S1366
Interdisciplinary - Global health
ESTRO 2026
University, Rize, Turkey. 6 Radiation Oncology, Radiation Medicine Center, Tbilisi, Georgia
Purpose/Objective: Hypofractionated radiotherapy (HFx) has been demonstrated to be effective in the treatment of various cancers. Despite being a time-efficient and effective treatment approach, the implementation of hypofractionation varies across different types of cancer and clinical settings(1-4). This international survey study aims to evaluate the clinical approaches to hypofractionation in radiotherapy, as well as to identify the key factors shaping these approaches. Material/Methods: This study was conducted using an electronic survey designed by radiation oncologists experienced in hypofractionation. The survey was prepared in English and underwent a preliminary evaluation by 7 researchers from four different countries.The first section of the survey focused on participants' demographic characteristics, clinical experience, general knowledge of hypofractionated radiotherapy, and the available technologies in their institutions. The subsequent five sections were dedicated to clinical scenarios related to breast, prostate, rectal, head and neck cancers, and central nervous system tumors.Statistical analyses were performed using SPSS version 22, with a significance level of p ≤ 0.05 considered statistically significant and we estimated prevalence with 95% CIs and compared regions using χ² and pairwise Fisher’s exact tests . Results: A total of 245 radiation oncologists from 49 countries participated in the study. The characteristics of the participants are summarized in Table 1. Overall HFx adoption was 84.1% (206/245; 95% CI 79.5–88.7). By region: MENA 89.4% (76/85; 95% CI 82.9–96.0), MENA- T 77.3% (51/66; 95% CI 67.2–87.4), Non-MENA 84.0% (79/94; 95% CI 76.6–91.4). The overall regional comparison was not statistically significant ( χ² =4.09, df=2, p=0.129). Pairwise analysis indicated a trend toward higher adoption in MENA vs MENA-T (Fisher’s p=0.071); MENA vs Non-MENA and MENA-T vs Non- MENA were not significant (p=0.381 and p=0.308). Significant determinants of HFx adoption were: lower/lower-middle income setting for breast (p=0.013); institutions serving >100,000 people for prostate (p=0.019); higher monthly patient volume (>400) for breast (p=0.023) and prostate (p=0.003); and “complex” centers (advanced technology/expertise) for breast (p=0.048), prostate (<0.001), rectal (<0.001), and CNS (<0.001). Additional correlates included specialized HFx training (prostate) (p=0.009) and having ≤ 1 rationale against HFx (prostate) (p=0.017) Table 2.
Conclusion: Spanish RO specialists show awareness of
sustainability and report integrating it into selected clinical decisions; however, major limitations persist regarding transportation access, lack of teleworking options, high paper use, and limited institutional infrastructure. These findings highlight multiple opportunities to promote sustainability through coordinated national strategies, education, and resource optimization. Keywords: sustainability, carbon emissions, health system Global Survey of Hypofractionation Practices in Curative and Adjuvant Radiotherapy Across Multiple Tumor Sites Sercan YILMAZ 1 , Nadeem Pervez 2 , Yasemin Guzle Adas 3 , Layth Mula-Hussain 4 , Ozgur Altmisdortoglu 5 , Salome Esakia 6 , Can Azak 3 , Zahed Almandhari 1 1 Radiation Oncology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman. 2 Radiation Oncology, Gulf International Cancer Center, Abu Dhabi, UAE. 3 Radiation Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey. 4 Radiation Digital Poster 3353 Oncology, University of British Columbia, Vancouver, Canada. 5 Radiation Oncology, Recep Tayyip Erdogan
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