N. Kovalchuk1, R. Zelinskyi2, L. Stadnyk3,4, S. Brovchuk5, V. Iakovenko6, N. Suchowerska7, Z. Shepil5, Y. Lozko8, and A. Beznosenko9; 1Department of Radiation Oncology, Stanford University, Stanford, CA, 2Ukrainian Association of Medical Physicists, Ukraine, 3Grigoriev Institute for Medical Radiology, Kharkiv, Kharkiv Region, Ukraine, 4SO «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine, 5Kyiv Regional Oncology Dispensary, Kyiv, Ukraine, 6Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada, 7Royal Prince Alfred Hospital, Camperdown, Australia, 8Stanford Cancer Institute Palo Alto, Palo Alto, CA, 9National Cancer Institute, Kyiv, Ukraine
Purpose/Objective(s): To assess the consequences of the invasion on RT services in Ukraine, provide strategies to maintain the vitality/capacity of RT services during the war. Materials/
Methods: Data on the operation of RT centers during the war was collected by the by the Grigoriev Institute for Medical Radiology in Kharkiv for the IAEA DIRAC database in January 2023 and provided insights into equipment, staffing, and patient volume at 41 RT centers in Ukraine, excluding occupied territories. Results: The invasion since 2014 led to the loss of access to 9 RT centers and 24 (22.2% of total) external beam radiotherapy (EBRT) machines. Before the 2022 invasion, there were 44 Co-60 machines and 33 linear accelerators in unoccupied territories. Following the 2022 invasion, most RT centers ceased operations, with significant disruptions in RT services due to inability to operate linear accelerators or perform source exchanges. Overall, annual 2022 RT patient volume decreased by 5,500 (-11%) compared to previous year: 47.3% decrease in LDR brachytherapy, 26.4% in orthovoltage and 16.5% in HDR brachytherapy. RT staffing redistribution across the country was significant with 68% of regions experiencing staffing changes >25%. Despite the war, efforts to modernize RT infrastructure continued, with the installation of 9 linear accelerators and plans to install 15 more. There is an acute need in training RT workforce on how to transition from Co-60 to IMRT technology. Conclusion: The invasion has severely affected RT services in Ukraine, necessitating urgent support to maintain quality care for cancer patients. Assistance in the form of equipment donations, training programs, and technological upgrades is crucial for ensuring the resilience and effectiveness of RT services in Ukraine during and after the conflict. This collaborative effort underscores the importance of international solidarity in mitigating the impact of war on healthcare systems and restoring hope for affected populations.
