S1487
Interdisciplinary - Patient involvement
ESTRO 2026
Simon Ingram 1 , Ross Tierney 2 , Sophie Boisbouvier 3,4 , Jemma Nunn 5 , Gordon Sands 1,6 , Susmitha Cherukuru Lakshmipathy 7 , Tanmoy Das 7 , Michael Fray 8 , Tracy Underwood 1,6 1 Research Department, Leo Cancer Care, Crawley, United Kingdom. 2 Engineering Department, Leo Cancer Care, Crawley, United Kingdom. 3 Radation Oncology Department, Centre Léon Bérard, Lyon, France. 4 UMR INSERM 1052-CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France. 5 Clinical Department, Leo Cancer Care, Crawley, United Kingdom. 6 Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom. 7 Human Factors Department, Leo Cancer Care, Crawley, United Kingdom. 8 School for Design and Creative Arts, Loughborough University, Loughborough, United Kingdom Purpose/Objective: Upright radiotherapy offers potential benefits in cost- effectiveness and patient comfort [1]. However, thoracic radiotherapy typically requires raised arms, and maintaining a comfortable, stable and reproducible “arms-up” position can be challenging [2]. In supine breast radiotherapy, it is well-recognised that some patients cannot sustain satisfactory arms- up positioning, especially when shoulder mobility is impaired by post-surgical effects, axillary cording, or adhesive capsulitis [3]. This study applied the principles of “Design Thinking” and “Co-design” (Figure 1) to develop patient-centred, ergonomic arms-up supports for upright radiotherapy of the thorax.
from a patient advocate, a physiotherapist, two radiation therapists, two physicists, an engineer and a human-centred designer. Prototypes were developed iteratively through cycles of ergonomic evaluation, 3D modelling, and rapid prototyping. Initial designs underwent formative testing in Spring 2023 with ten women with lived experience of breast radiotherapy. Refined prototypes were then evaluated with 21 healthy volunteers, and clinical staff in Spring 2024. A co-design workshop in Summer 2024 focused on inclusive design and ergonomics, involving experts in physiotherapy and human factors to refine arm comfort. New prototypes were tested in Winter 2024 with a new cohort of 14 volunteers with lived experience of breast radiotherapy. Throughout this process, feedback from questionnaires, usability testing, and simulated treatment sessions informed progressive refinements to geometry, adjustability, and overall form.
Results: Iterative development led to improvements in comfort, stability, and reproducibility. In Spring 2024 testing, participants were able to reposition themselves within the supports, typically achieving sub-centimetre reproducibility in the breast region without guidance from the study team. During Winter 2024 testing, 11/14 participants reported pre-existing upper-limb issues (eight related to cancer treatment, three unrelated). Using the new prototypes, 13/14 of these participants were able to raise their arms to a suitable height and maintain the position for a simulated treatment. Ten participants reported that the supports were more comfortable than those used during their supine radiotherapy (three were not sure,
Material/Methods: The stages of the co-design process are outlined in Figure 2. A multidisciplinary stakeholder workshop in Summer 2022 defined design specifications with input
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