S1354
Interdisciplinary - Global health
ESTRO 2026
George Institute for Global Health, Sydney, Australia. 3 Department of Radiation Oncology, National Academy of Medical Sciences Bir hospital, Kathmandu, Nepal. 4 Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh. 5 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 6 Department of Radiation Oncology and Radiosurgery, Military Central Hospital, Hanoi, Vietnam. 7 Department of Radiation Oncology, Dunedin Hospital Souther Health, Dunedin, New Zealand. 8 Cancer Alliance Queensland, Metro South Hospital and Health Service, Queensland, Australia. 9 Department of Radiotherapy, Jose R. Reyes Memorial Medical Center, Manila, Philippines. 10 Oncology Information Systems, Cancer Institute NSW, Sydney, Australia. 11 Radiation Oncology, Tata Memorial Hospital, Mumbai, India. 12 Faculty of Medicine, Cipto Mangunkusumo Hospital, Jakata, Indonesia. 13 Institute of Medical Physics, The University of Sydney, Sydney, Australia. 14 Central Coast Cancer Care, Gosford Hospital, Gosford, Australia. 15 Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan. 16 Department of Onco-Hematology, Calmette Hospital, Phnom Penh, Cambodia. 17 Department of Radiation Oncology, National Cancer Centre, Singapore, Singapore. 18 Department of Radiation Oncology, National Cancer Center of Mongolia, ulaanbaatar, Mongolia. 19 Department of Radiation Oncology, Institute of Nuclear medicine and Oncology, Lahore, Pakistan. 20 Radiotherapy & Oncology Department, National Cancer Institute, Putrajaya, Malaysia. 21 Department of Radiation Oncology, AECH Kiran Hospital, Karachi, Pakistan. 22 Department of Radiation Oncology, Christchurch Hospital, Christchurch, New Zealand. 23 National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 24 Cancer services, South Western Sydney Local Health District, Sydney, Australia. 25 Radiation Oncology, Ingham Institute, Sydney, Australia. 26 Liverpool and Macarthur Cancer Therapy Centres, South Western Sydney Local Health District, Sydney, Australia Purpose/Objective: Reliable, high-quality data is essential to optimise cancer care. Oncology Information Systems (OIS) enable data capture, management, and utilisation to support service delivery, quality assurance, and research. International initiatives, largely in high- income settings, have demonstrated the value of data harmonisation. However, half of global cancer cases are diagnosed in the Asia-Pacific (APAC) region1, where OIS maturity varies widely. Many low- and middle-income countries (LMICs) remain in earlier stages of implementation, often using legacy or limited-functionality systems. This poses challenges
sophisticated technology, and skilled personnel. During crises—such as pandemics, cyberattacks, energy shortages, or armed conflict—these dependencies render radiotherapy services particularly vulnerable. Germany’s technologically advanced but decentralised health system faces specific challenges in coordinating an effective response. Material/Methods: This narrative review synthesises peer-reviewed evidence, WHO and IAEA reports, and European policy documents on radiotherapy system performance under crisis conditions. It analyses governance, technological, workforce, and ethical dimensions of resilience within Germany’s federal structure, integrating lessons from recent global emergencies. Results: Germany possesses one of Europe’s densest radiotherapy networks and a robust workforce base. However, fragmented governance, regional variation in licensure, and inconsistent digital interoperability impede coordinated crisis response. Core vulnerabilities include dependence on international supply chains, cybersecurity risks, and limited mechanisms for workforce mobility across Länder. Experiences from pandemics, wars, and natural disasters demonstrate that resilience depends on cross-sectoral planning, ethical preparedness, and digital integration. Conclusion: Establishing a Central Coordination Office for Radiation Oncology, unified emergency licensing procedures, and interoperable data systems would strengthen continuity of care during crises. Embedding radiotherapy into national critical-infrastructure policy and civil-protection planning would ensure priority access to energy, logistics, and digital resources. Germany’s framework can serve as a model for resilient radiotherapy governance across Europe. Keywords: Continuity of care, disaster management Towards minimum data standards for oncology information systems: a modified Delphi study across Asia-Pacific Angela Liao 1,2 , Vikneswary Batumalai 2 , Bibek Acharya 3 , Touhida Akter 4 , Kitwadee Athigakunagorn 5 , Bui Bieu 6 , Shaun Costello 7 , Alex Dunn 8 , Jerickson A Flores 9 , David Fraser 10 , Sarbani Ghosh Laskar 11 , Handoko Handoko 12 , Robin Hill 13,14 , Nobuteru Kubo 15 , Mora Mel 16 , Janice S Tan 17 , Uranchimeg Tsegmed 18 , Rafia Usman 19 , Sangeeta Vahnalingam 20 , Zuhran Wadho 21 , Iain Ward 22 , Ran Wei 23 , Gui M Xiong 24,25 , Mei Ling Yap 2,26 1 Department of Radiation Oncology, Chris O'Brien Lifehouse, Sydney, Australia. 2 Cancer projects, The Digital Poster Highlight 1064
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