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Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00

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Sharline van Vliet - Perez (Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands)
Rosemarijn van Paassen (Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands)
Linda Wauben (Delft University of Technology, Department of BioMechanical Engineering, Delft, the Netherlands)
Robin Straathof (Delft University of Technology, Department of BioMechanical Engineering, Delft, the Netherlands)
Nick van de Berg (Delft University of Technology, Department of BioMechanical Engineering, Delft, the Netherlands)
Jenny Dankelman (Delft University of Technology, Department of BioMechanical Engineering, Delft, the Netherlands)
Ben Heijmen (Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands)
Inger-Karine Kolkman - Deurloo (Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands)
Remi Nout (Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands)

Abstract:
Objective Brachytherapy (BT) is an important component of the curative treatment for locally advanced cervical cancer (LACC). However, the patient’s experience in terms of pain, anxiety, and duration of each BT procedure step is still scarcely reported. The aim of this prospective study is to perform systematic time-action and patient experience analyses during cervical cancer BT as a benchmark for new technological developments and to guide further improvements. Method LACC patients treated with high-dose-rate BT were included for a time-action analysis (56 patients, 135 fractions) and patient experience analysis (29 patients, 70 fractions). The time-action analysis included a standardised form with the reported time needed for each step. The patient experience analysis included an EQ-5D questionnaire with health state index (0= dead, 1= full health) and EQ VAS score (0= worst imaginable health, 100= best imaginable health) at the beginning of the day to establish a baseline health status, and a numeric rating scale questionnaire (0= perfect situation, 10= worst possible situation) to assess the pain, anxiety and duration experience during each treatment step. The median and interquartile range (IQR) for all parameters is reported. Results The total procedure time (hours:minutes) from arrival at the BT department till discharge was 8:50 (8:00-9:25), i.e. preparation implantation, applicator implantation, recovery from implantation, imaging, treatment planning, irradiation, applicator removal, and recovery. Treatment planning was the longest treatment step with a time of 02:55 (IQR: 02:25-03:15). At the beginning of the day, patients had a health state index of 0.80 (IQR: 0.65-0.89) and EQ VAS score of 70 (IQR: 55-80). During treatment, the highest pain scores were reported while waiting for irradiation during treatment planning (median: 3, IQR: 0-6) and applicator removal (median: 3, IQR: 1-7), the highest anxiety scores were reported during applicator removal (median: 2, IQR: 0-7), and the highest perceptions of duration were reported during image acquisition (median: 4, IQR: 0-6). Conclusion This analysis highlights patient experience during different steps of the LACC BT workflow. The time-action and patient experience analyses can be used to optimise different steps of the BT treatment and as baseline for future studies.