S1364
Interdisciplinary - Global health
ESTRO 2026
for treatment, utilizing data from 2019 to 2022. Material/Methods: Data from Brazil's national Outpatient Procedure Authorization (APAC) system, covering 2019 to 2022, was gathered in .dbc format and analyzed using Python. The dataset included variables such as procedure type, year, patient demographics (gender and race), residential city, treatment location (by state and region), and instances of treatment outside the patient's home city. Distances to treatment centers were calculated using the Haversine formula in kilometers. This dataset was integrated into a Power BI database for improved analysis. All statistical analyses were conducted using IBM SPSS Statistics, version 29.0. A four-way ANOVA assessed the effects of year, region, sex, and race on travel distance, followed by an ANCOVA adjusting for region area as a covariate. Statistical significance was defined as p < 0.05. Results: Out of 8,350 soft tissue radiotherapy procedures reviewed, 5,212 patients (62.4%) needed to travel to receive radiation. The national average distance traveled for treatment was 140.24 kilometers, with no significant annual changes noted (p=0.634). However, within-region comparisons revealed heterogeneous patterns over time. The North showed a significant increase in mean distance (+17.9%, p < 0.001), while the Midwest ( − 26.5%, p < 0.001) and Northeast ( − 17.4%, p < 0.001) demonstrated marked reductions. The Southeast showed a minor, nonsignificant rise (+6.7%, p = 0.07), and the South remained stable (p = 0.42). Regional variations were significant: patients in the North traveled an average of 519.19 kilometers, 354.72 kilometers in the Midwest, 165.30 kilometers in the Northeast, 79.99 kilometers in the Southeast, and 76.12 kilometers in the South (p < 0.001). At the state level, distances ranged from 44.65 kilometers in Rio de Janeiro (Southeast) to 1,740.51 kilometers in Roraima (far North) (p < 0.001). White patients traveled an average of 121.62 kilometers, while non-white patients traveled 160.55 kilometers (p < 0.001). Additionally, males averaged 150.68 kilometers compared to 128.54 kilometers for females (p < 0.001).
Conclusion: The study demonstrates marked geographic and racial disparities in access to soft-tissue radiotherapy in Brazil, disproportionately affecting underserved regions, males, and non-White patients. References: 1. Mendez LC, et al. Clin Oncol (R Coll Radiol) 2018; 30: e29–36.2. Moraes FY, et al. Int J Radiat Oncol Biol Phys. 2015;92(4):707-12. doi: 10.1016/j.ijrobp.2014.12.063.3. Silverwood S, et al. Int J Radiat Oncol Biol Phys. 2024;118(4):891-899. doi: 10.1016/j.ijrobp.2023.10.030.4. Gouveia AG, et al. J Cancer Policy. 2024;39:100459. doi: 10.1016/j.jcpo.2023.100459.5. Viani GA, et al. Lancet Oncol. 2022;23(4):531-539. doi: 10.1016/S1470- 2045(22)00123-1.6. Hanna SA, et al. Lancet Reg Health Am. 2022;14:100333. doi: 10.1016/j.lana.2022.100333.7. Viani GA, et al. Int J Radiat Oncol Biol Phys. 2023;116(2):413-420. doi: 10.1016/j.ijrobp.2023.02.029. Keywords: Sarcoma, Radiotherapy, Access Telemedicine cross-sectional clinical trial on head and neck and skull base/brain cancer survivors following hadrontherapy (NCT05947149) Anna Maria Camarda 1 , Carmine Tinelli 2 , Nadia Facchinetti 3 , Viola Ghio 3 , Alberto Iannalfi 1 , Barbara Vischioni 1 , Maria Bonora 1 , Sara Ronchi 1 , Rossana Ingargiola 1 , Mariangela Caputo 1 , Sara Lillo 1 , Luca D'Ambrosio 1 , Lisa Licitra 4,5 , Ester Orlandi 1,6 1 Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 2 Scientific Direction, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 3 Clinical Trials Center, Scientific Direction, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 4 Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy. Digital Poster 3295
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