S1371
Interdisciplinary - Global health
ESTRO 2026
Zoia Shepil 1 , Vladyslav Buryk 2 , Ruslan Zelinsky 3 , Larysa Stadnyk 4 , Yuliia Lozko 3 , Serhii Brovchuk 1,5 , Lesia Mytsak 6 , Yulia Romalis 7 , Natalka Suchowerska 8 , Viktor Iakovenko 9 , Nelya Melnitchouk 10 , Darya Kizub 11 , Rohin Bhatia 12 , Nataliya Kovalchuk 13 1 Radiation Therapy, National Institute "O.O. Shalimov National Scientific Center of Surgery and Transplantology", Kyiv, Ukraine. 2 Radiation Therapy, Stereotactic Radiotherapy Center, Sigulda, Latvia. 3 Radiation Therapy, National Cancer Institute, Kyiv, Ukraine. 4 Radiation Therapy, Grigoriev Institute, Kharkiv, Ukraine. 5 Radiation Therapy, LISOD - Israeli Oncology Hospital, Pliuty, Ukraine. 6 Radiation Therapy, Precarpathian Clinical Oncology Center, Ivano Frankivsk, Ukraine. 7 Radiation Oncology, 7. Medical College of Wisconsin, Madison, WI, USA. 8 Radiation Oncology, 8. University of Sydney, Sydney, Australia. 9 Radiation Oncology, 9.UT Southwestern Medical Center, Dallas, TX, USA. 10 Oncology, 10. Brigham and Women’s Hospital, Boston, MA, USA. 11 Radiation Oncology, 11. MD Anderson Cancer Center, Houston, TX, USA. 12 Radiation Oncology, 12. Emory Winship Cancer Institute, Atlanta, GA, USA. 13 Radiation Oncology, 13. Stanford University, Stanford, CA, USA
had declined by 8% ( − 3,905 patients). In 2023, volumes returned to pre-war levels, rising by 9% (+4,327 patients) in 2024, though one center was bombed and remains closed.In 2025, Ukraine operates 43 RT departments with 92 MV machines (61 LINACs -not all are in clinical use, 31 Co-60 units), 37 (kV), and 38 afterloaders. 56% of departments still rely on Co-60 units, and 94.1% report source exchanges would not be feasible as most are procured in Russia. As a result, 78.6% of departments are actively transitioning to LINAC-based IMRT. Since 2022, 61.3% have installed or commissioned new LINACs, with 66.7% planning further installations by 2028 highlighting rapid modernization and the urgent need for training.Workforce shortages remain critical. As of 2025, department reported staffing deficits at 41.4% for physicists, 33.6% for RTTs, and 21.1% for radiation oncologists. Combined with the complexity of IMRT, these gaps have led to longer average wait times, rising from 6.4 days in 2021 to 10.3 days in 2025. Conclusion: Despite the ongoing war, Ukraine is actively modernizing its RT services, with a majority of departments transitioning from Co-60 to LINAC-based IMRT. These efforts underscore the urgent need for targeted training and workforce expansion to improve resilience and capacity during the war. References: International Atomic Energy Agency. The IAEA Directory of Radiotherapy Centres (DIRAC) [Internet]. 2025 [cited 2025 Nov 12]. Available from: https://dirac.iaea.org/Data/CountriesLightKovalchuk N, Zelinskyi R, Stadnyk L, Brovchuk S, Iakovenko V, Suchowerska N, Shepil Z, Lozko Y, Beznosenko A. Radiotherapy under the falling bombs: Lessons from Ukraine. Int J Radiat Oncol Biol Phys. 2024. Available from: https://www.redjournal.org/article/S0360- 3016%2824%2902438-6/fulltextPrice P, Sullivan R, Zubarev M, Zelinskyi R. Radiotherapy in conflict: lessons from Ukraine. Lancet Oncol. 2022 May 25. Available from: https://www.globalradiotherapy.org/post/radiotherapy -in-conflict-lessons-from-ukraine Keywords: Radiation Therapy Services, Nation-Wide Study
Purpose/Objective: The Russian invasion of Ukraine has severely
disrupted radiation oncology services, but the specific impact on radiation therapy (RT) delivery remains poorly defined. This study evaluates the operational capacity of Ukrainian RT centers to inform strategies for improving RT service delivery and resilience during the war. Material/Methods: This mixed-method, cross-sectional study integrated two data sources: (1) a 38-question Help Ukraine Group (HUG) survey conducted in August 2025 across all Ukrainian RT departments, assessing patient volumes, waiting times, equipment status, Co 60 source replacement, staffing, training needs, and operational challenges; and (2) IAEA DIRAC datasets collected by the Grigoriev Institute (2022–2025), tracking equipment, staffing, and patient volumes. Descriptive and comparative statistical analyses were used to evaluate trends and disruptions over time. Results: In January 2022, before the full-scale invasion, Ukraine operated 45 RT departments with 82 megavoltage (MV) machines (38 LINACs, 44 Co-60 units), 53 orthovoltage units (kV), and 36 brachytherapy afterloaders. During the first three months of war, two centers were occupied, most departments faced service disruptions averaging 26 days, patient volume dropped on average by 27.5%. Brachytherapy services were particularly impacted due to halted source procurement. By the end of 2022, RT patient volume
Mini-Oral 3829
Global modelling of hypofractionated and ultra- hypofractionated radiotherapy: implications for cost, capacity, and survival across 180 countries Ahmed Salem 1,2 , Julian Jeow 3 , Lina Al-Zerikat 4 , Rekaya Shabbir 5 , Ahlam Dohal 6 1 Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan. 2 Division of Cancer Sciences,
Made with FlippingBook - Share PDF online