J M Laba1, S Senan2, D Schellenberg3, S Harrow4, L Mulroy5, S Senthi6, A Swaminath7, N Kopek8, J R Pantarotto9, L Pan10, A Pearce11, A Warner1, A V Louie1,12, D A Palma1,12. 1. Department of Radiation Oncology, London Health Sciences Centre, London, ON. 2. Department of Radiation Oncology, VU University Medical Centre, Amsterdam, Netherlands. 3. Department of Radiation Oncology, BC Cancer Agency, Surrey, BC. 4. Department of Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, Scotland. 5. Department of Radiation Oncology, Dalhousie University, Halifax, NS. 6. Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, Australia. 7. Department of Radiation Oncology, Juravinski Cancer Center, Hamilton, ON. 8. Department of Oncology, McGill University, Montreal, QC. 9. Division of Radiation Oncology, University of Ottawa, Ottawa, ON. 10. Department of Radiation Oncology, Prince Edward Island Cancer Treatment Centre, Charlottetown, PE. 11. Department of Radiation Oncology, Northeast Cancer Centre, Sudbury, ON. 12. Department of Oncology, Western University, London, ON.
Abstract
BACKGROUND: Data about factors driving accrual to radiation oncology trials are limited. In oncology, 30%-40% of trials are considered unsuccessful, many because of poor accrual. The goal of the present study was to inform the design of future trials by evaluating the effects of institutional, clinician, and patient factors on accrual rates to a randomized radiation oncology trial. METHODS: Investigators participating in sabr-comet (NCT01446744), a randomized phase ii trial open in Canada, Europe, and Australia that is evaluating the role of stereotactic ablative radiotherapy (sabr) in oligometastatic disease, were invited to complete a survey about factors affecting accrual. Institutional ethics approval was obtained. The primary endpoint was the annual accrual rate per institution. Univariable and multivariable linear regression analyses were used to identify factors predictive of annual accrual rates. RESULTS: On univariable linear regression analysis, off-trial availability of sabr (p = 0.014) and equipoise of the referring physician (p = 0.014) were found to be predictive of annual accrual rates. The annual accrual rates were lower when centres offered sabr for oligometastases off-trial (median: 3.7 patients vs. 8.4 patients enrolled) and when referring physicians felt that, compared with having equipoise, sabr was beneficial (median: 4.8 patients vs. 8.4 patients enrolled). Multivariable analysis identified perceived level of equipoise of the referring physician to be predictive of the annual accrual rate (p = 0.023). CONCLUSIONS: The level of equipoise of referring physicians might play a key role in accrual to radiation oncology randomized controlled trials. Efforts to communicate with and educate referring physicians might therefore be beneficial for improving trial accrual rates.
BACKGROUND: Data about factors driving accrual to radiation oncology trials are limited. In oncology, 30%-40% of trials are considered unsuccessful, many because of poor accrual. The goal of the present study was to inform the design of future trials by evaluating the effects of institutional, clinician, and patient factors on accrual rates to a randomized radiation oncology trial. METHODS: Investigators participating in sabr-comet (NCT01446744), a randomized phase ii trial open in Canada, Europe, and Australia that is evaluating the role of stereotactic ablative radiotherapy (sabr) in oligometastatic disease, were invited to complete a survey about factors affecting accrual. Institutional ethics approval was obtained. The primary endpoint was the annual accrual rate per institution. Univariable and multivariable linear regression analyses were used to identify factors predictive of annual accrual rates. RESULTS: On univariable linear regression analysis, off-trial availability of sabr (p = 0.014) and equipoise of the referring physician (p = 0.014) were found to be predictive of annual accrual rates. The annual accrual rates were lower when centres offered sabr for oligometastases off-trial (median: 3.7 patients vs. 8.4 patients enrolled) and when referring physicians felt that, compared with having equipoise, sabr was beneficial (median: 4.8 patients vs. 8.4 patients enrolled). Multivariable analysis identified perceived level of equipoise of the referring physician to be predictive of the annual accrual rate (p = 0.023). CONCLUSIONS: The level of equipoise of referring physicians might play a key role in accrual to radiation oncology randomized controlled trials. Efforts to communicate with and educate referring physicians might therefore be beneficial for improving trial accrual rates.
Authors: Stephen L Lewis; Sandro Porceddu; Naoki Nakamura; David A Palma; Simon S Lo; Peter Hoskin; Drew Moghanaki; Steven J Chmura; Joseph K Salama Journal: Am J Clin Oncol Date: 2017-08 Impact factor: 2.339
Authors: Anneke T Schroen; Gina R Petroni; Hongkun Wang; Monika J Thielen; Robert Gray; Jacqueline Benedetti; Xiaofei F Wang; Daniel J Sargent; Donald L Wickerham; Walter Cronin; Benjamin Djulbegovic; Craig L Slingluff Journal: Clin Cancer Res Date: 2011-10-05 Impact factor: 12.531
Authors: David A Palma; Cornelis J A Haasbeek; George B Rodrigues; Max Dahele; Michael Lock; Brian Yaremko; Robert Olson; Mitchell Liu; Jason Panarotto; Gwendolyn H M J Griffioen; Stewart Gaede; Ben Slotman; Suresh Senan Journal: BMC Cancer Date: 2012-07-23 Impact factor: 4.430