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Current Oncology
Volume 24
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Identifying Barriers to Accrual in Radiation Oncology Randomized Trials

by
J. M. Laba
1,
S. Senan
2,
D. Schellenberg
3,
S. Harrow
4,
L. Mulroy
5,
S. Senthi
6,
A. Swaminath
7,
N. Kopek
8,
J.R. Pantarotto
9,
L. Pan
10,
A. Pearce
11,
A. Warner
1,
A.V. Louie
1,12 and
David A. Palma
1,12,*
1
Department of Radiation Oncology, London Health Sciences Centre, 790 Commissioners Road East, London, Ontario N6A 4L6, Canada
2
Department of Radiation Oncology, VU University Medical Centre, Amsterdam, The Netherlands
3
Department of Radiation Oncology, BC Cancer Agency, Surrey, BC, Canada
4
Department of Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
5
Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
6
Alfred Health Radiation Oncology, The Alfred Hospital, Melbourne, Australia
7
Department of Radiation Oncology, Juravinski Cancer Center, Hamilton, ON, Canada
8
Department of Oncology, McGill University, Montreal, QC, Canada
9
Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada
10
Department of Radiation Oncology, Prince Edward Island Cancer Treatment Centre, Charlottetown, PE, Canada
11
Department of Radiation Oncology, Northeast Cancer Centre, Sudbury, ON, Canada
12
Department of Oncology, Western University, London, ON, Canada
 
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Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(6), 524-530; https://doi.org/10.3747/co.24.3662
Submission received: 2 September 2017 / Revised: 7 October 2017 / Accepted: 11 November 2017 / Published: 1 December 2017

Abstract

Background: Data about factors driving accrual to radiation oncology trials are limited. In oncology, 30%–40% of trials are considered unsuccessful, many because of poor accrual. The goal of the present study was to inform the design of future trials by evaluating the effects of institutional, clinician, and patient factors on accrual rates to a randomized radiation oncology trial. Methods: Investigators participating in sabr-comet (NCT01446744), a randomized phase ii trial open in Canada, Europe, and Australia that is evaluating the role of stereotactic ablative radiotherapy (sabr) in oligometastatic disease, were invited to complete a survey about factors affecting accrual. Institutional ethics approval was obtained. The primary endpoint was the annual accrual rate per institution. Univariable and multivariable linear regression analyses were used to identify factors predictive of annual accrual rates. Results: On univariable linear regression analysis, off-trial availability of sabr (p = 0.014) and equipoise of the referring physician (p = 0.014) were found to be predictive of annual accrual rates. The annual accrual rates were lower when centres offered sabr for oligometastases off-trial (median: 3.7 patients vs. 8.4 patients enrolled) and when referring physicians felt that, compared with having equipoise, sabr was beneficial (median: 4.8 patients vs. 8.4 patients enrolled). Multivariable analysis identified perceived level of equipoise of the referring physician to be predictive of the annual accrual rate (p = 0.023). Conclusions: The level of equipoise of referring physicians might play a key role in accrual to radiation oncology randomized controlled trials. Efforts to communicate with and educate referring physicians might therefore be beneficial for improving trial accrual rates.
Keywords: oligometastases; stereotactic radiotherapy; clinical trials; accrual oligometastases; stereotactic radiotherapy; clinical trials; accrual

Share and Cite

MDPI and ACS Style

Laba, J.M.; Senan, S.; Schellenberg, D.; Harrow, S.; Mulroy, L.; Senthi, S.; Swaminath, A.; Kopek, N.; Pantarotto, J.R.; Pan, L.; et al. Identifying Barriers to Accrual in Radiation Oncology Randomized Trials. Curr. Oncol. 2017, 24, 524-530. https://doi.org/10.3747/co.24.3662

AMA Style

Laba JM, Senan S, Schellenberg D, Harrow S, Mulroy L, Senthi S, Swaminath A, Kopek N, Pantarotto JR, Pan L, et al. Identifying Barriers to Accrual in Radiation Oncology Randomized Trials. Current Oncology. 2017; 24(6):524-530. https://doi.org/10.3747/co.24.3662

Chicago/Turabian Style

Laba, J. M., S. Senan, D. Schellenberg, S. Harrow, L. Mulroy, S. Senthi, A. Swaminath, N. Kopek, J.R. Pantarotto, L. Pan, and et al. 2017. "Identifying Barriers to Accrual in Radiation Oncology Randomized Trials" Current Oncology 24, no. 6: 524-530. https://doi.org/10.3747/co.24.3662

APA Style

Laba, J. M., Senan, S., Schellenberg, D., Harrow, S., Mulroy, L., Senthi, S., Swaminath, A., Kopek, N., Pantarotto, J. R., Pan, L., Pearce, A., Warner, A., Louie, A. V., & Palma, D. A. (2017). Identifying Barriers to Accrual in Radiation Oncology Randomized Trials. Current Oncology, 24(6), 524-530. https://doi.org/10.3747/co.24.3662

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