ESTRO 2024 - Abstract Book

S2769

Interdisciplinary - Health economics & health services research

ESTRO 2024

515

Digital Poster

The future needs of external beam radiotherapy in Portugal until 2040

Edna Darlene Rodrigues 1,2 , Paulo Almeida 3 , Escarlata López 4 , Laetitia Teixeira 1,2

1 School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal. 2 CINTESIS – Center for Health Technology and Services Research, AgeingC, Porto, Portugal. 3 Centro Hospitalar Universitário São João, E.P.E., Internal Medicine, Porto, Portugal. 4 GenesisCare, Oncología Radioterápica, Madrid, Spain

Purpose/Objective:

External beam radiotherapy (EBRT) is essential to offer an effective cancer treatment, but it needs to be accessible, well-timed, and high-quality. There is a global lack of radiotherapy (RT) infrastructure and investment that compromises the cancer outcomes. Portugal has 24 RT centres and 56 MV units registered and only 17 MV units with less than 10 years from installation. The authors aim to quantify the future needs of EBRT until 2040 to cover the future demand.

Material/Methods:

Based on the GLOBOCAN estimate for new cancer cases in Portugal for 2040 it was calculated the optimal number (OUP) of EBRT courses. The OUP is the proportion of new cancer cases that should receive EBRT at least once. In line with the International Atomic Energy Agency (IAEA) DIrectory of RAdiotherapy Centres and ESTRO - Health Economics in Radiation Oncology guidelines, we estimated the number of EBRT machines / Megavoltage (MV) units needed. The ESTRO-HERO guidelines recommended a range from 400 to 450 patients per year for each MV unit. The IAEA staffing guidelines states that are needed one radiation oncologist for every 250-300 patients/year, one medical physicist per 300-400 patients/year and one radiation therapist for every 100-150 patients/year. The estimate assumed that current MV units comply with these recommendations. These estimated staff requirements exclude the replace of retired or resigned employees. Overall, for all cancer cases in Portugal (excluding non-melanoma skin cancers), the median increase in the optimal number of EBRT courses in 2040 was calculated to be 18%, in comparison to 2020 needs. The projected number of optimal EBRT courses for 2040 was estimated to be approximately 34.000. In the scenario where each MV unit treats 450 patients per year and the OUP per new cancer cases is 49.7%, to cover EBRT demand 74 MV units will be needed. Based on the 56 MV units available in Portugal in 2021, an extra 18 ones need to be installed to cover EBRT demand. In the other hand, for the scenario where each MV unit treats 400 patients per year and the percentage of EBRT utilisation per new cancer cases is 51,1%, to cover EBRT demand, 86 MV units will be needed. Based on the 56 MV units available in Portugal in 2021, an extra 30 MV units needs to be gradually installed to cover RT demand. So, a range between 18 and 30 additional MV units are required to be installed to provide full access to EBRT until 2040. Regarding staff demand, the authors considered the two marginal scenarios from the range between 18 to 30 additional MV units until 2040. For the 18 additional MV units, there will be needed 28 radiation oncologists, 22 medical physicists, and 61 radiation therapists. On the other hand, for the 30 additional MV units, there will be Results: