Building Resilience and Modernizing Radiation Therapy In Ukraine through Comprehensive Education and International Collaboration
Abstract
Purpose
The Russian invasion of Ukraine has significantly disrupted radiation therapy (RT) services, highlighting the urgent need to replace Cobalt-60 machines and modernize infrastructure and training across 43 RT centers. In response, Help Ukraine Group (HUG) and Rayos Contra Cancer (RCC), supported by SweCare, AAPM, ASTRO, ESTRO, ABS, and vendors, launched a national RT training initiative in 2025. The program aimed to support Ukraine’s transition from 2D and Co-60-based treatment to advanced 3D and IMRT techniques, while building clinical, technical, and research competencies among radiation oncologists (RO), medical physicists (MP), and radiation therapists (RTT).
Methods
This mixed-format program integrated local, virtual, and international training. Eight 3-day hands-on workshops for RO/RTTs were delivered at the Shalimov Institute, and 15 MP workshops at the Spizhenko Clinic. Twelve professionals completed 2-week observerships at Södersjukhuset and Akademiska Sjukhuset in Sweden, and three attended ESTRO 2025 in Vienna. Virtual education included RCC-led courses on 2D-to-3D transition, plan evaluation, and head-and-neck contouring, and HUG-led SBRT, brachytherapy, and research methodology courses. ESTRO provided 40 free contouring course registrations. Full-day RT sessions were delivered at the OncoHUB UpToDate 6.0 national conference. Program evaluation used pre-/post-tests and satisfaction surveys (1-10 scale).
Results
A total of 1,079 training participations across 39 RT centers were recorded across all formats: 777 via virtual courses, 124 in on-site workshops, 12 in international observerships, and 166 through conference activities. Virtual training participants demonstrated a 47.3% average improvement in test scores, with a mean satisfaction score of 9.8/10. On-site workshop participants showed a 29.7% knowledge gain and rated the experience 10.0/10. Observership participants reported adoption plans for new clinical workflows and satisfaction of 9.8/10.
Conclusion
This comprehensive, scalable training model strengthened Ukraine’s RT capacity during wartime. Sustained investment in blended education and international collaboration is essential for long-term modernization and system resilience.