Driving developments in UK oesophageal radiotherapy through the SCOPE trials
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RESEARCH
Open Access
Driving developments in UK oesophageal radiotherapy through the SCOPE trials S. Gwynne1,2* , E. Higgins1, A. Poon King1, G. Radhakrishna3, L. Wills2, S. Mukherjee4, Maria Hawkins4, G. Jones2, J. Staffurth2,5 and T. Crosby6
Abstract Background: The SCOPE trials (SCOPE 1, NeoSCOPE and SCOPE 2) have been the backbone of oesophageal RT trials in the UK. Many changes in oesophageal RT techniques have taken place in this time. The SCOPE trials have, in addition to adopting these new techniques, been influential in aiding centres with their implementation. We discuss the progress made through the SCOPE trials and include details of a questionnaire sent to participating centres. to establish the role that trial participation played in RT changes in their centre. Methods: Questionnaires were sent to 47 centres, 27 were returned. Results: 100% of centres stated their departmental protocol for TVD was based on the relevant SCOPE trial protocol. 4DCT use has increased from 42 to 71%. Type B planning algorithms, mandated in the NeoSCOPE trial, were used in 79.9% pre NeoSCOPE and now in 83.3%. 12.5% of centres were using a stomach filling protocol pre NeoSCOPE, now risen to 50%. CBCT was mandated for IGRT in the NeoSCOPE trial. 66.7% used this routinely pre NeoSCOPE/SCOPE 2 which has risen to 87.5% in the survey. Conclusion: The results of the questionnaires show how participation in national oesophageal RT trials has led to the adoption of newer RT techniques in UK centres, leading to better patient care. Keywords: Oesophagus, Radiotherapy, Quality assurance
Background Chemoradiotherapy (CRT) has a role in the management of potentially curable oesophageal cancer in the definitive (dCRT) [1] and neoadjuvant (naCRT) settings [2]. The SCOPE trials (SCOPE 1 [3], NeoSCOPE [4] and SCOPE 2 [5]) have been the backbone of trials involving radiotherapy (RT) for oesophageal cancer in the UK over the last ten years. SCOPE 1 opened to recruitment in 2008, NeoSCOPE in 2013, and SCOPE 2 opened in early 2017. Many changes in oesophageal RT techniques have taken place in the intervening period. In the UK, most modern RT techniques implemented in departments across the country have been as the result of large scale randomised trials [6]. The SCOPE trials in oesophageal cancer have, in addition to adopting these new techniques, been influential in aiding centres with their implementation. Here we * Correspondence: [email protected] 1 South West Wales Cancer Centre, Swansea, UK 2 NIHR Cardiff RTTQA Group, Cardiff, UK Full list of author information is available at the end of the article
discuss the progress made through the SCOPE trials and include details of a questionnaire sent to participating centres to establish the role that trial participation played in RT changes in their centre.
Methods Questionnaires were provided to 47 centres that had participated in SCOPE 1/NeoSCOPE or expressed interest in SCOPE 2. Questionnaires were first distributed to participants at the SCOPE 2 launch meeting held in April 2016
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