Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Abstract

Radiotherapy is an essential component of cancer therapy. Lack of access to radiotherapy in lessdeveloped countries prevents its use for both cure and symptom relief, resulting in a significant disparity in patient suffering. Several recent initiatives have highlighted the need for expanded access to both palliative medicine and radiotherapy globally. Yet, these efforts have remained largely independent, without attention to overlap and integration. This review provides an update on the progress toward global palliative radiotherapy access and proposes a strategic framework to address further scale-up. Synergies between radiotherapy, palliative medicine, and other global health initiatives will be essential in bringing palliative radiotherapy to patients around the globe.

Non-Radiation Based Early Pain Relief Treatment Options for Patients With Non-Small Cell Lung Cancer and Cancer Induced Bone Pain: A Systematic Review

“…Besides that there are disparities in the access to radiotherapy facilities in high and low-income countries. For example, in Central Africa 0.05 machines are available per million people versus 11.4 machines in North-America (39). Furthermore, even if there is access, older, multi-fractionated radiotherapy schedules for treatment of painful bone metastases are often used, instead of the recommended single-fraction radiotherapy, as was shown in a survey on radiation facilities in African countries (40).…”

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

“…Trials comparing palliative fractionation schedules would help to define the optimum strategy for palliation [74]. A summary of ongoing initiatives to overcome barriers for the integration of radiotherapy into palliative care has recently been published [75]. A formal initiative is needed to appropriately define the role of palliative radiotherapy for locally advanced and metastatic cervical cancer.…”

Hypofractionated radiotherapy in the real-world setting: An international ESTRO-GIRO survey

“…14 This is especially relevant in low-and middle-income countries (LMICs), where availability of machines is limited and the presentation of patients with disease is often delayed. 9,15 Adopting hypofractionation has also been found to be the most efficient treatment option by reducing treatment time and reducing costs associated with daily treatment. 16 Shorter treatment courses also liberates machine time, thereby improving access to radiotherapy for a greater number of patients.…”