S1394
Interdisciplinary - Health economics & health services research
ESTRO 2026
San Sebastián, Santiago, Chile. 3 Center for Cancer Prevention and Control (CECAN), Pontificia Universidad Católica de Chile, Santiago, Chile
where ORUR approaches 80–85%, rectal cancer demonstrates a moderate but essential need for RT, primarily concentrated in the neoadjuvant setting. These findings provide a benchmark for national and regional cancer control planning, highlighting the importance of maintaining adequate RT infrastructure and expertise in colorectal oncology
Purpose/Objective: Rectal cancer is one of the most common
gastrointestinal malignancies and a leading cause of cancer-related morbidity worldwide. Radiotherapy (RT), typically as part of neoadjuvant chemoradiotherapy or short-course preoperative RT, plays a critical role in achieving local control and sphincter preservation in locally advanced disease. To inform equitable resource allocation, it is essential to define the optimal radiotherapy utilization rate (ORUR)—the proportion of rectal cancer patients who should receive RT at least once during their disease course according to evidence-based guidelines. This scoping review aimed to identify and summarize published estimates of ORUR for rectal cancer. Material/Methods: A systematic PubMed search was performed for English-language studies published between January 2015 and July 2025, following PRISMA-ScR methodology. Search terms included “optimal radiotherapy utilization,” “rectal cancer,” “colorectal cancer,” and “demand.” Eligible studies were those that estimated ORUR based on guideline-driven models, population-level modeling, or benchmark analyses. Studies reporting only actual utilization (TUR) were excluded. Data extracted included study design, population, methodology, year of incidence data, and reported ORUR values. The protocol was registered on the Open Science Framework https://doi.org/10.17605/OSF.IO/B4DTJ Results: From 683 records screened, 7 studies met inclusion criteria. Reported ORUR for rectal cancer ranged between 45% and 60%, depending on methodology. Population-based models such as ESTRO-HERO and the CCORE frameworkconsistently estimated ORUR near 55%, positioning rectal cancer among the malignancies with intermediate RT demand. The MALTHUS model yielded slightly lower estimates (~45– 50%) by incorporating comorbidities and competing mortality risks. Guideline-driven analyses indicated that the majority of RT indications derive from locally advanced rectal cancer requiring neoadjuvant therapy, with smaller contributions from adjuvant settings (e.g., positive circumferential margins) and selected palliative scenarios. Across all approaches, ORUR for rectal cancer remained stable across high-income and middle-income countries, underscoring the robustness of these estimates. Conclusion: Optimal RT utilization for rectal cancer consistently ranges from 50–55%, with some adjusted models reporting slightly lower values. Unlike cervical cancer,
References: Mackenzie P, et al. Radiother Oncol. 2023;188:109862. Shack L, et al. Radiother Oncol. 2017;122:152–158. Lievens Y, et al. Eur J Cancer. 2017;84:102–113. Borras JM, et al. Radiother Oncol. 2015;116:45–50. Atun R, et al. Lancet Oncol. 2015;16(9):1153–1186. Keywords: radiotherapy utilization, optimal demand, ORUR Digital Poster 1892 Optimal Radiotherapy Utilization Rates in prostate Cancer: A Scoping Review Gonzalo Ulloa 1 , Raúl Aguilar-Barrientos 2,3 , Pablo Munoz-Schuffenegger 1,3
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