S1390
Interdisciplinary - Health economics & health services research
ESTRO 2026
treated with PBT according to the year of diagnosis. Deprivation index of the place of residence at the time of diagnosis and distance from home to the closest PBT center were used to assess socioeconomic and geographical disparities, respectively. In univariate and multivariable analyses using Generalized Estimating Equations, we estimated odds-ratios of receiving PBT (alone or in addition to photons or electrons) versus no PBT, according to several factors that we selected a priori. To investigate whether the associations varied over time, we tested interaction terms between calendar year of diagnosis and factors associated with the use of PBT. Results: The proportion of cases treated with PBT increased from 1.4% in 2006 to 28.9% in 2021. In the overall period, most of the 928 cases treated with PBT were central nervous system neoplasms (62%), soft-tissue sarcomas (16%) and intracranial germ cell tumors (8%). The likelihood of receiving PBT was the highest for youngest patients, cases treated with surgery without chemotherapy, and cases without metastases. However, the influence of clinical factors significantly decreased over time (p-value <0.001). There were substantial geographical variations in the frequency of use of PBT, persisting after adjustment for clinical factors. Patients living in a region where a PBT center was implemented, or in a department having official conventions with a PBT center, had a higher probability of receiving PBT compared to those living elsewhere. This pattern significantly increased in the most recent years (p-value = 0.01). Patients living in the most deprived areas had the lowest probability of receiving PBT.
Conclusion: In France, while the accessibility of PBT has improved during the last years, the variety of clinical situations considered for referral to PBT in pediatric patients has increased. However, the rising use of PBT was accompanied by geographical and socioeconomic disparities. Keywords: Protons, Pediatrics, Healthcare access
Digital Poster Highlight 1551
Evaluating the impact of hypofractionation on patient waiting times via automated scheduling scenario exploration Sophie Wuyckens 1 , Ivar Bengtsson 1 , Geert De Kerf 2 , Elin Hynning 1 , Albin Fredriksson 1 , Viktor Wase 1 1 Research, RaySearch Laboratories AB, Stockholm, Sweden. 2 Radiation Oncology, Iridium Netwerk, Antwerp, Belgium
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