S44
Brachytherapy - General brachytherapy
ESTRO 2026
influencing exposure, including staff location and patient adherence to inhaler technique. Material/Methods: An observational cross-sectional study was conducted in a single-centre brachytherapy theatre (August– September 2024). Healthcare staff (oncologists, nurses, radiographers) wore passive organic vapour monitors to measure methoxyflurane concentrations (ppm) during 23 patient procedures. Staff position, professional role, and patient adherence were recorded. Data were analysed using descriptive statistics and Kruskal–Wallis tests to identify differences by room position and adherence level. Results: Eighty-one monitors were analysed across 23 procedures (10 gynaecological, 13 rectal). The median individual exposure was 0.68 ppm (IQR 0.64; mean 0.70 ppm), well below the recommended 15 ppm maximum exposure limit by Frangos3. Median cumulative exposure per participant was 3.28 ppm (IQR 4.97). Staff at the patient’s head were exposed to higher levels than those at mid-room or foot-end positions (p < 0.05). No significant differences were found by patient inhaler adherence (p = 0.09). The highest cumulative exposure recorded (17.1 ppm) marginally exceeded the single-session guideline, warranting further investigation of long-term cumulative risk. Conclusion: Occupational methoxyflurane exposure during brachytherapy was generally low and within safety limits, though exposure varied significantly by staff position. Proximity to the patient’s airway was the main determinant of exposure. These findings support practical risk-reduction strategies such as staff rotation, enhanced ventilation, and real-time air monitoring. Further multi-centre studies incorporating biological exposure markers are recommended to evaluate cumulative and long-term effects. Keywords: Methoxyflurane, Occupational exposure, Analgesia, References: Humphrey, P., Dures, E., Hoskin, P. and Cramp, F., 2021. Brachytherapy for locally advanced cervical cancer: a survey of UK provision of care and support. Radiotherapy and Oncology, 159, pp.60-66Williams, O.D. and Pluck, G., 2020. The use of methoxyflurane (Penthrox®) for procedural analgesia in the emergency department and pre-hospital environment. Trauma, 22(2), pp.85-93.Frangos, J., Mikkonen, A. and Down, C., 2016. Derivation of an occupational exposure limit for an inhalation analgesic methoxyflurane (Penthrox®). Regulatory Toxicology and Pharmacology, 80, pp.210-225.
rate 95.2%), reporting a total of 24 HDR afterloaders: 66.7% using Co-60 sources and 33.3% using Ir-192. The mean equipment age was 23.1 ± 10.9 years (range, 1– 40 years). Four centers indicated that they are upgrading their systems. On average, each center treats 10.4 ± 6.9 patients per week, mostly for gynecological cancers, with limited interstitial activity. Only 20% of centers considered their applicator sets adequate, and 20% perform any non-gynecological brachytherapy. Despite war-related disruptions, 45% of respondents reported an increase in brachytherapy patient volume, and 85% expressed interest in expanding brachytherapy techniques.In response, an initiative group is forming the Collegium of Ukrainian Brachytherapy (CUB), a stand-alone national society. Planned activities include training, guideline development, research collaboration, and advocacy for modernization of brachytherapy infrastructure, including implementation of 3D imaging and treatment planning. Conclusion: Strengthening brachytherapy is essential for modern cancer care in Ukraine. Although aging equipment, limited applicators, and infrastructure challenges persist, motivation to expand clinical practice remains high. Formation of CUB represents an important step toward coordinated modernization, international collaboration, and improved patient outcomes. Keywords: Resource assessment, Ukraine, society formation Digital Poster 4663 Are levels of Methoxyflurane in the atmosphere in a brachytherapy theatre safe for healthcare professionals when patients use the Penthrox® inhaler? Ciarna brooker 1 , Jenny Harris 2 , Benita Thomas 1 , Alexandra Stewart 1 1 Royal Surrey Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 2 Cancer Care and Health Statistics, University of Surrey, Guildford, United Kingdom Purpose/Objective: Brachytherapy is an established cancer treatment that often causes significant pain during applicator or needle insertion1. Inhaled methoxyflurane (IMF), a short-acting, self-administered analgesic, has been shown to effectively reduce pain2. However, data on occupational exposure among healthcare staff during brachytherapy remain limited, particularly within shielded treatment rooms with restricted ventilation.Objective:To quantify atmospheric methoxyflurane levels during brachytherapy procedures, assess staff exposure, and explore factors
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