Introduction/Background Interstitial Needle brachytherapy (INB) is a form of radiotherapy where radioactive sources (RS) are directly placed into or close to the tumor to deliver high doses of radiation. These are backed by several studies which have shown better disease control and overall survival when combined with External Beam Radiotherapy in Gynaecological Malignancies.

We are the first Centre in Oman to successfully start the INB program in gynaecological cancers. In this abstract, we highlighted the various challenges to the implementation of INB that can impact its utilization.

Methodology The challenges in setting up the INB program, were stratified into: Equipment, Expertise, Quality, Patient Compliance, and Importation of RS.

Equipment INB requires purposed-built brachytherapy suite and specialized equipment, which involves support for maintenance. We managed this by having a pre-purchase clause with the vendor in which there would be a service-engineer available in the department as there are no service centers in region.

Expertise INB requires a learning curve. We dealt with this by asking the vendors for arranging visits and training to well-established Brachy-centres.

Quality Regular multi-disciplinary team meetings (MDTs) and internationally collaborated peer-reviews of each case to ensure high-quality delivery of treatment.

Patient compliance We overcame patient anxiety and misconceptions with educational sessions using videos, presentations, printed material, and access to the patient website portal.

Importation of RS: Regulatory services are not well established in developing countries, necessitating extra documentation and new policies and rules. Some associated government agencies are not aware of the concept of radioactivity. Logistical issues and custom clearances were a challenge and were the biggest hurdle we encountered.

Conclusion This abstract provides a glimpse of the challenges we faced establishing INB program; working with regulatory services, training our staff, having regular MDT and peer-reviews have helped us pass these hurdles.

Disclosures No Disclosure