S1388
Interdisciplinary - Health economics & health services research
ESTRO 2026
Valerio Nardone 1 , Roberta Grassi 1 , Emma D'Ippolito 1 , Bianca Santo 2 , Sara Falivene 3 , Alessia Di Rito 4 , Ilaria Benevento 5 , Donato Pezzulla 6 1 Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy. 2 Radiotherapy Unit, Ospedale "Vito Fazzi", Lecce, Italy. 3 Department of Radiation Oncology, Istituto Nazionale Tumori IRCCS Pascale, Naples, Italy. 4 UOC Radiotherapy, PO Monsignor A.R. Dimiccoli, Barletta, Italy. 5 Radiation Oncology Unit, Oncology Research Institute of Basilicata-IRCCS-CROB, Rionero in Vulture, Italy. 6 Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy Purpose/Objective: Financial toxicity (FT) is an emerging concern in oncology, referring to the economic burden and psychological distress experienced by cancer patients due to treatment-related costs. This phenomenon encompasses both direct medical expenses and indirect costs such as transportation, accommodation, and income loss. Material/Methods: The FIT-RT (Financial Toxicity for Radiotherapy patients in Italy) is a prospective, multicenter, non-profit observational study. It aims to systematically assess the prevalence and impact of Financial Toxicity (FT) among Italian cancer patients (pts) undergoing radiotherapy. Using the validated PROFFIT questionnaire and the EORTC QLQ-C30 quality of life tool, the study evaluates financial distress at three key timepoints: before treatment, at completion and during follow-up.
challenges. Results:
Of 53 identified centers across 10 European countries, 49 (92.4%) completed the survey; 48 provided consent for data publication. A marked expansion in HT installations was observed, with the number of active centers increasing from 29 to 48 over the past five years. Among the 48 centers, 25% (12/48) use water- filtered infrared-A (wIRA) superficial, 31% (15/48) capacitive, 44% (21/48) radiative superficial, and 44% (21/48) radiative deep HT systems, including 19% (4/21) with MR-guidance. The mean annual number of patients per center treated with combined superficial HT+RT was 22.8 (median 17, range 1–73) and with deep HT+RT 35.5 (median 27, range 3-160). Overall Europe, recurrent breast cancer accounted for the majority (44.8%, 368/822) of the annual superficial HT+RT cases, while soft tissue sarcoma (31.9%, 261/817) and cervical cancer (17.1%, 140/817) predominated in deep HT+RT. In additon, 38.8% (19/49) of centers participate in prospective HT trials.In 85.4% (41/48) of centers, HT is conducted under the responsibility of radiation oncology. Across all participating centers, 65% (31/48) involve medical physicists in quality assurance (QA). ESHO QA guidelines for HT application are implemented in 80% (39/48) of centers, and temperature monitoring systems are present in 94% (45/48).Reported major barriers to the broader clinical adoption of HT included insufficient reimbursement (20%), skepticism regarding effectiveness (17.6%), and high initial investment costs (14.8%). Conclusion: This first comprehensive survey on HT activity in Europe provides evidence for rising use of HT, with 66% increase in device installations over the past five years and approximately 1600 patients treated annually with HT+RT.Ensuring consistent well- controlled high-quality HT delivery requires adherence to standardized QA protocols and mandatory temperature monitoring to enable reliable data comparison. This patterns-of-care analysis will help informing the development of harmonized clinical practices and foster collaborative research to strengthen the evidence base for HT in modern radiation oncology. Keywords: Hyperthermia, ESTRO Focus Group, Patterns-of-care Digital Poster Highlight 1236 Evaluation of financial toxicity in patients undergoing radiotherapy: an Italian multicenter prospective study promoted by young AIRO. NCT07175350
Results: 122 patients have been enrolled in 7 centers; 47 pts in Naples center and 32 pts in the Lecce center. FT analysis was conducted using the PROFFIT questionnaire. The overall mean score was 47.4 with a standard deviation of 25.6, indicating significant variability in the perceived financial burden of radiotherapy. Patients reported financial strain with varying degrees of intensity. FT was strongly associated with demographic variables. For patients in Naples, 11 patients (23.9%) reported travel times of 0– 30 minutes, 26 patients (56.5%) reported travel times of 30–60 minutes, and 10 patients (21.7%) reported
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