ESTRO 2025 - Abstract Book

S2221

Interdisciplinary – Global health

ESTRO 2025

Castriconi R et al. Inter-institutional variability of knowledge-based plan prediction of left whole breast irradiation. Phys Med. 2024 Apr;120:103331. doi: 10.1016/j.ejmp.2024.103331.

1410

Digital Poster Advancing prostate cancer radiotherapy in Bangladesh: an European-Asian collaboration for context specific guideline development. Kamal A.F.M. Uddin 1 , Letizia Cavallini 2 , Maria Ntreta 3 , Arina A Zamfir 3 , Romina Rossi 4 , Milly Buwenge 2 , Silvia Cammelli 2,3 , Alessio G Morganti 3,2 , Savino Cilla 5 , Mostafa A Sumon 6 1 Department of Radiation Oncology, National Institute of ENT & Scientific Secretary Oncology Club, Dhaka, Bangladesh. 2 Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy. 3 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 4 2. Palliative Care Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Forlì-Cesena, Italy. 5 Medical Physic Unit, Responsible Research Hospital, Campobasso, Italy. 6 Radiation Oncology, Kurmitola General Hospital, Dhaka, Bangladesh Purpose/Objective: Prostate cancer (PCa) presents significant challenges in low- and middle-income countries (LMICs), where limited healthcare resources complicate treatment. This study aimed to develop radiotherapy (RT) guidelines tailored to the specific context of Bangladesh. The initiative was driven by the need to bridge the gap between international standards and local healthcare realities, optimizing the management of PCa by guideline adherence within the country’s unique resource constraints. Material/Methods: In collaboration with the Oncology Club, Bangladesh, the University of Bologna conducted the Advanced RT Course from February to May 2024, combining remote and in-person sessions. The course focused on enhancing local clinicians' proficiency in advanced RT techniques, including contouring of organs at risk, prostate, prostate bed, and nodal targets. A multidisciplinary approach was employed, involving radiation oncologists, clinical oncologists, and physicists. Participants were divided into groups and tasked with developing draft guidelines covering key areas: staging, contouring, planning, treatment protocols, and follow-up. The guideline development process was iterative, involving pre-course reading materials, group assignments, collaborative feedback sessions, and external expert reviews to ensure international standards were met while adapting to local constraints. Results: The tailored guidelines, developed for the first time in the country, addressed critical barriers in Bangladesh, such as limited access to MRI, advanced diagnostic tools (like choline-PET and PSMA-PET scans), and a shortage of specialists in prostatic diseases. The adapted guidelines provided practical modifications for staging, treatment planning, and follow-up, focusing on resource optimization. Incorporation of pictorial component for contouring of all major points made it a more effective document. Key adaptations included streamlined protocols for exclusive, adjuvant, and salvage RT, aligning with available resources and the specific disease prevalence in Bangladesh. This localized approach ensured the guidelines were pragmatic and feasible within the local healthcare infrastructure. Conclusion: The development of these adapted RT guidelines represents a significant step toward improving cancer care in Bangladesh. The initiative highlights the importance of context-specific oncology guidelines in LMICs, where disparities in healthcare resources necessitate tailored approaches. This guideline can be used by any practicing oncologist during their day-to-day practice as a useful tool. By leveraging global knowledge and local expertise, the project offers a model for adapting international standards to fit local healthcare contexts. Future directions include