ESTRO 2025 - Abstract Book

S2335

Interdisciplinary – Health economics & health services research

ESTRO 2025

Conclusion: Despite geographic displacement during treatment, the median financial burden reported was moderate. Family support (staying with relatives) and assistance from patient associations appear crucial in mitigating financial challenges. Reducing the overall duration of radiotherapy could further ease the financial strain. Future studies assessing indirect costs objectively are recommended to better capture the financial burdens associated with radiotherapy.

Keywords: financial difficulties

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Digital Poster Advances in Radiotherapy Treatment in the Baltic States from 2016 to 2023 as seen through the lens of technology, delivery techniques and capacity Erika Korobeinikova 1 , Kristaps Palskis 2 , Eduard Gershkevitsh 3 , Manjit Dosanjh 4,5 1 Oncology Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania. 2 Institute of Particle Physics and Accelerator Technologies, Riga Technical University, Riga, Latvia. 3 Medical Physics Service, North Estonia Medical Centre, Tallinn, Estonia. 4 Department of Physics, University of Oxford, Oxford, United Kingdom. 5 STELLA Project, International Cancer Expert Corps (ICEC), Washington, DC, USA Purpose/Objective: To analyze advances in external beam radiotherapy (EBRT) techniques across Lithuania, Latvia, and Estonia from 2016 to 2023, focusing on transition to advanced modalities and changes in treatment capacity. Material/Methods: Data were collected from all radiotherapy centers in the region (2 in Estonia, 5 in Latvia, 4 in Lithuania) through questionnaires. Key metrics included EBRT patient volumes, treatment machines, and utilization of techniques: 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), stereotactic radiosurgery/stereotactic body radiotherapy (SRS/SBRT). Trends were analyzed to evaluate regional disparities. Results: In 2023, the Baltic States collectively treated 12,440 patients annually with EBRT. Lithuania had the highest treatment volume per capita (235 per 100,000 inhabitants), followed by Latvia (177) and Estonia (171). Equipment availability : From 2016 to 2023, EBRT units increased in Estonia (6 to 7) and Latvia (9 to 10, including CyberKnife). Lithuania saw a slight reduction (12 to 11, including Gamma Knife). • IMRT/VMAT : By 2023, all LINACs in the region were IMRT/VMAT-capable (excluding Gamma Knife). In 2016, this was 100% in Estonia, 75% in Lithuania, and 44% in Latvia. • SRS/SBRT : Capability increased in Estonia (67% to 71%) and Lithuania (8% to 72%). Latvia showed a slight decrease (11% to 10%). Country-level treatment delivery changes from 2016 to 2023 (Figure 1) : • Estonia : EBRT patient count rose by 15% (2275 to 2660). VMAT/IMRT increased from 19.4% of treatments to 49.2%, 3D-CRT declined from 80.6% to 42.2%. SRS/SBRT was introduced in 2018, and now accounts for 8.6% of cases. • Lithuania : Patient counts rose by 23% (5,493 to 6,778). VMAT/IMRT usage increased from 28.8% to 73.3%, and 3D-CRT fell from 70% to 14.5%. SRS/SBRT grew from 1.2% to 12.2%. • Latvia : Patient counts remained stable (3,300 to 3,325). VMAT/IMRT usage rose from 17.5% to 70.8%, and 3D-CRT declined from 81.5% to 21.4%. SRS/SBRT expanded from 1% to 7.8%. Disparities across three countries in 2023: 3D-CRT treatments ranged from 42.2% in Estonia to 14.5% in Lithuania. IMRT/VMAT utilization was highest in