S1423
Interdisciplinary - Health economics & health services research
ESTRO 2026
2006. Keywords: Mobile Radiotherapy, Patient Access, Shielding
Digital Poster 3900 Long-term financial strain after proton therapy in Switzerland: a follow-up study Léonie Vivonne Grawehr 1,2 , Barbara Bachtiary 2 , Ulrike Kliebsch 2 , Damien Charles Weber 2 1 Facultiy of Medicine, University of Zurich, Zurich, Switzerland. 2 Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland Purpose/Objective: Financial strain in cancer care is a common and serious concern that can adversely affect the quality of life of both patients and caregivers. This follow-up study aimed to assess long-term financial strain among adult cancer survivors and caregivers of paediatric cancer survivors several years after proton therapy in Switzerland, and to compare these findings with financial strain levels measured immediately after treatment. Material/Methods: Financial strain was assessed using the validated Comprehensive Score for Financial Toxicity (COST), along with relevant demographic and clinical data. Follow-up COST scores were compared with those obtained at the completion of proton therapy. Multivariate regression analyses were conducted to identify factors associated with persistent financial strain and with worsening financial situations over time. Results: Of 118 eligible participants, 85 completed the follow- up assessment (median follow-up: 3.7 years; response rate: 72%). Among caregivers, COST scores improved significantly, indicating reduced financial strain. In contrast, no significant improvement in economic well- being was observed among adult patients. In the adult cohort, being retired, having financially dependent children, and reporting lower health-related quality of life were significant predictors of persistent financial strain. Female gender emerged as an independent risk factor for increasing financial strain at follow-up. Conclusion: In Switzerland, the financial situation of adult cancer survivors treated with proton therapy remains essentially unchanged several years after treatment. Retired patients, those with financially dependent children, and individuals with lower health-related quality of life face a higher risk of long-term financial strain and should receive targeted financial and psychosocial support. References:
Conclusion: These results indicate that a portable linac coupled with an upright patient positioner could deliver a fully- shielded, portable system, designed to increase patient access to radiotherapy. The use of standardised shipping containers could allow multimodal transportation. Further research should focus on optimising possible layouts and using Monte Carlo simulations to verify shielding calculations. References: [1] Baade PD, Dasgupta P, Aitken JF, Turrell G. Distance to the closest radiotherapy facility and
survival after a diagnosis of rectal cancer in Queensland. Medical Journal of Australia 2011;195:350–4.
https://doi.org/10.5694/mja10.11204.[2] Wawrzuta D, Klejdysz J, P ę dziwiatr K, Chojnacka M. Global access to radiotherapy: A geospatial analysis of current disparities and optimal facility placement. Radiotherapy and Oncology 2025;211. https://doi.org/10.1016/j.radonc.2025.111061.[3] NCRP Report 151. Structural Shielding Design and Evaluation for Megavoltage X- and Gamma-Ray Radiotherapy Facilities. 2005.[4] IAEA. Radiation Protection in the Design of Radiotherapy Facilities.
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