Best practice for patient-centred radiotherapy in clinical trials and beyond – a national multidisciplinary consensus

Patient-centred radiotherapy refers to an approach where patients’ needs and preferences are prioritised. Guidelines for this personalised approach are lacking. We present a multidisciplinary national consensus and recommendations for best practice in patient-centred radiotherapy for both clinical trials and routine practice. A multidisciplinary working group was formed, comprising of healthcare professionals and patient advocates with lived experience of radiotherapy. Three interlinking themes were identified around patient-centred radiotherapy: information, decision-making and outcomes. Scoping reviews were carried out for each theme, considering current challenges and recommendations for best practice. Recommendations were shaped through consultation with 12 patient advocates. There is a pressing need to better support patients prior to, during and following radiotherapy. Radiotherapy-related patient information is often complex and challenging to understand. Information resources should be co-created with patient advocates and individualised wherever possible, including for patients from under-served groups. Shared decision-making (SDM) processes may enhance treatment satisfaction and reduce decision-regret, but these are not widely implemented. SDM requires prepared patients, trained teams, alongside adequate resources and should be offered as per patients’ preferences. Healthcare systems data offer complementary information to clinical trials, with the potential to provide additional insight into long-term benefits and risks of radiotherapy within ‘real-world’ conditions. Patient-reported outcome measures may provide greater insight regarding toxicity and impact on quality of life and should be used in synergy with clinician-reported outcomes. Outcome measures should be collected long-term and results should be widely disseminated to both the public and professional community. Equity of access to radiotherapy, clinical trials and survivorship services is a priority. Patients rightly expect more from healthcare professionals, and it is important that the radiotherapy community recognises this and embraces changes which will enhance patient-centred care. Our recommendations aim to guide best practice for patient-centred radiotherapy.