ESTRO 2025 - Abstract Book

S204

Brachytherapy - General

ESTRO 2025

3634

Poster Discussion Assessing Global Supply and Demand of Brachytherapy Resources Abdurrahman Hajeer 1 , Mohammad Akash 2 , Ahmed Salem 3,4

1 Medical School, University of Manchester, Manchester, United Kingdom. 2 Faculty of Medicine, The Hashemite University, Zarqa, Jordan. 3 Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan. 4 Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom Purpose/Objective: Brachytherapy is an important cancer treatment, but global access is unknown. We quantified global demand and supply for brachytherapy, focusing on identifying disparities in access. Material/Methods: Cancer incidence in 186 countries was derived from GLOBOCAN2022 for prostate, cervical, endometrial, vaginal, vulval cancers and ocular melanoma. Brachytherapy utilisation rates derived from the 2013 Collaboration for Cancer Outcomes Research and Evaluation (CCORE) model were applied to estimate brachytherapy demand (HIC Model). We also created an Adjusted Model to account for late-stage cancer diagnosis in LIC & MIC by applying Malaysian cancer registry data and removing early-stage cancer diagnosis for LIC. Prostate cancer indication was removed for LICs & MICs, as viable non-brachytherapy treatment options exist. Both HIC and Adjusted models included a vulval cancer brachytherapy utilisation rate modified from CCORE model. Country income and population data were extracted from the World Bank. The number of brachytherapy centres was extracted from the IAEA DIRAC database. For countries with >500 brachytherapy patients/centre, additional centres were identified through a literature review. Maximum yearly capacity for a brachytherapy centre was calculated at 218 brachytherapy patients/centre, based on mean brachytherapy patients/centre +1SD for HIC with population >2million. Euclidean distance analysis was conducted to calculate average population-weighted distance to nearest centre for areas with population density >607.88 people/ SqKm. Results: Ten of 21 countries with >500 brachytherapy patients/centre had more centres than listed on DIRAC. The mean number of brachytherapy patients per centre for LICs, MICs and HICs was 3,830.32, 383.71, and 132.06, respectively (p<0.0001). Correlation analysis revealed an inverse relationship between brachytherapy patients/centre and income, ρ=-0.7012 (p<0.0001; Table 1). Brachytherapy demand was met in most HICs (N=44; 81.48%), some MICs (N=26; 27.08%) and no LIC. Top indications for brachytherapy were cervical (HIC model: 51%; Adjusted Model: 59%), uterine (24%; 25%) and prostate cancers (21%; 12%). LICs (10.4%) displayed a higher brachytherapy utilisation rate compared to MICs (4.1%) and HICs (2.9%) (p<0.0001; Figure 1), reflecting a higher incidence of cervical cancer. A deficit of 36, 644 and 197 centres were calculated for HIC, MIC and LIC, respectively. The average population weighted distance to the nearest centre was lowest in HICs (68km) followed by MICs (260km) and highest in LICs (551km) (p<0.000125; Figure 2). Factor Factor HIC Model Adjusted Model Log10,000population/centre LogGNI -0.77* -0.78* LogBrachytherapy patients/centre -0.70* -0.71* Table 1: *p<0.0001