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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Implementation Strategies to Promote Short-Course Radiation for Bone Metastases.

Erin F Gillespie1,2, Patricia Mae G Santos1, Michael Curry3

  • 1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.

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Implementing a set of strategies did not increase short-course radiotherapy for bone metastases. However, practice improved over time, highlighting the need for better evidence-based radiation oncology approaches.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Quality Improvement

Background:

  • Short-course radiotherapy (RT) offers benefits for non-spine bone metastases but faces variable adoption.
  • Variations in RT practice necessitate strategies to improve adherence to evidence-based guidelines.

Purpose of the Study:

  • To assess if three implementation strategies increase the adoption of short-course RT for non-spine bone metastases.
  • To evaluate the feasibility, acceptability, and appropriateness of dissemination of guidelines, audit-and-feedback, and eConsult.

Main Methods:

  • A prospective, stepped-wedge, cluster randomized quality improvement study at 3 cancer centers.
  • Implementation strategies included guideline dissemination, personalized audit-and-feedback, and an eConsult platform.
  • Mixed-effects logistic regression analyzed adherence to short-course RT, with physician surveys assessing strategy perceptions.

Main Results:

  • The implementation strategies were not associated with increased short-course RT use (OR, 0.78; P=.40).
  • Unadjusted adherence rates were 53% preimplementation and 56% postimplementation.
  • Adherence increased with calendar time (OR, 1.68; P=.003), and all strategies were perceived as feasible and acceptable.

Conclusions:

  • A multicomponent implementation strategy did not significantly increase short-course RT adoption in this academic-community partnership.
  • Practice improvement over time suggests secular trends or increased awareness.
  • Further research is needed to optimize evidence-based radiation practice implementation.