Author: Serhii Brovchuk, Viktor M. Iakovenko, Nataliya Kovalchuk, Yuliia Lozko, Zoia Shepil, Natalka Suchowerska, Ruslan Zelinskyi 👨🔬
Affiliation: Kyiv Regional Oncology Dispensary, Stanford University, O.O. Shalimov National Institute of Surgery and Transplantology, School of Physics, The University of Sydney, Medical Physics Department, Medical center of Yuriy Spizhenko, Department of Radiation Oncology, UT Southwestern Medical Center, Stanford Cancer Center 🌍
Purpose: The full-scale russian invasion of Ukraine has caused the largest humanitarian disaster in Europe since World War II. This study identifies gaps in RT services caused by the war and outlines strategies to sustain RT capacity and vitality.
Methods: Help Ukraine Group (HUG), in collaboration with IAEA, ASTRO, and AAPM, distributed surveys to assess RT infrastructure, workforce, and training needs in Ukraine. Data from these surveys and the DIRAC database were analyzed to develop an action plan addressing critical challenges.
Results: Ukraine has one of the lowest rates of MV RT machines in Europe, with 1.7/million people. The war led to the loss of 11 RT centers and 26 EBRT machines. Reliance on 32 aging Co-60 units poses a significant issue, with no replacement sources available. Sixteen HDR afterloaders exceed 25 years of age, 13 RT centers lack CT scanners, and the entire country is served by just 3 PET/CT scanners. Pre-war shortages of medical physicists and therapists have worsened due to the war. Despite this, RT patient volumes have returned to pre-war levels, demonstrating resilience and dedication among Ukraine’s RT workforce. Since the invasion, modernization efforts have accelerated with the installation of 15 linear accelerators and plans for 26 more. However, transitioning from Co-60 to IMRT highlights urgent training needs due to significant workforce knowledge gaps. HUG, partnering with UICC, ASTRO, ESTRO, AAPM, and vendors, has delivered immobilization equipment to over 10 cancer centers, software to 30 centers, facilitated 12 training courses, and organized 50 international observerships. Future efforts will focus on scaling support and advancing RT reforms in collaboration with IAEA.
Conclusion: The war has disrupted RT services, necessitating global collaboration for equipment donations, workforce training, and infrastructure upgrades. This model underscores the importance of international solidarity during crises and serves as a blueprint for other LMICs.