S2822
RTT - RTT education, training, and advanced practice
ESTRO 2026
Digital Poster Highlight 1504
June 2024 the workflow was switched to RTT- driven (Period C).Rate of adaption was extracted from these three periods. Furthermore, a staff-focused questionnaire was used for monitoring the adaptive process with recording of reasons for adapting or not. Choice of adaptation or not has no impact on economics of the department. Results: During period A 27 patients were treated, and theadaption rate was447/679 fractions (65.8%). After imager upgrade (period B)11 patients were treated and the adaption rate increased to 203/266 fractions76.3% (p=0.002 for difference).Following RTT driven workflow (period C)16 patients were treated and the adaption rate was 370/410 fractions (90,2%, p<0.0001 compared to A and B, cf. Figure 1). The main reason for not adapting during periods A and B was either no dosimetricadvantage to adaptation or that no physician was available at treatment. During period C the main reason for not choosing an adapted plan that there was no difference between the two plans (79%). For one patient treated in period C the scheduled plan was consistently chosen because of either better target coverage or lower dose to OAR.This has not been observed in other patients in that period.Adaptationwas chosen primarily due to better target coverage/more homogenic dose (83%) orreduced dose to normal tissue (17%).
Radiation Therapists’ Attitudes, Challenges, and Opportunities in Caring for Cancer Patients with Dementia: A Mixed-Methods Study Wendy S H Hoy 1 , Sarah E Smith 2 , Tabitha Chan 1 , Yvonne YN Loh 1 1 Department of Radiation Oncology, NATIONAL UNIVERSITY CANCER INSTITUTE, SINGAPORE, Singapore, Singapore. 2 Radiotherapy & Oncology, Sheffield Hallam University, Sheffield, United Kingdom Purpose/Objective: Cancer and dementia frequently co-exist, posing complex challenges for radiation therapy delivery, where reproducibility, communication, and safety are paramount. Radiation therapists (RTTs) are at the frontline of this care, yet limited evidence exists in Singapore on how RTTs manage this vulnerable population. This study sought to explore RTTs’ attitudes, challenges, and strategies when treating patients with comorbid dementia and cancer, with the broader aim of informing service development and advancing dementia-sensitive oncology practice. Material/Methods: A mixed-methods design was adopted. Quantitative data were collected via an online survey of RTTs (n=86) using the Dementia Attitude Scale, supplemented with items on caregiving challenges and strategies. Descriptive statistics and non-parametric tests (Mann- Whitney U, Kruskal-Wallis H) were applied to survey data. Qualitative data were obtained through three focus group discussions (n=10) guided by the UK Promoting Excellence framework. Thematic analysis was used for focus group transcripts to identify patterns in attitudes, barriers, and adaptive practices. Results: RTTs demonstrated neutral to moderately positive attitudes (mean DAS = 93.6). Personal exposure to dementia significantly improved comfort and knowledge (p = 0.001); clinical exposure enhanced comfort (p = 0.034). Notably, only 2.3 % participants reported formal dementia training. Major challenges included communication barriers, behavioural symptoms, treatment reproducibility, and patient safety. Strategies to address these included caregiver involvement, advocated RTTs for advanced clinical roles, modified communication methods, flexible scheduling, and additional safety measures. Focus group narratives reinforced these findings, highlighting both empathy in care delivery and the stress placed on junior staff. Conclusion: This study provides the mixed-methods evidence on RTTs’ experiences in dementia care within radiotherapy. While RTTs demonstrated compassionate attitudes towards radiation therapy
Figure 1 Trend for adaptation during the three periods (A, B and C). Conclusion: Introducing both a new imager and RTT-driven workflow has increased the adaptation rate. RTT- driven online adaptation is feasible and resolves the problem of “physician not available” as a decision parameter in choice of treatment. This developmentmay allow treatment modifications, such as margin reductions, that depend on full availability of the adaptive option. Keywords: Online ART, vulvar carcinoma, RTT lead workflow
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