{"id":9502,"date":"2025-12-05T09:12:13","date_gmt":"2025-12-05T09:12:13","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=9502"},"modified":"2025-12-05T09:12:14","modified_gmt":"2025-12-05T09:12:14","slug":"cure-vs-toxicity-quantifying-preferences-for-non-surgical-management-of-rectal-cancer-using-a-prospective-discrete-choice-experiment-study-2025","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2025\/12\/05\/cure-vs-toxicity-quantifying-preferences-for-non-surgical-management-of-rectal-cancer-using-a-prospective-discrete-choice-experiment-study-2025\/","title":{"rendered":"Cure vs. toxicity: quantifying preferences for non-surgical management of rectal cancer using a prospective discrete choice experiment study (2025)"},"content":{"rendered":"\n

Type of publication:<\/strong><\/p>\n\n\n\n

Conference abstract<\/p>\n\n\n\n

Author(s):<\/strong><\/p>\n\n\n\n

Webb E.J.; Twiddy M.; Noutch S.; Adapala R.; Bach S.P.; Brown S.; Burnett C.; Burrage A.; Gilbert A.; Hawkins M.; Howard D.; Hudson E.; Jefford M.; Kochhar R.; Saunders M.; Seligmann J.; Smith A.; Teo M.; West N.; Sebag-Montefiore D.; *Gollins S.; Appelt A.L.<\/p>\n\n\n\n

Citation:<\/strong><\/p>\n\n\n\n

Radiotherapy and Oncology. Conference: ESTRO 2025. Vienna Austria. 206(Supplement 1) (pp S1253-S1255), 2025. Date of Publication: 01 May 2025.<\/p>\n\n\n\n

Abstract:<\/strong><\/p>\n\n\n\n

Purpose\/Objective: Dose-escalation may increase the chance of successful non-surgical rectal cancer management, but requires an understanding of acceptable trade-offs between chance of cure and toxicity risks. This study is the first to measure patient preferences for non-surgical management (NOM) of rectal cancer using a discrete choice experiment (DCE). Material\/Methods: A prospective, multicentre study conducted in seven UK radiotherapy centres. Patients consented to participation prior to initiation of radiotherapy-based NOM for rectal cancer (any stage), and completed the survey pre-treatment and 6 months post-treatment. The DCE was developed with qualitative patient input and had a Bayesian D-efficient design. Patients made repeated choices between hypothetical NOM treatments, described using six attributes: treatment length; chance of being cancer-free two years post-treatment; side effect risks during and two years posttreatment; support available. Participants indicated preferences for non-surgical vs. surgical treatment on a Likert scale. Baseline responses were analysed using mixed logit, quantifying trade-offs between attributes, using preference for chance of cure as the unit of measurement. Post-estimation, individual preferences conditional on choices were estimated. Changes in mean preferences pre\/post-treatment were analysed using multinomial logit, with the delta method used to test for pre\/post-treatment differences. Differences in preferences for surgical\/nonsurgical management were assessed using Mann-Whitney U tests. Result(s): There were 96 participants recruited, and 51 completed follow-up. Participants had a mean baseline age of 68.4 and were 38.9% female. There were no significant differences between characteristics of people who did\/did not complete follow-up. Figure 1 shows distributions of patients' baseline preferences. Patients on average required a 0.34 percentage point (pp) higher chance of cure to accept a 1pp higher chance of short-term side effects, compared to 0.78pp for a 1pp higher chance of long-term side effects, and 3.3pp higher chance of cure to accept support from usual GP rather than a dedicated nurse. The mean chance of cure patients would trade for shorter treatment lengths was not significantly different from 0 (p=.900). Preferences for treatment attributes did not change significantly pre\/post-treatment (p-values between.374 and.759, Figure 2a). There was a significant shift in preferences towards non-surgical vs. surgical management post-treatment (p=.017, Figure 2b). Conclusion(s): Participants would accept extra toxicity in exchange for better chances of cure, suggesting most would accept treatment intensification, including dose-escalation. Participants were more concerned about long-term than shortterm side effects, highlighting the need for long-term follow-up of toxicity, and for clinical decision-making to take account of individual patients' preferences.<\/p>\n\n\n\n

DOI: <\/strong>10.1016\/S0167-8140%2825%2901971-1<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Webb E.J.; Twiddy M.; Noutch S.; Adapala R.; Bach S.P.; Brown S.; Burnett C.; Burrage A.; Gilbert A.; Hawkins M.; Howard D.; Hudson E.; Jefford M.; Kochhar R.; Saunders M.; Seligmann J.; Smith A.;…<\/span><\/p>\n

Read more Cure vs. toxicity: quantifying preferences for non-surgical management of rectal cancer using a prospective discrete choice experiment study (2025)<\/span> ›<\/span><\/a><\/div>\n

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