ESTRO 2025 - Abstract Book

S2251

Interdisciplinary – Global health

ESTRO 2025

4455

Digital Poster Support for Radiotherapy in Ukraine: Help Ukraine Group activities and the Importance of International Collaboration Nataliya Kovalchuk 1 , Ruslan Zelinskyi 2 , Serhii Brovchuk 3 , Zoia Shepil 3 , Viktor Iakovenko 4 , Yuliia Lozko 5 , Natalka Suchowerska 6 1 Radiation Oncology, Stanford University, Stanford, USA. 2 Radiation Oncology, Spizhenko Clinic, Kyiv, Ukraine. 3 Radiation Oncology, Shalimov Institute, Kyiv, Ukraine. 4 Radiation Oncology, UTSW, Austin, USA. 5 Radiation Oncology, NCI, Kyiv, Ukraine. 6 Radiation Oncology, University of Sydney, Sydney, Australia Purpose/Objective: The full-scale Russian invasion of Ukraine on February 24, 2022 brought the largest humanitarian disaster in Europe since World War II. This work examines the gaps in radiotherapy (RT) services caused by the war and proposes strategies to sustain RT capacity and vitality. Material/Methods: Help Ukraine Group (HUG), in collaboration with the IAEA, ASTRO, and AAPM, designed and distributed surveys to evaluate RT infrastructure, workforce, and training needs in Ukraine. These findings were combined with data from the DIRAC database, compiled by the Grigoriev Institute for Medical Radiology in Kharkiv, to develop an action plan targeting critical areas of need. Results: Ukraine has one of the lowest rates of MV RT machines in Europe, with just 1.7/million people. The war caused the loss of 11 RT centers and 26 EBRT machines. A significant challenge is reliance on 32 aging Co-60 machines, primarily manufactured in Russia, with sources irreplaceable under current circumstances. Additionally, 16 HDR afterloaders are over 25-years-old and require replacement, 13 RT centers lack CT scanners, and the entire country is served by only 3 PET/CT scanners. Even before the war, Ukraine faced severe shortages of medical physicists and therapists, as noted by ACR recommendations. The war further exacerbated staffing issues, with the decline in the numbers of radiation oncologists and therapists. Nevertheless, RT patient volume returned to pre-war levels, showcasing the resilience and heroism of Ukraine’s RT workforce. Despite the challenges, Ukrainian radiotherapy is modernizing at rapid rate since the invasion with the installation of 15 linear accelerators and purchase of 26 more. As identified by our surveys, this rapid modernization prompts the critical need for training as the transition from Co-60 to IMRT continues and significant gaps in workforce knowledge and confidence across modern RT areas are identified. To address the above challenges, HUG, in partnership with UICC, ASTRO, ESTRO, AAPM, and the vendors, has delivered immobilization equipment to over 10 cancer centers, provided software to 30 centers, facilitated 12 training courses, and organized 50 international observerships for oncology practitioners. Future efforts will focus on sustaining these initiatives and strengthening collaboration with IAEA to scale support and advance RT reforms in healthcare and education. Conclusion: The invasion has severely disrupted RT services in Ukraine, necessitating urgent international support for equipment donations, workforce training, and infrastructure upgrades. This collaborative model highlights global solidarity’s importance in sustaining healthcare during crises and provides a blueprint for other LMICs/UMICs facing similar challenges.

Keywords: Ukraine, radiotherapy, war