2644 - Survey on Education of Systemic Therapy (Immunotherapy, Targeted Therapy, Chemotherapy) during Radiation Oncology Residency

Purpose/Objective(s): Systemic therapies—chemotherapy, immunotherapy, and targeted therapy—are vital components of cancer treatment and are frequently combined with radiation therapy. However, there is variability in how radiation oncology (RO) residency programs incorporate education on these therapies. Understanding the current state of systemic therapy education is crucial for improving residency training and preparing future radiation oncologists to deliver comprehensive care.

Materials/Methods: This study evaluates the scope, delivery, and effectiveness of systemic therapy education in radiation oncology residency. It examines residents' familiarity, confidence in managing systemic therapies with radiation, and barriers to adequate training. A cross-sectional survey was conducted among 28 radiation oncology residents and recent graduates from 13 U.S. institutions using SurveyMonkey. The survey collected data on structured education, familiarity with therapy schedules, confidence in managing adverse events, and barriers to training. Descriptive statistics were used for analysis.

Results: Survey responses came from residents at various training stages (PGY-2: 21.4%, PGY-3: 21.4%, PGY-4: 25%, PGY-5: 21.4%) and 10.7% early career. Most programs (50%) offered only didactic lectures on systemic therapies, while 33% had no structured education and relied on self-study. Few residents reported exposure to rotations in medical oncology (4%) or a combination of didactics and rotations (11%). 48% of residents were familiar with chemotherapy, immunotherapy, and targeted therapy regimens in combination with radiation, while 24% were unfamiliar. Confidence in staying updated on treatment paradigms was reported by 44%, with 24% lacking confidence, others 32% indicated confidence in treatment paradigms involving chemotherapy alone, immunotherapy alone or targeted therapy alone 4%. Regarding adverse events, 45.5% felt confident in differentiating toxicities from chemotherapy, immunotherapy, and targeted therapy versus radiation side effects. 73% of residents felt “somewhat prepared” to collaborate with medical oncologists on cases requiring systemic therapy and radiation. A need for more formal training on the interactions between immunotherapy and radiation was expressed by 59%. Major obstacles identified included limited structured education (45.5%), time constraints due to clinical duties (59%), and low priority of systemic therapy training (55%)

Conclusion: The survey reveals variability in systemic therapy education during radiation oncology residency programs. While systemic therapies are critical, many programs provide limited formal training, and residents often rely on self-study. There is strong demand for structured education, particularly regarding immunotherapy and radiation interactions. Addressing barriers could improve residents' preparedness to manage systemic therapies in combination with radiation, thus enhancing patient care.