S1396
Interdisciplinary - Health economics & health services research
ESTRO 2026
designed and distributed to oART- equipped radiotherapy centres to collect data on clinical use, workflow, training, and quality assurance (QA) aspects. Material/Methods: The questionnaire included 112 questions divided into eight domains: (1) organisational aspects, (2) clinical data, (3) dosimetry and QA, (4) training and competencies, (5) treatment planning, (6) treatment delivery, (7) system performance and user experience; and (8) collaboration. Responses were collected from all centres currently using or preparing to implement oART. Results: Eight centres participated in the survey, using three types of oART systems: Ethos (Varian) - 6, EVO (Elekta) - 1, and Unity (Elekta) - 1. Two additional centres plan to start by the end of 2025. The implementation in Poland ranges from April 2024 to October 2025. The median number of treated patients per centre was 216 (range: 3 - 664). All centres preferred prostate and bladder cancer as the primary treatment sites (all centres), with whole nodal pelvic radiotherapy, uterine, cervical, and rectal cancers subsequently introduced in 4-5 centres. The planning treatment margins were reduced in 7 out of 8 centres after the introduction of oART. In five centres, the entire team of physicists and physicians perform oART procedures, while only two centres reported full radiation therapy technologists (RTTs) involvement; in others, a dedicated group of RTTs handles adaptive workflows. IMRT was consistently selected as the treatment technique. Only four centres reported system commissioning without any reservations, and in these cases, clinical implementation typically took less than one month. The adaptive plan was selected in > 95% of treatment fractions at all centres. According to reports, the biggest obstacles to the widespread use of oART are: long treatment session time, inadequate staff training, and low reimbursement. Conclusion: This is the first survey summarizing the implementation of oART in Poland. Despite a relatively short period, oART is already in routine use in most centres, with a growing number of treated patients. Pelvis remains the dominant treatment site. The collected data provide an overview of clinical practices, training, and QA approaches across canters but also reveal key challenges related to staffing, time constraints, and financial aspects. It may serve as a basis for establishing national and international recommendations in oART. Keywords: Online Adaptive Radiotherapy, National Survey,
Digital Poster 1927 Implementation and current status of online adaptive radiotherapy (oART) in Poland: a national survey Anna Zawadzka 1 , Dawid Bodusz 2 , Mariusz Gruda 1 , Agnieszka Walewska 1 , Mateusz Spa ł ek 3 , Magdalena Peszy ń ska-Piorun 4 , Konrad Stawiski 5 , Marzena Janiszewska 6 , Agata Szulc 7 , Maciej Gil 7 , Barbara Bekman 8 , Iwona D ę bosz-Suwi ń ska 2 , Konrad Urbanek 9 , Eleonora Góra 10 , Damian Kabat 10 , Micha ł Falco 11 , Magdalena Ł ukowiak 12,13 , Dorota Nenko 14 , Martyna Sroka 14 , Dominik Ma ł ecki 14 , Agnieszka Orzechowska 15 , Izabela Wiatrowska 15 , Janusz Winiecki 15,16 , Dorota Kiprian 3 1 Department of Medical Physics, Maria Sklodowska- Curie National Research Institute of Oncology, Warszawa, Poland. 2 Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland. 3 II Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland. 4 Radiotherapy Planning Department, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland. 5 Radiotherapy Department, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland. 6 Department of Medical Physics, Lower Silesian Center of Oncology, Pulmonology and Hematology, Wroclaw, Poland. 7 Radiotherapy Department, Lower Silesian Center of Oncology, Pulmonology and Hematology, Wroclaw, Poland. 8 Treatment Planning Department, Maria Sklodowska- Curie National Research Institute of Oncology, Gliwice, Poland. 9 Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Poland. 10 Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Poland. 11 Radiotherapy Department, Westpomeranian Oncology Centre, Szczecin, Poland. 12 Department of Medical Physics, Pomeranian Medical University in Szczecin, Szczecin, Poland. 13 Department of Medical Physics, Westpomeranian Oncology Centre, Szczecin, Poland. 14 Radiotherapy Department, Oncology Center Katowice, Katowice, Poland. 15 Medical Physics Department, Oncology Centre in Bydgoszcz, Bydgoszcz, Poland. 16 Department of Oncology and Brachytherapy, Collegium Medicum in Bydgoszcz of Nicholas Copernicus University in Toru ń , Poland, Bydgoszcz, Poland Purpose/Objective: This study aimed to evaluate the implementation and current status of online adaptive radiotherapy (oART) in Poland. A comprehensive national survey was
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