus groups were held early in the trial development process to establish patients’ views on the trial proposal. Topics discussed include perception of proton beam therapy, patient acceptability of the trial pathway and design, patient-facing materials, and common clinical scenarios. Focus groups were led by the investigators and facilitated by patient involvement teams from the institutions who are involved in this research. Responses for each topic were analysed, and fed back to the trial’s development group. Results Three focus groups were held in separate locations in the UK (Manchester, Cardiff, Wigan). Proton beam therapy was perceived as superior to standard radiotherapy making the trial attractive. Patients felt strongly that travel costs should be reimbursed to ensure equity of access to proton beam therapy. They were very supportive of a shorter treatment schedule and felt that toxicity reduction was the most important endpoint. Discussion and Conclusions Incorporating patient views early in the trial development process resulted in significant trial design refinements including travel/accommodation provisions, choice of primary endpoint, randomisation ratio and fractionation schedule. Focus groups are a reproducible and efficient method of incorporating the patient and public voice into research.
Suggested Citation
Owen J. Nicholas & Olivier Joseph & Annie Keane & Kate Cleary & Sue H. Campbell & Sarah H. Gwynne & Tom Crosby & Ganesh Radhakrishna & Maria A. Hawkins, 2021.
"Patient and Public Involvement Refines the Design of ProtOeus: A Proposed Phase II Trial of Proton Beam Therapy in Oesophageal Cancer,"
The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(5), pages 545-553, September.
Handle:
RePEc:spr:patien:v:14:y:2021:i:5:d:10.1007_s40271-020-00487-8
DOI: 10.1007/s40271-020-00487-8
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