S1421
Interdisciplinary - Health economics & health services research
ESTRO 2026
Carrara 1 , Tomoaki Tamaki 1 , Thomas E Merchant 3 , May Abdel-Wahab 1 1 Division of Human Health, International Atomic Energy Agency, Vienna, Austria. 2 Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil. 3 Department of Radiation Oncology, St. Jude’s Children Research Hospital, Memphis, USA. 4 Department of Radiation Oncology, Irmandade Santa Casa de Misericordia de Sao Carlos, Sao Carlos, Brazil. 5 Biostatistics and Research, RTCON Solucoes em Radioterapia, Sao Paulo, Brazil. 6 Department of Radiation Oncology, Grupo de Apoio ao Adolescente e a Crianca com Cancer, Sao Paulo, Brazil. 7 Department of Radiation Oncology, Hospital de Pediatría Garrahan, Buenos Aires, Argentina Purpose/Objective: Sustainable improvements in paediatric radiotherapy (PR) delivery in Latin America and the Caribbean (LAC) require a better understanding of current workflows, resource constraints, and workforce capacity. We surveyed PR practitioners to define practice patterns, systemic barriers, and training challenges that can inform region-specific quality improvement efforts. Material/Methods: Between February and March 2025, a cross-sectional survey was distributed by e-mail to attendees of a previous International Atomic Energy Agency (IAEA)’s Regional Workshop on PR Services in LAC and was further shared among peers and in collaborative professional groups/communities. The survey consisted of 34 structured questions, devised to investigate attendees’ feedback regarding: background and personal contexts; technical and infrastructural limitations, institutional and interprofessional dynamics, education and professional challenges, and immediate needs related to training in PR. Results: From 108 respondents across multiple professional backgrounds, statistical analysis was performed focusing on those with more than 1 year of experience in PR (n = 89; 65 radiation oncologists [ROs], 24 medical physicists [MPs]). Most respondents reported > 5 years of PR experience, with MPs significantly more likely to have >10 years (62.5% vs. 38.5%; OR = 2.67, p = 0.048). IMRT/VMAT (89.8%) and 3DCRT (76.9%) were the most frequently used techniques, in contrast to SBRT/SRS/SFRT, the less used. Formal PR training was more frequent among ROs (83.1% vs. 37.5%; p < 0.001), reflected in higher self-perceived readiness (55.4% vs. 29.2%; p = 0.038), and reported significantly higher participation in continuing education activities. Additionally, 69.4% of all respondents ranked PR- specific treatment planning as the highest ongoing training priority. Both ROs and MPs showed general alignment on identification of structural barriers for PR practise (e.g., slot shortage and waiting list, lack of
anaesthesia and technology incorporation, unsatisfactory multidisciplinary training), with no statistically significant differences. On organizational collaboration, MPs perceived greater institutional undervaluation of PR complexity than ROs (87.5% vs. 52.3%; OR = 6.0, p < 0.01), while excessive workload, financial (dis)satisfaction, and institutional poor communication were similarly perceived. Quality assurance (QA) practices revealed that, as per one’s institution standards, 24.1% (n = 26) perform only selected daily and/or monthly tests, and patient- specific QA for IMRT/VMAT cases was performed only in 59.3% (n = 64). Conclusion: This unprecedented broad scope survey identified key gaps in PR practice in LAC that represent actionable opportunities to strengthen region-level coordinated actions towards quality improvement, and development of safe and accelerated programs, and policy strategies, aligned with IAEA's initiatives. References: •Paulino AC, et al. Pediatr Blood Cancer. 2020 Oct;67(10):e28619.•Anacak Y, et al. Clin Oncol (R Coll Radiol). 2021 Apr;33(4):e211-e220.•Salminen E, et al. Radiother Oncol. 2009 Nov;93(2):368-71.•Gorostegui- Obanos M, et al. Pediatr Blood Cancer. 2024 Nov;71(11):e31262.•Atun R, et al. Lancet Oncol. 2015 Sep;16(10):1153-86.•Elbanna M et al., Lancet Oncol. 2023;24:e376-e384.•Hess CB, et al. Pediatr Blood Cancer. 2021 May;68 Suppl 2:e28299. Keywords: paediatric, multidisciplinary, practise Feasibility of shielding a mobile, upright radiotherapy solution using a standard-size shipping container that could be moved via sea, rail, or road Gordon D Sands 1,2 , Michael Kissick 3,4 , Tracy Underwood 1,2 , Thomas R Mackie 3,4 1 Research Department, Leo Cancer Care, Crawley, United Kingdom. 2 Med Phys & Biomedical Eng, University College London, London, United Kingdom. 3 Research Department, Leo Cancer Care, Madison, USA. 4 Department of Medical Physics, University of Wisconsin, Madison, USA Purpose/Objective: Evidence suggests worse survival rates for patients living more than two hours from their nearest radiotherapy centre [2]. Portable linear accelerators could offer a feasible pathway to: (i) broaden radiotherapy access in sparsely populated and low- and middle-income countries where distances between radiotherapy centres are large [3], (ii) support patients unable to travel, (iii) maintain treatment Digital Poster 3797
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