ESTRO 2022 - Abstract Book

S21

Abstract book

ESTRO 2022

various components of cancer management. For example, the current median density of radiotherapy machines per million population are 5.1 in high-income countries (HICs) and 0 in low-income countries. This is a tragedy on many fronts. In addition, the Lancet Oncology Commission report on radiotherapy concluded that the potential to save nearly one million lives per year by 2035 through optimal access to radiotherapy would lead to a net macroeconomic benefit of up to $365 billion in US dollars (USD) over the 20-year scale-up period. There are many factors affecting access to RT. For example, around 5% of the national health expenditure goes towards cancer in general, and radiotherapy expenditure per se constitutes only around 5% of the total cancer cost. Furthermore, socioeconomic status of a country often correlates with the available resources, making global access to radiotherapy very heterogeneous. In addition, challenges in human resource availability are an issue. Even while trained professionals are key for the sustainable growth of radiotherapy. The number of professionals is not the only factor to consider, but more importantly, the quality of professional training must be considered. As for equipment, a significant upfront investment is required for setting up a radiotherapy program. Even then, operational and maintenance can still be challenging for LMICs. This affects sustainability of the programs and the ability to achieve growth in radiotherapy access on a national level. Innovative solutions are essential. While more resources are definitely needed, it is as important that we determine best practices to enhance efficiencies. Factors leading to successful implementation of educational, research and clinical activities must be assessed. Innovation in education through microlearning, use of IT based technologies and multi-media are needed. Telecommunication, automation, remote support, virtual collaboration can help. Opportunities to improve efficiencies through innovation are needed such as instituting virtual reality training before hands on in-person training, to steepen the learning curves. Acceleration of the education and training of new radiation oncology professionals must keep up with the rate of increase of cancer incidence. Research is a key pillar for the long-term improvement of cancer control. International multi-institutional global research allows diverse participation and is results are more readily applicable to LMICs. Research can also identify the complexities in health systems and costing of interventions. Finally, efficiencies such as the greater use of hypofractionation and the assessment of the effectiveness of educational and other interventions is also needed. Collaboration can enhance the rate of progress. Global initiatives in breast cancer, cervical cancer and pediatric cancers have brought together multiple UN organizations, NGOs, academic institutions and others to work together towards a common goal. The IAEA’s ambitious Rays of hope Global initiative launched at the 2022 African Union heads of State meeting by IAEA DG Grossi and incoming chair of the African Union and Senegalese President Sall includes an initial assessment of affordability and cost-benefit of service expansion in radiotherapy and diagnostic imaging as well as support for equipment, training, research, nuclear safety infrastructure, quality improvement, innovation and education. Direct technical expertise and support of regional Anchor centers will be provided as well. Abstract Text Health inequalities are unfair, systematic differences in health between people from different backgrounds (1). They include experiences relating to socio-economic factors, protected characteristics, geography and socially excluded groups. The Society and College of Radiographers in the United Kingdom produced an extensive practice guideline on skin care in 2020 along with patient and staff skin care guidance leaflets (2). However, these guidelines and leaflets are limited by the currently available research evidence to support skin care interventions and that same research base may provide limited insight into how radiation dermatitis presents across all skin tones. Recent evidence from Jagsi et al. (2020) found evidence of race-related differences in radiotherapy related toxicities that require further research (3). This talk will explore skin care outcomes of ethnically diverse patients after receiving radiotherapy treatment. Key results of a recent survey to understand confidence in distinguishing, managing and treating radiation induced skin reactions in the UK therapeutic radiography (radiation therapist) workforce will be discussed. The presentation will conclude with a call to action within the radiotherapy (radiation therapy) workforce to consider a new direction in skin care assessment to reduce existing inequalities. SP-0046 Ethnic disparities in outcomes with radiation therapy N. Julka-Anderson 1 1 Imperial College Healthcare NHS Trust , Radiotherapy, London, United Kingdom

References:

1. The King’s Fund. Health inequalities in a nutshell. The King’s Fund. 2021.

2. The Society College of Radiographers. Radiation Dermatitis Guidelines for Radiotherapy Healthcare Professionals. The Society College of Radiographers. Report number: 1, 2020. 3. Jagsi R, Griffith KA, Vicini F, Boike T, Burmeister J, Dominello MM. Toward Improving Patient’s Experiences of Acute Toxicity From Breast Radiotherapy: Insights From the Analysis of Patient-Reported Outcomes in a Large Multicenter Cohort. Journal of Clinical Oncology 2020; 38(34): 4019-4029. DOI: 10.1200/JCO.20.01703.

SP-0047 Inequality in toxicity management in radiotherapy - A focus on skin management

J. Daly

Abstract not available Belgium