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Development of VET-ROC, the Veterans Radiation Oncology Consortium to Support and Promote VA Clinical Research
Purpose: To inform stakeholders of a newly formed, VAbased, research oriented collaborative group, the Veterans Radiation Oncology Consortium (VET-ROC).
Background: To strengthen, promote and enhance VA oncology and radiation oncology centered research, VET-ROC was conceived in October 2018 at the San Antonio VA Radiation Oncology Field Based Meeting and formed with the consent of 18 members sites.
Results: An email sent to all 85 known VA radiation oncologists in October 2018 drew 18 positive responses to join a clinical research consortium within VA. Members responded to 2 questionnaires about the state of their program in October 2018 and April 2019. Per their responses, VET-ROC sites consist of approximately 47 FTE Radiation Oncologists and > 26 FTE Physicists. The sites reported a total of 7.1 FTEE Clinical Research Coordinators (CRC’s) in October 2018 and 10.2 FTE CRC’s in April 2019 with most sites sharing CRC’s with other specialties. Five sites reported a lack of any research coordinator in October 2018, and in April 2019, 3 of those 5 sites had received approval from their resource management committees to hire CRCs.
The group had a face to face meeting in FEB 2019 and has held conference calls every 4-6 weeks since then to review opportunities for research, shared best practices, partake in educational webinars, identify barriers to research development, opportunities for research proposals with at least 2 groups of members submitting Merit Review awards to CSR&D that may have been possible as a result of VET-ROC. Feedback on the progress the group has made has been largely positive. Individual responses noted that the group had created opportunities that would not have been possible otherwise. There were suggestions to formalize the structure of the group.
Conclusion: Since its formation, VET-ROC has been a very positive experience for its members who consist of a select group of Radiation Oncologists with shared common interests in clinical research. The group will likely continue to move grow and move forward if it can translate its momentum into research support obtained from a diverse source of funding mechanisms.
Purpose: To inform stakeholders of a newly formed, VAbased, research oriented collaborative group, the Veterans Radiation Oncology Consortium (VET-ROC).
Background: To strengthen, promote and enhance VA oncology and radiation oncology centered research, VET-ROC was conceived in October 2018 at the San Antonio VA Radiation Oncology Field Based Meeting and formed with the consent of 18 members sites.
Results: An email sent to all 85 known VA radiation oncologists in October 2018 drew 18 positive responses to join a clinical research consortium within VA. Members responded to 2 questionnaires about the state of their program in October 2018 and April 2019. Per their responses, VET-ROC sites consist of approximately 47 FTE Radiation Oncologists and > 26 FTE Physicists. The sites reported a total of 7.1 FTEE Clinical Research Coordinators (CRC’s) in October 2018 and 10.2 FTE CRC’s in April 2019 with most sites sharing CRC’s with other specialties. Five sites reported a lack of any research coordinator in October 2018, and in April 2019, 3 of those 5 sites had received approval from their resource management committees to hire CRCs.
The group had a face to face meeting in FEB 2019 and has held conference calls every 4-6 weeks since then to review opportunities for research, shared best practices, partake in educational webinars, identify barriers to research development, opportunities for research proposals with at least 2 groups of members submitting Merit Review awards to CSR&D that may have been possible as a result of VET-ROC. Feedback on the progress the group has made has been largely positive. Individual responses noted that the group had created opportunities that would not have been possible otherwise. There were suggestions to formalize the structure of the group.
Conclusion: Since its formation, VET-ROC has been a very positive experience for its members who consist of a select group of Radiation Oncologists with shared common interests in clinical research. The group will likely continue to move grow and move forward if it can translate its momentum into research support obtained from a diverse source of funding mechanisms.
Purpose: To inform stakeholders of a newly formed, VAbased, research oriented collaborative group, the Veterans Radiation Oncology Consortium (VET-ROC).
Background: To strengthen, promote and enhance VA oncology and radiation oncology centered research, VET-ROC was conceived in October 2018 at the San Antonio VA Radiation Oncology Field Based Meeting and formed with the consent of 18 members sites.
Results: An email sent to all 85 known VA radiation oncologists in October 2018 drew 18 positive responses to join a clinical research consortium within VA. Members responded to 2 questionnaires about the state of their program in October 2018 and April 2019. Per their responses, VET-ROC sites consist of approximately 47 FTE Radiation Oncologists and > 26 FTE Physicists. The sites reported a total of 7.1 FTEE Clinical Research Coordinators (CRC’s) in October 2018 and 10.2 FTE CRC’s in April 2019 with most sites sharing CRC’s with other specialties. Five sites reported a lack of any research coordinator in October 2018, and in April 2019, 3 of those 5 sites had received approval from their resource management committees to hire CRCs.
The group had a face to face meeting in FEB 2019 and has held conference calls every 4-6 weeks since then to review opportunities for research, shared best practices, partake in educational webinars, identify barriers to research development, opportunities for research proposals with at least 2 groups of members submitting Merit Review awards to CSR&D that may have been possible as a result of VET-ROC. Feedback on the progress the group has made has been largely positive. Individual responses noted that the group had created opportunities that would not have been possible otherwise. There were suggestions to formalize the structure of the group.
Conclusion: Since its formation, VET-ROC has been a very positive experience for its members who consist of a select group of Radiation Oncologists with shared common interests in clinical research. The group will likely continue to move grow and move forward if it can translate its momentum into research support obtained from a diverse source of funding mechanisms.
Use of Palliative Radiotherapy for Stage IV Lung Cancer Patients with Thoracic Symptoms in the Veterans Health Administration (VHA)
Background: Palliative radiotherapy plays an important role in metastatic lung cancer (LC) treatment. Of VHA LC patients, 46% present with metastatic disease. The American Society for Radiation Oncology (ASTRO) has developed evidenced-based guidelines regarding management of metastatic LC.
Methods: In May 2016, an electronic survey of 84 VHA Radiation Oncologists (ROs) was conducted to assess metastatic LC management. Information on years in practice, employment status, academic appointment, board certification, and familiarity with ASTRO lung cancer guidelines was obtained. Two clinical scenarios were presented to glean opinions on dose/fractionation schemes preferred, preferences for/ against concurrent chemotherapy, and use of endobronchial brachytherapy (EBB) and/or YAG laser technology. Survey results were assessed for concordance with ASTRO guidelines.
Results: The survey response rate was 64%. Among respondents, 96% were board certified, 90% held academic appointments, 85% were full-time employees, 11% were part-time employees, and 3% were employed on contract. When asked about use of palliative radiotherapy for lung cancer, 88% were familiar with ASTRO guidelines, 13% had used Stereotactic Body Radiotherapy (SBRT) for palliation, and 26% referred to outside centers for EBB.
Clinical Scenarios: Case 1 – Metastatic (M1b) disease with local chest wall pain and 3 month life expectancy: All respondents recommended palliative radiotherapy, and most (98%) did not recommend concurrent chemotherapy. The fractionation schemes most often used were 20 Gy in 5 fractions (69%) and 30 Gy in 10 fractions (22%).
Case 2 – Metastatic (M1a) disease with endobronchial tumor blockage: 87% of the respondents would use conventional radiotherapy for symptoms such as hemoptysis, intractable cough, and pain, and the remainder would use SBRT. Almost half of respondents (49%) recommended EBB or YAG lung re-expansion before external beam radiotherapy.
Conclusion: In our study of VHA ROs and their knowledge of management of advanced (M1a/M1b) lung cancer, we found no distinction in clinical decisions based on demographic profiles. Almost all reported knowledge of evidence-based treatment guidelines for palliative radiotherapy of lung cancer and most recommended treatment according to current guidelines.”
Background: Palliative radiotherapy plays an important role in metastatic lung cancer (LC) treatment. Of VHA LC patients, 46% present with metastatic disease. The American Society for Radiation Oncology (ASTRO) has developed evidenced-based guidelines regarding management of metastatic LC.
Methods: In May 2016, an electronic survey of 84 VHA Radiation Oncologists (ROs) was conducted to assess metastatic LC management. Information on years in practice, employment status, academic appointment, board certification, and familiarity with ASTRO lung cancer guidelines was obtained. Two clinical scenarios were presented to glean opinions on dose/fractionation schemes preferred, preferences for/ against concurrent chemotherapy, and use of endobronchial brachytherapy (EBB) and/or YAG laser technology. Survey results were assessed for concordance with ASTRO guidelines.
Results: The survey response rate was 64%. Among respondents, 96% were board certified, 90% held academic appointments, 85% were full-time employees, 11% were part-time employees, and 3% were employed on contract. When asked about use of palliative radiotherapy for lung cancer, 88% were familiar with ASTRO guidelines, 13% had used Stereotactic Body Radiotherapy (SBRT) for palliation, and 26% referred to outside centers for EBB.
Clinical Scenarios: Case 1 – Metastatic (M1b) disease with local chest wall pain and 3 month life expectancy: All respondents recommended palliative radiotherapy, and most (98%) did not recommend concurrent chemotherapy. The fractionation schemes most often used were 20 Gy in 5 fractions (69%) and 30 Gy in 10 fractions (22%).
Case 2 – Metastatic (M1a) disease with endobronchial tumor blockage: 87% of the respondents would use conventional radiotherapy for symptoms such as hemoptysis, intractable cough, and pain, and the remainder would use SBRT. Almost half of respondents (49%) recommended EBB or YAG lung re-expansion before external beam radiotherapy.
Conclusion: In our study of VHA ROs and their knowledge of management of advanced (M1a/M1b) lung cancer, we found no distinction in clinical decisions based on demographic profiles. Almost all reported knowledge of evidence-based treatment guidelines for palliative radiotherapy of lung cancer and most recommended treatment according to current guidelines.”
Background: Palliative radiotherapy plays an important role in metastatic lung cancer (LC) treatment. Of VHA LC patients, 46% present with metastatic disease. The American Society for Radiation Oncology (ASTRO) has developed evidenced-based guidelines regarding management of metastatic LC.
Methods: In May 2016, an electronic survey of 84 VHA Radiation Oncologists (ROs) was conducted to assess metastatic LC management. Information on years in practice, employment status, academic appointment, board certification, and familiarity with ASTRO lung cancer guidelines was obtained. Two clinical scenarios were presented to glean opinions on dose/fractionation schemes preferred, preferences for/ against concurrent chemotherapy, and use of endobronchial brachytherapy (EBB) and/or YAG laser technology. Survey results were assessed for concordance with ASTRO guidelines.
Results: The survey response rate was 64%. Among respondents, 96% were board certified, 90% held academic appointments, 85% were full-time employees, 11% were part-time employees, and 3% were employed on contract. When asked about use of palliative radiotherapy for lung cancer, 88% were familiar with ASTRO guidelines, 13% had used Stereotactic Body Radiotherapy (SBRT) for palliation, and 26% referred to outside centers for EBB.
Clinical Scenarios: Case 1 – Metastatic (M1b) disease with local chest wall pain and 3 month life expectancy: All respondents recommended palliative radiotherapy, and most (98%) did not recommend concurrent chemotherapy. The fractionation schemes most often used were 20 Gy in 5 fractions (69%) and 30 Gy in 10 fractions (22%).
Case 2 – Metastatic (M1a) disease with endobronchial tumor blockage: 87% of the respondents would use conventional radiotherapy for symptoms such as hemoptysis, intractable cough, and pain, and the remainder would use SBRT. Almost half of respondents (49%) recommended EBB or YAG lung re-expansion before external beam radiotherapy.
Conclusion: In our study of VHA ROs and their knowledge of management of advanced (M1a/M1b) lung cancer, we found no distinction in clinical decisions based on demographic profiles. Almost all reported knowledge of evidence-based treatment guidelines for palliative radiotherapy of lung cancer and most recommended treatment according to current guidelines.”