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Research and clinical trials are essential for the development of radiotherapy treatments and techniques. As lung cancer is the most prevalent cancer diagnosed in the UK, this patient population is crucial to recruit into eligible clinical trials. Within this vulnerable group, clinical trial participation is low. Stereotactic ablative radiotherapy (SABR) lung cancer patients can often be frail and suffer from other co-morbidities. They are therefore referred for SABR as the majority are not suitable for surgical resection. The aim of this study was to identify any specific patient demographic factors that could influence participation in the current Lung DNA clinical trial.

This retrospective service evaluation aimed to try and identify factors that affected eligible SABR lung cancer patients participating in the Lung DNA clinical trial. The study included 91 patients referred for SABR, treated from April 2019 to December 2021. 30 patients participated in the trial and 61 patients declined participation, indicating a trial recruitment rate of 33%. Seven factors were investigated for their relationship to trial participation: age; sex; distance to hospital; transport to hospital; social deprivation; Forced Expiratory Volume 1 (FEV1) and performance status. Statistical analysis was performed to investigate each factor individually using independent-samples t-test and Chi-square test for independence respectively. The interrelation between these factors and patient participation was investigated using binary logistic regression.

The results of the independent-sample t-tests and Chi-square test for independence showed no statistical significance that any one factor alone affected patient participation or non-participation in the clinical trial. There was no statistical significance in the binary logistic regression c2 (7, N=86) = 4.518, p>0.7.

This study showed that there was no statistical relationship between any of the seven factors being investigated and the participation in the Lung DNA clinical trial. However, in a comparable bio-bank study running for prostate cancer patients, the recruitment rate from March 2021 to October 2022 was 55%, compared with 33% for the Lung DNA trial. Further investigation into the factors surrounding patient participation in the prostate trial could be used in comparison with the results from the Lung DNA trial. This study supports the need for additional research to be done to identify the reasons behind non-participation and to employ strategies to increase patient participation.