118 - Beyond Malignancy: Addressing the Educational Gap in Radiation Therapy for Non-Malignant Diseases: An ARRO-jDEGRO Initiative
Presenter(s)
T. Kutuk1, R. M. Blach2, M. A. Sonnhoff2, D. R. Steike3, J. Kocsis4, O. E. Ojo5, A. D'Souza6, L. Schmidt7, J. Kriz8, and N. S. Koneru9; 1Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, 2Department of Radiotherapy, Hannover Medical School, Hannover, Germany, 3Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany, 4Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH, 5Department of Radiation Medicine, Northwell, Lake Success, NY, 6Washington University School of Medicine in St. Louis, St. Louis, MO, 7Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany, 8Radiation Oncology Clemens Hospital Muenster, Muenster, Germany, 9Loyola University Strich School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL
Purpose/Objective(s):
Low-dose radiotherapy has a long history in the management of nonmalignant diseases, yet structured education in radiation therapy (RT) for nonmalignant diseases remains limited in many residency programs. We hypothesized that substantial international variation exists in training, clinical exposure, and confidence in RT for nonmalignant diseases, and that trainees desire greater formal education.Materials/Methods:
An international cross-sectional survey was developed by resident networks and distributed to radiation oncology clinicians and trainees across multiple countries. The survey assessed training exposure, clinical experience, self-reported familiarity and confidence (5-point Likert scale), perceived barriers and preferred educational formats. Descriptive statistics were used to summarize responses and compare regional trends.Results:
A total of 129 respondents from 17 countries completed the survey. Participants included attending physicians (n=62, 48.1%), residents and fellows (n=52, 40.3%), and other professionals (n=15, 11.6%). Overall, 55.8% (n=72) reported completing a rotation involving RT for nonmalignant diseases, while 33.3% (n=43) reported no rotation. Clinical exposure varied widely: 36.4% (n=47) participated in 0-10 cases and 40.3% (n=52) in >50 cases. Marked regional differences were observed. Among German respondents (n=75), 74.7% (n=56) completed a rotation in RT for nonmalignant diseases and 48.0% (n=36) treated >50 cases. Among U.S. respondents (n=20), only 20.0% (n=4) completed a rotation and 65.0% (n=13) reported exposure limited to 0-10 cases. Mean familiarity scores were highest in Germany (4.02±0.9) compared with other countries (2.71±1.0) and the United States (2.54±0.9). Confidence in counseling patients showed similar trends (Germany 3.96±0.8 vs United States 2.33±0.8). Formal teaching was absent for 36.4% (n=47) of respondents. Nearly all participants (95.8%, n=114/119) supported inclusion of RT for nonmalignant diseases in core residency curricula. The most commonly cited barriers were perceived low relevance (34.9%, n=45), limited case volume (34.9%, n=45), lack of curricular inclusion (27.9%, n=36), limited faculty expertise (25.6%, n=33), and reimbursement or institutional challenges (24.0%, n=31). Preferred educational formats included live webinars (66.7%, n=86), online lecture archives (50.4%, n=65), and case-based discussions (48.1%, n=62).Conclusion:
Substantial international disparities exist in education and clinical exposure in RT for nonmalignant diseases, with markedly limited training in the United States compared with Europe. Despite this gap, global interest in formal education is high. International resident-led collaborations and structured educational initiatives may help restore training, expand multidisciplinary engagement, and support the integration of RT for nonmalignant diseases into modern practice.