2324 - Perceptions and Attitudes of Multidisciplinary Oncology Physicians and Advanced Practice Providers (APPs) Regarding Stereotactic Body Radiotherapy (SBRT) for Gastrointestinal (GI) Cancers

Purpose/Objective(s): With the advancement of radiation therapy technologies, ablative stereotactic body radiation therapy (SBRT) is often discussed at GI tumor boards. This project assessed non-radiation oncology (RO) providers' attitudes and perceptions of such therapy to identify potential gaps in interdisciplinary education that may affect the referral and treatment timeline for patients that are candidates for curative radiation therapy.

Materials/Methods: An anonymous, IRB-exempt survey was offered to GI oncology faculty and APPs within a single NCI designated comprehensive cancer center across the main campus and regional sites to assess perceptions of SBRT. The survey included 1-5 Likert scale questions ranging from Strongly Disagree to Strongly Agree, and frequency-based questions assessing practitioner confidence and practice patterns. Descriptive statistics were used to summarize survey responses.

Results:

24 GI practitioners completed the survey, including 9 medical oncologists (38%), 7 surgical oncologists (29%), and 8 APPs (33%). Experience managing GI cancer patients varied: 8% had =2 years, 25% had 2-5 years, 25% had 5-10 years, and 42% had >10 years.

Among the 18 practitioners managing pancreatic cancer, 71% agreed and 18% disagreed that the role of preoperative radiation therapy in borderline resectable pancreatic cancer depends on chemotherapy response. Disagreement rates by practitioner type were 12.5% of medical oncologists, 0% of surgical oncologists, and 28.6% of APPs.

Among the 18 practitioners managing colorectal cancer, 61% were confident or very confident in the local control effectiveness of SBRT for patients with up to three liver metastases, and 72% expressed confidence in SBRT treating up to three lung metastases. For liver metastases, confidence was reported by 75% of medical oncologists, 80% of surgical oncologists, and 20% of APPs. For lung metastases, 75% of medical oncologists, 80% of surgical oncologists, and 60% of APPs were confident or very confident. Regarding oligometastatic colorectal nodal disease, 63% of practitioners indicated they would involve radiation oncology and interventional radiology for local therapy considerations.

Confidence in distinguishing when to use SBRT versus other local therapies (i.e., surgery or ablation) was moderate: 39% agreed or strongly agreed, while 48% were neutral. By practitioner type, 22% of medical oncologists, 57% of surgical oncologists, and 43% of APPs agreed or strongly agreed that they felt confident.

Conclusion: Both physicians and APPs at our center were more confident in the role of SBRT to ablate metastases to the lung vs liver. Further tailored education at our center is needed to update non-RO clinicians regarding the SBRT outcome data for GI cancers.