S1398
Interdisciplinary - Health economics & health services research
ESTRO 2026
assessment of FT and implementation of targeted interventions are essential to improve patient well- being and overall outcomes. Keywords: Financial, toxicity, radiotherapy
Radiation Oncology, Abderrahmen Mami Hospital, Ariana, Tunisia
Purpose/Objective: Financial toxicity (FT) refers to the economic burden and subjective distress resulting from cancer diagnosis and treatment. It has been recognized as a component of cancer care, as it negatively impacts patient’s quality of life (QoL), and clinical outcomes This study aimed to assess the prevalence of FT among Tunisian patients undergoing radiotherapy (RT), identify associated risk factors and evaluate its impact on health status and QoL. Material/Methods: We conducted a cross-sectional study including patients who completed radiotherapy at our institution between July and October 2025. FT was assessed using FACIT-COST (COST) questionnaire, higher scores indicating better financial well-being. FT was graded as: Grade 0 ( ≥ 26), Grade 1 (14–25), Grade 2 (1–13), and Grade 3 (0). Global health status (GHS) and QoL were assessed using the EORTC QLQ-C30 questionnaire. Spearman’s correlation and Fisher’s exact test were used for univariate analysis, and ordinal regression for multivariate analysis. A p-value <0.05 was considered statistically significant. Results: One hundred patients were included. The median age was 59.4 years [18–79]. Sex ratio was 0.72. The most frequent cancer site was breast cancer (38%), followed by lung (28%) and prostate (14%) cancers. Sixty-two percent of patients were treated with curative intent,and 11% received concomitant treatment. Regarding FT, 31% of patients were classified as Grade 0, 56% as Grade 1, 13% as Grade 2, and none as Grade 3. Palliative RT was associated with greater FT (p = 0.012). Patients reporting income loss experienced higher levels of FT (p = 0.004). Additional expenses related to RT were associated with increased financial distress (p = 0.0013). Patients indicating that their physical condition or medical treatment caused financial difficulties had lower COST scores (p < 0.0001). Patients who felt well or very well informed about potential personal financial burdens reported higher COST scores (p = 0.002). Higher COST scores were positively correlated with better GHS and QOL, with p = 0.0001 and p = 0.0001, respectively. On multivariate analysis, financial difficulties related to physical condition or treatment remained associated with greater FT (p = 0.07), being well informed about financial risks and higher QOL were independently associated with lower FT (p = 0.041 and p = 0.046,
Digital Poster Highlight 2128 Are Clinical Trial Participants Representative of the Head and Neck Cancer Population? Katherine Fair 1 , Stephanie Anderson 1 , Craig Smith 2,3 , Samuel McInerney 1 , Adam Peters 1 , David I Conway 2 , Derek Grose 1 , Carolynn Lamb 1 , Stefano Schipani 1 , Saurabh Vohra 1 , Christina Wilson 1 , Claire Paterson 1,3 1 Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. 2 School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom. 3 Glasgow Head and Neck Cancer Research Group, (GLAHNC), Glasgow, United Kingdom Purpose/Objective: Inclusivity is essential in clinical research for result generalisation. This is especially important in head and neck cancer (HNC) where there is a greater disease burden in people from most socioeconomically deprived backgrounds. The aim of this study was to evaluate area-based deprivation characteristics and travel time, of HNC trial participants with a control cohort from the same region. Material/Methods: This was a retrospective study carried out in a regional cancer centre, the setting for all non-surgical treatment for HNC in the cancer network. The trial cohort (TC) consisted of all participants in HNC trials between May 2014 and February 2025; they were identified from the EDGE research management system. All patients diagnosed with HNC in 2023 formed the control cohort (CC) and were identified from the regional multidisciplinary team database.Patient and disease characteristics were collected and compared between the two cohorts. Travel time to the cancer centre was calculated with an offline Google distance matrix API. An area-based index of multiple deprivation – the Scottish Index of Multiple Deprivation (SIMD) [1] was used. SIMD-1 indicates the most socioeconomically deprived areas and SIMD-5 the least. Demographic, clinical and travel- time data were analysed using descriptive statistics and multivariable logistic regression to assess factors associated with study participation. Results: See table-1. There were 480 patients in the TC and 693 in the CC. Younger age, male sex, tumours of the oropharynx, advanced-stage disease, and radical treatment intent were all significantly associated with participation in HNC trials, although sex differences
respectively). Conclusion:
FT is a prevalent issue among Tunisian cancer patients undergoing RT. Adequate financial information and support appear to mitigate this burden. Systematic
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