Patterns of Practice in Palliative Radiotherapy in Africa – Case Revisited

Jeremić, Branislav; Vanderpuye, Verna; Abdelwahab, Sherif; Gaye, Papa Macoumba; Kochbati, L.; Diwani, M.; Emwula, P.; Oro, B.; Lishimpi, Kennedy; Kigula-Mugambe, Joseph; Dawotola, D.; Wondemagegnehu, Tigeneh; Nyongesa, Catherine; Oumar, N.; Elomrani, A.; Shuman, Thomas; Langenhoven, Lizanne; Fourie, Lizelle

doi:10.1016/j.clon.2014.03.004

Cited by 19 publications

(12 citation statements)

References 29 publications

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“…Interruption of radiotherapy treatments are a frequent occurrence as the daily costs of traveling for therapy can be significant [ 101 ]. Many centers in Africa charge user fees, which for the impoverished lead to a high rate of non-compliance.…”

Section: Radiotherapymentioning

confidence: 99%

An update on the management of breast cancer in Africa

Vanderpuye

Grover

Hammad

et al. 2017

Infect Agents Cancer

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127

124

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BackgroundThere is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities.MethodsA search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms “breast cancer in Africa and developing countries”. One hundred ninety were deemed appropriate.ResultsBreast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities.ConclusionThis review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.

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Section: Radiotherapymentioning

confidence: 99%

An update on the management of breast cancer in Africa

Vanderpuye

Grover

Hammad

et al. 2017

Infect Agents Cancer

Self Cite

127

124

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“…A survey of African radiotherapy departments in 2005 showed that 70% of centres treated brain metastases with 30 Gy in 10 fractions, 28% used 20 Gy in five fractions and the remaining centres used different schedules [39]. The survey was repeated in 2013, with similar results to the previous survey; 73% of institutions used 30 Gy in 10 fractions of WBRT [40]. In another survey administered globally through the American Society for Radiation Oncology (ASTRO), the European Society for Therapeutic Radiology and Oncology (ESTRO), the Canadian Association of Radiation Oncology (CARO) and the Royal Australian and New Zealand College of Radiologist (RANZCR)/Trans-Tasman Oncology Group (TROG) in 2010, the most commonly chosen response for a WBRT dose fractionation scheme was 30 Gy in 10 fractions (41e55%) or 20 Gy in five fractions (14e40%) [41].…”

Section: Brain Metastasesmentioning

confidence: 76%

“…There is a lack of literature reporting the variation in the use of stereotactic radiotherapy for brain metastases. A survey of African departments in 2013 showed that only one institution was equipped to treat with stereotactic radiotherapy [40]. In the global survey in 2010, the availability of radiosurgery facilities varied significantly between participants' country of practice.…”

Section: Brain Metastasesmentioning

confidence: 99%

Health Economic and Health Service Issues of Palliative Radiotherapy

2020

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“…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). This further limits the access to (up-todate) radiotherapy facilities and strengthens the need for other early pain relief options for patients with NSCLC".…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Introduction: Cancer induced bone pain (CIBP) is frequent in patients with non-small cell lung cancer (NSCLC). Radiation therapy continues to be the gold standard for treatment of painful bone metastases, however only a limited number of metastases can be irradiated. We evaluated non-radiation based early CIBP relief options in NSCLC through a systematic review. Methods: Systematic review including all prospective articles published between 01-1994 and 06-2020 on Pubmed, Cochrane Library and ClinicalTrials.gov database. Inclusion: nonradiation based trials evaluating CIBP early pain relief options (initially defined as pain score evaluated within two weeks, because of no randomized trials, later inclusion broadened to pain score evaluated within six weeks) in ≥10 NSCLC patients. Radioisotope trials were excluded as these treatments have interactions with systemic anticancer therapy. Results: 188 articles were found; 10 articles (6 randomized controlled (4 double blinded), 1 phase II single-arm, and 3 prospective trials) fulfilled the inclusion criteria. Six of these trials consisted of ≥2 treatment arms, whereas the others were single-arm studies. In total, 554 NSCLC patients were evaluated in these trials. The included trials were very heterogeneous regarding evaluated treatment options, methods of pain measuring, and endpoints. No high-level evidence for specific early pain relief treatment options was found. Discussion: Non-radiation based studies evaluating treatment options to rapidly reduce CIBP in NSCLC are scarce. This systematic review shows that there is no high-level evidence to recommend a specific treatment for early pain relief. Future research should focus on early pain relief treatment options for CIBP in NSCLC.

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Patterns of Practice in Palliative Radiotherapy in Africa – Case Revisited

Cited by 19 publications

References 29 publications

An update on the management of breast cancer in Africa

An update on the management of breast cancer in Africa

Health Economic and Health Service Issues of Palliative Radiotherapy

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

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