Expanding Access to Radiation Therapy: An Update on Brazil's Current Challenges and Opportunities

Moraes, Fábio Ynoe de; Mendez, Lucas C.; Rosa, Arthur Accioly; Marta, Gustavo Nader

doi:10.1016/j.ijrobp.2018.05.003

Cited by 11 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reasons to explain the Brazilian findings comparing the periods are: first, the Brazilian RT accumulated patient demand due to the LINAC shortage [5] , [6] , [7] . Hence, even with the reduction in diagnosis and surgeries, the number RT treatments were maintained in 2020 for several tumor types.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Radiotherapy activity in the COVID 19 pandemic: Brazil's operational national-level study

Moraes

Gouveia

Lima

et al. 2023

Journal of Cancer Policy

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…In addition, Radiotherapy services were oriented to adopt treatment guidelines using short (hypofractionated) radiotherapy courses. However, with a recognized shortage of radiotherapy machines (LINAC) in Brazil, there are concerns about access to treatment [5] , [6] , [7] .…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy activity in the COVID 19 pandemic: Brazil's operational national-level study

Moraes

Gouveia

Lima

et al. 2023

Journal of Cancer Policy

View full text Add to dashboard Cite

“…Along this line, reports have shown that Brazil is in the midst of a serious radiation therapy access crisis. 34 …”

Section: Discussionmentioning

confidence: 99%

Chemoradiotherapy With or Without Surgery for Esophageal Squamous Cancer According to Hospital Volume

Duarte

Pereira

Lopes

et al. 2020

JCO Global Oncology

View full text Add to dashboard Cite

PURPOSE Esophageal squamous cell cancer (ESCC) is still associated with a dismal prognosis. However, surgical series have shown that high-volume hospitals have better outcomes and that the impact of center volume on definitive chemoradiotherapy (dCRT) or CRT plus surgery (CRT + S) remains unknown. METHODS We performed a retrospective analysis of patients with locally advanced stage II-III (non-T4) ESCC treated with dCRT or CRT + S in São Paulo state, Brazil. Descriptive variables were assessed with the χ2 test after categorization of hospital volume (high-volume [HV] center, top 5 higher volume, or low-volume [LV] center). Overall survival (OS) was assessed with Kaplan-Meier curves, log-rank tests, and Cox proportional hazards. Finally, an interaction test between each facility’s treatments was performed. RESULTS Between 2000 and 2013, 1,347 patients were analyzed (77% treated with dCRT and 65.7% in HV centers) with a median follow-up of 23.7 months. The median OS for dCRT was 14.1 months (95% CI, 13.3 to 15.3 months) and for CRT + S, 20.6 months (95% CI, 16.1 to 24.9 months). In the multivariable analysis, dCRT was associated with worse OS (hazard ratio [HR], 1.38; 95% CI, 1.19 to 1.61; P < .001) compared with CRT + S. HV hospitals were associated with better OS (HR, 0.82; 95% CI, 0.71 to 0.94; P = .004) compared with LV hospitals. Importantly, CRT + S superiority was restricted to HV hospitals (dCRT v CRT + S: HR, 1.56; 95% CI, 1.29 to 1.89; P < .001), while in LV hospitals, there was no statistically significant difference (HR, 1.23; 95% CI, 0.88 to 1.43; P = .350), with a significant interaction test ( Pinteraction = .035). CONCLUSION Our data show that CRT + S is superior to dCRT in the treatment of ESCC exclusively in HV hospitals, which favors the literature trend to centralize the treatment of ESCC in HV centers.

show abstract

“…For more than two decades, Brazil has passed through a severe undersupply of linear accelerator (LINAC) machines [14][15][16]. LINAC shortage can negatively impact oncological outcomes, imbalances between treatment options and, ultimately, considerable damages to patients and the health system [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on the curative treatment of prostate cancer: a national cross-sectional study

Gouveia

Moraes

Lima

et al. 2022

Rep Pract Oncol Radiother.

View full text Add to dashboard Cite

Background: COVID-19 pandemic affected access to cancer treatment worldwide. However, there is a lack of data about the impact in developing countries.The objective was to evaluate COVID-19 impact on curative prostate cancer (Pca) treatment in Brazil. Materials and methods:With data extracted from the Brazilian Ministry of Health database, the Non-COVID and COVID periods were analyzed to compare the absolute number of radical prostatectomy (RP) and radiotherapy (RT) executed in the country and regions.Results: With data from 50,169 Pca patients (Non-COVID = 28,106 cases and COVID = 22,063) treated with RP or RT in Brazil, a significant decline in patients receiving RT or RP (-6.043 cases; p = 0.0001) was detected. Both treatment procedures (RT or PR) were reduced in all five Brazilian regions comparing the Non-COVID and COVID periods. Overall, there was a reduction on RP and RT procedures in 92% (24/25) and 76% (19/25) of the evaluated states, respectively. Comparing the variation of RT and RP per state between COVID and Non-COVID period, there is a significant difference (-18.6% vs. -29%, p = 0.03) with a higher negative impact on the RP group. The RT and RP variation had no significant relationship with the incidence of COVID cases in the states. Limitations include the non-evaluation of treatment combinations, the impact of hypofractionated radiotherapy, and other factors influencing the treatment choice. Conclusions:During the COVID-19 pandemic, the curative treatment with RP and RT of Pca was abruptly limited and affected. However, the number of RP was more impacted than RT during the COVID period.

show abstract

Expanding Access to Radiation Therapy: An Update on Brazil's Current Challenges and Opportunities

Cited by 11 publications

References 6 publications

Radiotherapy activity in the COVID 19 pandemic: Brazil's operational national-level study

Radiotherapy activity in the COVID 19 pandemic: Brazil's operational national-level study

Chemoradiotherapy With or Without Surgery for Esophageal Squamous Cancer According to Hospital Volume

Impact of COVID-19 on the curative treatment of prostate cancer: a national cross-sectional study

Contact Info

Product

Resources

About