S1382
Interdisciplinary - Health economics & health services research
ESTRO 2026
of Clinical Oncology, Beacon Centre, Musgrave Park Hospital, Somerset, NHS Foundation Trust., Somerset, United Kingdom Purpose/Objective: Clinical trials are essential for advancing radiotherapy (RT) treatments and improving patient outcomes 1. Despite this, RT trials represent only 9% of all oncology randomised controlled trials (RCTs) globally, even though approximately 50% of cancer patients require RT during their treatment2.The Irish national cancer strategy 2017-2026 has a target of 6% for clinical trial participation3 Understanding the factors influencing patient participation in RT trials is critical to optimising research investments, enhancing trial generalisability, and improving patient access to innovative care. Material/Methods: This retrospective review analysed real-world data from July 2021 to October 2025 across the UPMC Ireland Cancer Centre network. All newly diagnosed or relapsed patients referred for RT and eligible for an open Clinical Trial within our portfolio, were informed about relevant trials during their initial consultation with a Clinical Nurse Specialist and Radiation Oncologist. Follow-up calls by a clinical trials RTT specialist assessed interest and documented reasons for declining participation into an electronic registry. Data from 211 trial eligible patients across 10 RT trials were analysed, see fig. 1.
Conclusion: This review highlights that while patients are generally open to participating in RT trials, trial design significantly influences their decision-making. Randomisation, especially when involving no additional-treatment or placebo arms, can conflict with patient expectations of cancer care. Logistical challenges such as travel, time commitments, and work or caregiving responsibilities further deter participation. Psychosocial factors, including anxiety and decision fatigue at diagnosis, also play a role. To ensure equitable access to RT research, a multifaceted approach is needed. This includes simplifying trial designs, decentralising access, improving clinician- patient communication, and involving patients in trial development. These findings offer actionable insights for designing patient-centred RT trials and improving recruitment strategies. References: 1 HSE National Cancer Control programme, Clinical Trials for Cancer Patients. Available at https://www.hse.ie [Accessed 09/06/2025].2 Dodkins J, Hopman W, Connor Wells J, Lievens Y, Malik R.A, Pramesh C.S, GyaWali B, Hammad N, Mukherji D, Sullivan R, Parkes J, Booth C and Aggarwal A (2022). Is Clinical Research Serving the Needs of the Global Cancer Burden? An analysis of Contemporary Global
Radiation Therapy Randomised Controlled Trials. International Journal of Radiation
Oncology*Biology*Physics. Vol 113, Issue 3, 1July 2022, pages 500-508. 3 HSE, National cancer Strategy 2017- 2026. Available at https://www.gov.ie/en/department- of health/publications/national-cancer-strategy-2017- 2026-implementation-report-2023/ [Accessed 13/10/2025]. Keywords: Clinical Trials, Real-world Barriers, Patient
Results: Of the 211 eligible patients, 75 patients (35.5%) enrolled into a clinical trial. 136 (64.5%) patients declined trial participation see fig 2. The three most common patient reasons for refusal were: dissatisfaction or fear of randomisation (21%), preference for standard of care treatment (17%), and travel-related barriers (11.76%). Trials offering active treatment in all arms had higher acceptance rates, while those with placebo or no additional treatment arms saw greater patient entry reluctance.
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Impact of the human papilloma virus vaccination on cervical cancer incidence in Ontario, Canada: 15-year population trends Joanna Deng 1 , Eric Leung 1 , Rachel Kupets 2 , Aishah E Al- Qaderi 1 , Elizabeth A Barnes 1 , Hanbo Chen 1
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