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An International Survey on Practice Patterns on the use of Stereotactic Ablative Radiotherapy for Oligoprogressive Cancer

Our research team, led by Dr. Sarah Baker, Department of Radiation Oncology, BC Cancer Surrey, and University of British Columbia, would like to ask you confidential questions in this survey on practice patterns in the use of stereotactic ablative radiotherapy for oligoprogressive cancer. Please complete this survey if in your clinical practice, you treat patients with stereotactic ablative radiotherapy (SABR)/ stereotactic body radiotherapy (SBRT). Survey results will help us to learn more about common practice patterns and will help with the development of a clinical trial of SABR in the oligoprogressive setting.

If you do the survey, you are consenting to participate. Completion of the survey is voluntary. It will take 15 minutes to complete. Prior to submission of your questionnaire answers, you can withdraw your consent by closing the survey. Once you start the survey, it must be completed within a single session. Due to the anonymous nature of the survey, once the survey is submitted, you will NOT be able to withdraw your consent.

There are no direct benefits to you if you decide to take part in this study. Published results of the survey may be of benefit to radiation oncologists by providing information about common practice patterns.

There are no direct risks to participants. All questionnaire answers will be anonymous. Aggregate data derived from this study will be used for research purposes. If the results of the study are published, your name will not be used and no information that discloses your identity will be released or published without your specific consent to the disclosure.

Only the study team and the technical support team at the Provincial Health Service Authority (PHSA) in British Columbia will access your information. The results of this survey are confidential. When results are reported, presented, or published the project team will remove any information that could identify you or anyone else. The team may use an anonymous quote from your comments if provided. Survey data will be stored securely at PHSA for 5 years.
Your personal information is protected by our privacy law in BC. This law is called the Freedom of Information and Protection of Privacy Act (FIPPA). We are collecting your information under section 26 (c ) (e ) of FIPPA.

For answers to questions relating to this research study or for information about study procedures, you may contact Dr. Sarah Baker at sarah.baker1@bccancer.bc.ca

For questions about your rights as a research participant or privacy related questions, you can contact BC Cancer Research Ethics at reb@bccancer.bc.ca, or 604.877.6284. Please reference the study number H23-03837 when contacting Research Ethics so staff can better assist you.

Consent

By proceeding with the survey, I voluntarily consent to PHSA collecting, using, and disclosing the information I provide. I have read and understand this form.

Survey of Current Clinical Practice Patterns in Oligoprogressive Cancer

For the following survey, oligoprogression is defined as a limited number of progressing lesions on active systemic treatment, with or without other sites of stable disease.

1. Where do you practice?

Country

Province

State

2. How many radiation oncologists treat patients with SABR at your institution?

3. How many years have you been in practice as a radiation oncologist?

I am in residency/fellowship

1-5

6-10

11-20

21-30

> 30

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4. How many patients with oligoprogression do you personally treat with SABR each year?

1-5

6-10

11 - 20

> 20

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5. At your institution, are all patients with oligoprogressive cancer who are referred for SABR discussed at a tumor board rounds?

Yes

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6. Does your institution have specific selection criteria for which patients should be offered SABR for oligoprogression?

7. In your practice, what re-staging imaging is required for patients with suspected oligoprogression prior to offering SABR? (select all that apply)

CT only of body site of concern (eg. CT chest for lung lesion)

CT chest/abdomen/pelvis

Bone scan

PET-CT

Brain imaging (CT or MRI head) in tumors with propensity for brain metastases

1 Almost always

2 Frequently

3 Sometimes

4 Rarely

5 Never

To delay next line systemic therapy

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Local control of oligoprogressing lesion

reset

To improve progression-free survival

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To improve overall survival

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To allow a drug holiday for the patient

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To allow continuation of current systemic therapy

reset

9. I consider SABR an accepted standard-of-care treatment option for select patients with oligoprogression

Yes No

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10. For which primary tumor types would you routinely offer SABR for oligoprogression outside of a clinical trial setting? (select all that apply)

Breast

Prostate

Melanoma

Lung - driver mutation positive

Lung - driver mutation negative

Renal cell carcinoma

Any primary tumors

Other

Please list

11. In your opinion, what minimum duration should a patient have stable disease on systemic treatment prior to oligoprogression, in order to be considered for SABR?

12. What is the maximum number of progressing lesions you would consider appropriate for SABR in a patient (outside of a clinical trial setting)?

13. With the introduction of SABR for oligoprogressive malignancy, patients who would not normally be referred for radiotherapy are being seen in consultation by radiation oncology and many are offered highly conformal/complex radiotherapy treatment. What, if any, impact has this had on your radiation oncology department? (select all that apply)

Increasing personal workload due to increasing plan complexity

Increasing personal workload due to greater number of patients

Longer waitlists for oncology consultation, CT simulation, or radiotherapy treatment

Greater dosimetry workload

No impact

14. In your practice, what is the sequencing of SABR for a patient with 2 or more oligoprogressing lesions?

15. What is the minimum ECOG performance status of a patient you would consider for SABR for oligoprogression?

16. I am more likely to offer SABR as a possible treatment option for a patient with oligoprogression if the referring medical oncologist has indicated a preference for SABR

17. For oligoprogressive cancer, I am more likely to offer single-fraction than multi-fraction SABR

Lymph node

Lung - peripheral

Lung - central

Spine

Non-spine bone

Liver

Adrenal

19. I use the same SABR dose regardless of tumor histology

Please explain

20. I would enroll patients with 1-2 oligoprogressive lesions in a clinical trial in which the patient may be randomized to receive no SABR and not allowed to receive SABR at further progression (low dose palliative RT allowed)

Why?

21. I would enroll patients with 3-5 oligoprogressive lesions to a clinical trial in which the patient may be randomized to receive no SABR and not allowed to receive SABR at further progression (low dose palliative RT allowed)

Why?

22. I would consider enrolling patients with oligoprogressive cancer (1-5 lesions) with the following primary tumor type to a clinical trial in which the patient may be randomized to receive no SABR and not allowed to receive SABR at further progression (select all that apply):

Breast

Prostate

Lung - driver mutation positive

Lung - driver mutation negative

Renal cell carcinoma

Other primary tumors

23. I would consider enrolling patients with 1-5 oligoprogressive lesions in a clinical trial in which the patient may be randomized between SABR and palliative dose RT

Why?

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.