S1405
Interdisciplinary - Health economics & health services research
ESTRO 2026
Miet Vandemaele 1 , Renée De Noyette 1 , Ajay Aggarwal 2,3 , Yolande Lievens 1,4 1 Radiation Oncology - Department of human structure and repair, Ghent University, Ghent, Belgium. 2 Institute of Cancer Policy, King's College London, London, United Kingdom. 3 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. 4 Radiation Oncology, Ghent University hospital, Ghent, Belgium Purpose/Objective: Understanding and identifying what benefits patients themselves would prioritise from radiotherapy treatment, is essential to ensure that research and appraisal of innovations use endpoints that matter most to patients, as well as for guiding clinical practice and healthcare policy. [1, 2] Material/Methods: A systematic search of Pubmed and Embase was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses – Scoping Review (PRISMA-ScR) guidelines. [3] Studies were included for 2010-2025 inclusive, using Index terms and keywords related to patient priority assessment for radiotherapy endpoints (e.g. ‘patient priority’, ‘rating’, ‘utility’). Eligible studies reported original data of patient preferences/priorities in radiotherapy. Abstracts were screened by two reviewers (MV, RD), data extraction (patient characteristics, methodology, and main results) was performed by one (MV). Results: Of 7,285 articles screened, 52 met the inclusion criteria. A qualitative review was performed; quantitative synthesis of the extracted data was not possible due to heterogeneity in study populations and methodologies. Table 1 summarises the included studies, representing 21 different tumour sites, most often prostate or breast cancer (8 studies each), and 11 countries. A curative setting or early/localised disease predominated (24 studies), followed by advanced disease (4), metastatic disease (3), recurrent disease (2) and palliative intent (1). Seven studies included multiple stages, eleven did not report any or included healthy volunteers. Methodologies varied widely, including quantitative (e.g. time trade-off, discrete choice) and qualitative (e.g. interviews) approaches. Overall survival was most frequently elicited as single priority endpoint (in 15 studies), followed by Functional (e.g. speech preservation) (5 studies), Systemic progression (e.g. progression-free survival) (3), Local or locoregional (3) and Adverse Events (1) endpoints. In 10 studies presenting a set of multiple (range 2-19) endpoints and 16 studies reporting variations in priority based on varying benefit/harm exchanges, Overall survival, Functional and Adverse events endpoints were prioritised consistently. Figure 1 shows the distribution of priority
endpoints across tumour types and disease stage.
Conclusion: This review reveals the paucity and heterogeneity in the available evidence on patient priorities for radiotherapy, with significant gaps in the knowledge regarding important patient populations (e.g. lung cancer, palliative patients) or geographical regions (e.g. LMICs). Although Overall survival, adverse events and functionality are prioritised consistently, the frequent reporting of variable or multiple priorities implies the need for a broader range of endpoints to adequately capture patients’ priorities. Additional patient-centred studies are urgently needed to inform about the value of radiotherapy innovations and support policy decision-making. [1]
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