Proceedings of the 49th Annual ASTRO Meeting S565

2651 Recruitment Model for Decision Making in Innovative Therapies: Application to Carbon Ions and

Protons Radiotherapy

P. Pommier1, J. Borras2, M. Barom3, E. Amsallem4, F. Feschet5

1Centre Leon Berard, Lyon, France, 2Pla director Oncologia, Barcelona, Spain, 3University Hospital, Besancon, France,4CNAMTS, Saint Etienne, France, 5University Institute of Technology, Clermont Ferrand, France

Purpose/Objective(s): An original model was developed to simulate the consequences on patients’ recruitment in innovative ther-apy facilities of several scenarios for the expected clinical benefit and the specificities of the demand and the offer. It was applied tocarbon ions and protons radiotherapy and tested in the French context: carbon ion radiotherapy facility project and two existingprotons facilities, Medicyc (Nice) with indications limited to eye melanoma and the ICPO (Paris) within renovation with an addi-tional gantry.

Materials/Methods: The demand consisted on selected indications, each of them associated with a proton and/or a carbon ionstherapeutic protocol that are classified in ‘‘priority levels’’ according to the expected benefit and its level of proof compared toalternative standard therapies. Each protocol specified several requirements: gantry versus fixed beams and treatment room immo-bilization duration. The offer included 4 centers: ICPO, MediCyc and two potential locations for a carbon ion center, Lyon(ETOILE) and/or Caen (Asclepios). Each of the treatment rooms were characterized by their medical and technical equipmentand by a treatment time capacity. The impact of the distance for patient recruitment led to the definition of sub-areas with specificgeographic attraction towards each centre and in which the incidence of each indication was estimated. Two scenarios for the re-cruitment area were simulated: one limited to France and one extended to Europe (Table 1). The multi-step allocation process startswith a random draw of a patient in the highest priority levels’ protocol, identifies room(s) available, applies if required the geo-graphic attraction factors as to propose a room allocation to the patient, who will finally accept or not to be recruited accordingthe expected benefit and the distance factors.

Results: Major quantitative and qualitative consequences were reported. For instance, the increase of high priority indications ob-tained by the extension to Europe and the equipment of all the rooms with a gantry was also associated to a significant reduction ofthe total recruitment due to protocols’ characteristics. The modification of the expected benefit or attraction values or led to an ex-tension of the indications only in the ‘‘France scenario’’. The location of the carbon ion centers did not impact the recruitment withonly one center, but the simulation of both centers resulted in significant qualitative differences for their respective recruitment.

Conclusions: The recruitment model may be an important contribution to support decision making in a context on uncertaintiesand competition for innovative therapies.

Table 1

France Europe

ETOILE

Asclepios ETOILE Asclepios

Priority Group %

Ref. 1 shift Low attract. Gantries Ref. Ref. 1 shift Low attract. Gantries Ref.

1

18 39.8 14.3 26.6 16.6 66.5 99 63 67 65

2

27 48.8 18.6 73 26.3 33 0.4 36.5 32.7 34.4

4

55 11.3 40 0.4 57% 0.5 0.4 0.5 0.3 0.5

5

2

7

0.1 0.1 25 0.1

N

888 399 1038 603 904 651 425 644 641 648

Author Disclosure: P. Pommier, None; J. Borras, None; M. Baron, None; E. Amsallem, None; F. Feschet, None.

2652 Integrating Radiation Oncology Into the Medical School Curriculum: Initial Results of the Oncology

Education Initiative

D. Singh, P. J. Slanetz, A. E. Hirsch

Boston University School of Medicine, Boston, MA

Purpose/Objective(s): Multidisciplinary cancer care requires integration of teaching across established educational boundaries.As exposure to oncology and radiation oncology is limited in the undergraduate medical education curriculum, we introducedan Oncology Education Initiative. We report on the addition of structured multidisciplinary oncology education to the requiredradiology core clerkship at our Institution.

Materials/Methods: We conducted an institutional based cohort study of fourth-year medical students rotating through a requiredclerkship in radiology at our Institution beginning with the class of 2007. An educational questionnaire measuring perceived qualityof oncology education prior to and following exposure to a structured didactic program.

Results: Of the 149 fourth-year students, 82 (55%) have completed the clerkship to date. While 28 of 82 (34%) of students reportedhaving limited exposure to cancer care in the clinical years, 76 of 82 (93%) were motivated to learn more about the subject and 69of 82 (84%) reported a better understanding of the multidisciplinary nature of cancer care following this oncology educationinitiative. Seventy-four of 82 (90%) felt that the radiology clerkship was an opportune time to receive oncology and radiationoncology teaching. As a result of the initiative, nearly one third of the students not applying for a radiation oncology residencyelected to rotate through the department for advanced on-site training in the field.

Conclusions: Systematic exposure to multidisciplinary oncology education as part of a radiology core clerkship provides anexcellent opportunity for integrated teaching of oncologic principles and patient management. This type of experience addressesan important yet underrepresented component of undergraduate medical education.

Author Disclosure: D. Singh, None; P.J. Slanetz, None; A.E. Hirsch, None.