Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

One less visit matters: personalising palliative radiotherapy care (146091)

Felicity Hudson 1 2 3 , Kylie Dundas 1 2 3 , Daniela Miller 1 , Philip Vial 1 , Alison Gray 1 2 3 , Cesar Ochoa 1 , Michelle Roach 1 , Carol-Lan Wilder 1 , Michael Cardoso 1 3 , Shalini Vinod 1 2 3
  1. Liverpool and Macarthur Cancer Therapy Centres, South Western Sydney Cancer Services, Liverpool, NSW, Australia
  2. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  3. South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

Aims

To implement and evaluate a SimulatiOn Free palliative radioTherapy (SOFT) workflow using diagnostic computed tomography (CT) imaging to reduce treatment burden, unnecessary appointments, and resource use for patients receiving simple palliative radiotherapy.

Methods

Our department introduced a SOFT pathway enabling selected simple palliative radiotherapy plans to be created from existing diagnostic CT scans, avoiding a dedicated simulation CT. Radiation oncologists, radiation therapists, physicists and nurses co-designed eligibility criteria, quality assurance processes, documentation, education, and governance frameworks. Staff acceptability was assessed using a survey adapted from literature1. Key implementation outcomes included workflow completion rates, resource utilisation, treatment times, and reasons for reversion to conventional simulation.

Results

Between March 2025 and February 2026, 96 SOFT workflows were attempted for 74 patients, with 84 proceeding to treatment (87.5%). Of the 12 workflows that did not proceed to treatment, only 2 were attributable to unsuitable diagnostic imaging. The pathway avoided 70 simulation appointments, saving 23.3 hours of CT simulation capacity and approximately 32.6 radiation therapist staff hours. Twenty-three hours of interpreter bookings and 19 ambulance transfers were avoided. Forty-eight inpatients avoided additional transfers and nursing interventions, while 26 outpatients avoided an extra hospital visit. Planning times were comparable to standard workflows. Combined simulation and treatment on-bed time was reduced by approximately 16 minutes per patient. Staff acceptance was high, with 81% agreeing that SOFT was an acceptable and feasible alternative to conventional simulation.

Conclusions

SOFT streamlines simple palliative radiotherapy delivery for select patients by using existing diagnostic CT to personalise treatment pathways and reduce unnecessary patient burden. The workflow reduced patient visits, treatment-related time in the department, and health-service resource utilisation without increasing planning time. Future work will focus on expanding eligibility criteria, evaluating additional palliative treatment techniques, and monitoring long-term sustainability and safety outcomes.

  1. 1. O'Neil M, Laba JM, Nguyen TK, Lock M, Goodman CD, Huynh E, et al. Diagnostic CT-Enabled Planning (DART): Results of a Randomized Trial in Palliative Radiation Therapy. Int J Radiat Oncol Biol Phys. 2024;120(1):69-76.