ESTRO 2021 Abstract Book

S1204

ESTRO 2021

Nearly two-thirds (66.51%) of all German radiation oncologists would administer dexamethasone prophylactically during stereotactic cerebral irradiation. Of these, 14.18% would administer the dose intravenously with a daily maximum dose of 32mg. Conclusion Prophylactic dexamethasone administration during cerebral irradiation is frequently used, especially in more intensive therapy regimens although the benefit remains a matter of debate and further prospective studies are needed. PO-1468 Radiotherapy journey to peripheral centers in Turkey: How far is close enough? E. Oymak 1 , C. Şahin 2 , Z. Akpınar Palabıyık 3 , C. Önal 4 1 Iskenderun Gelisim Hospital, Radiation Oncology, Hatay, Turkey; 2 Kutahya Health Sciences University, Training and Research Center, Health Sciences, Kutahya, Turkey; 3 Sakarya University Training and Research Hospital, Radiation Oncology, Sakarya, Turkey; 4 Baskent University Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Radiation Oncology, Adana, Turkey Purpose or Objective Worldwide access to RT is lower than what it should be. The majority of cancer control programs focus on predictions based on population, incidence rates, population density, socioeconomic groups. Almost all of these demographics come from larger cities. The situation in rural regions is often unknown, and people in these areas are expected to reach the closest healthcare provider. Turkish National Oncology Reform Plan for 2023 details the cancer incidence rates, describes a tiered investment plan for cities depending on population, the specifications of each service type and proposes the locations for new RT services. Geographical factors or travel distance has not been taken into consideration. We aimed to measure the travel distance in three most rural regions patients need to cover to reach the nearest RT centers in Turkey. Materials and Methods 2774 patients’ RT journey at three peripheral centers in Turkey that represent the most outreach points in their network were analyzed. All are singular clinics in their district. 1900 patients in Sakarya, 360 in Kutahya, 514 in Iskenderun were included. According to reported addresses, the distances to the hospital have been measured using maps. Distance to the hospital less or equal to 30 km is grouped as urban residence, and above 30 km is grouped as rural. The average distance of rural patients is determined for each center. Results The number of rural patients for Sakarya, Kutahya and Iskenderun are 788 (41.5%), 158 (43.9%) and 151 (29.4%). Average distance for these patients were 64.3 km (range 35–280), 78 km (range 43–247), 49.9 km (range 35–85), respectively. The average one-way distance to peripheral clinics for all rural patients was 62.1

km.

Conclusion The difference between optimal and actual RT utilization rate is effective cancer plans. International examples are Ontario Cancer Plan and UK Cancer Strategy that focus on keeping access within mandated wait times. Data from France mentions there are no ‘desert areas’ left in the country, the percentage of patients treated in centers farther than 100 km from their residence was 5.5%. Our study evaluated three peripheral RT center in Turkey and divided patients into urban and rural residences. The results show that 38.2% of patients live farther than 30 km away from the hospital and need to travel an average of 120 km every day to receive RT. This unexpectedly long RT journey applies to every visit they need to make. The means to make such travel vary greatly and exacerbates the medical burden. To our knowledge, this study is the first to analyze the RT journey in terms of travel distance. Even if the necessary number of RT devices in a country are met, it does not translate into equitable access unless the distribution of units are allocated fairly. We hope our study will give an idea about RT journey of patients in rural regions and provide assistance for future plans of investment.