ESTRO 2025 - Abstract Book

S2254

Interdisciplinary – Global health

ESTRO 2025

Conclusion: International observerships significantly enhance the professional capabilities of Ukrainian physicians, including radiation oncologists and medical physicists, fostering improvements in clinical practice and medical education. Addressing systemic barriers through collaboration with international and local institutions is essential to fully realize these benefits. This study underscores the role of international training programs in advancing global radiation oncology and medical physics.

Keywords: Collaboration, Healthcare Accessibility,Innovation

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Digital Poster Impact of 18F-FDG PET/CT on Staging and Treatment Decisions in Non-Small Cell Lung Cancer: experience of a North African medical oncology department Nada Mabrouk 1 , Asma Felfoul 2 , Wiem Khechine 1 , aladin Hmad 1 , amira daldoul 1 , Sonia Zaied 1 1 Department of medical Oncology, Fattouma Bourguiba Hospital, Monastir, Tunisia. 2 Department of medical Oncology, Fattouma Bourguiba Hospital, monastir, Tunisia Purpose/Objective: Lung cancer is the second most common malignancy and the leading cause of cancer mortality worldwide. Non small cell lung cancer (NSCLC) represents about 85% ofcases. Early diagnosis and precise staging are crucial for improving prognosis and guiding treatment strategies. 18 F-FDG PET/CThas significantly impacted the management of NSCLC, providing superior diagnostic and staging accuracy compared to conventional CT scans. Material/Methods: We conducted a retrospective study at the Oncology Department of Monastir in Tunisia from January 2021 to December 2023, including 21 patients diagnosed with NSCLC who underwent 18 FDG PET /CT. The aim is to evaluate the diagnostic accuracy, staging adjustments, and management modifications guided by PET/CT. Results: The mean age of the patients was 65 years, all patients were male with a history of smoking.Median Time to diagnosis was 3.4 months.At presentation, 7 patients (33.3%) had chest pain, 4 (19%) haddyspnea, and 3 (14.3%) were diagnosed incidentally. Asthenia and weight loss were observed in 2 patients (9.5%).Diagnosis was confirmed through CT-guided biopsy in 12 patients, bronchoscopy-guided biopsyin 3 patients, and surgical specimens in 6 patients.Histological analysis revealedadenocarcinoma in 13 patients (61.9%) and squamous cell carcinoma in 6 patients (28.6%), and NSCLC not otherwise specified in 2 patients (9.5%).All patientsunderwentbrain-chest abdomen-pelvis CT for initial staging, which revealed: stage II in 4 patients (19.1%), stage IIIA in 4 patients (19%), stage IIIB in 4 patients (19%), stage IIIC in 5 patients (23.8%), and stage IV in 4 patients (19%). 18 F-FDG PET/CT was performed in 57% of cases (n=12) for initial diagnosis, 28.6% (n=6) for restaging after treatment,9.5% (n=2) after relapse, and in 1 patient (4.8%) for lesion characterization. The median delay to PET/CT was one month (range: 0.3–6 months). PET/CT findings resulted in downstaging in 23.8% of cases, upstaging in 28.6%, while staging remained unchanged in 42.9% compared to conventional imaging. Treatment strategies were modified in 38.8% of patients (n=8) based on PET/CT results. Five patients (23.8%) underwent surgery, 4(19%) received chemotherapy, and 10 (47.6%) were treatedwith neoadjuvant chemotherapy, of whom only two patients receivedsequential radiotherapy, four patients (19%) were lost to follow-up, and 4 were ineligible for radiation due to progressive disease or poor ventilatory function. Conclusion: 18 FDG PET /CTis essential in the management of NSCLCparticularly in stages II and III cancer. It provides diagnostic accuracy, better staging, and the ability to guide treatment decisions.