ESTRO 2025 - Abstract Book

S2297

Interdisciplinary – Health economics & health services research

ESTRO 2025

Purpose/Objective: Stereotactic Radiation Therapy (SRT) has proven to be safe and effective in both the intracranial and extracranial settings. Based on this, many centres around the world now offer these services to their patients. There are numerous barriers to successful clinical implementation of SRT including access to clinical and technical expertise, complex and time-consuming commissioning requirements, requirement for specific staff training and education, as well as rigorous ongoing quality assurance and quality control requirements 1 .

In this study, we present on the implementation of SRT across an international network of over 40 cancer centres spanning 5 countries (Australia, New Zealand, Singapore, Mainland China, and the UK) from 2019 to now.

Material/Methods: The implementation program was underpinned by a centralized clinical governance model which included physician led clinical streams, staff training, education, competency, endorsement programs, and overarching policy and procedure guidelines. Specific multi-disciplinary project teams were assembled to develop commissioning templates, clinical guidelines, and specific policy and procedure documents for each SRT technique to be implemented. To support the training and competency requirements of physicians, a remote mentoring system was implemented as well as virtual stereotactic chart rounds 2 . To support the training and competency requirements for radiation therapists and medical physicists, remote stereotactic support teams were established and provide both treatment planning support and also support during treatment simulation and delivery. Results: Since the program was launched in 2019, eight SRT techniques have been developed and have been implemented over 158 times across 40 cancer centres in the network. In total, over 100 physicians are endorsed or under mentorship across the network and over 3400 cases have undergone independent peer review by an endorsed physician. 5500 treatment plans and over 5000 treatment planning courses have been supported by the remote treatment planning team, and the remote team have also supported over 5500 treatment deliveries. Since 2019, over 9700 stereotactic treatment courses have been provided to patients in the network and this number continues to grow by 25% annually. Conclusion: In conclusion, a highly replicable and expandable stereotactic program has been successfully developed and implemented across an international network of over 40 cancer centres. This model has effectively and efficiently provided these advanced techniques for patients, overcoming many of the typical barriers to implementation.

Keywords: Stereotactic, Sustainability, Access

References: 1. Liu H et al. Guidelines for safe practice of stereotactic body (ablative) radiation therapy: RANZCR 2023 update. JMIRO. 2024 68: 217-227. 2. Fitzgerald R et al. Quality and Access – Early experience of implementing a virtual stereotactic chart round across a national network. JMIRO. 2020 64(3): 422-426

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Proffered Paper Global geographic access to radiotherapy: a geospatial analysis of current coverage and strategic center placement Dominik Wawrzuta 1 , Justyna Klejdysz 2,3 , Marzanna Chojnacka 1