Radiotherapy utilization in developing countries: An IAEA study

Rosenblatt, Eduardo; Fidarova, Elena; Zubizarreta, Eduardo; Bartoň, Michael; Jones, Glenn; Mackillop, William J.; Cordero, Lisbeth; Yarney, Joel; Lim, Gerard; Gan, John V.; Cernea, Valentin; Stojanović-Rundić, Suzana; Strojan, Primož; Kochbati, L.; Quarneti, Aldo

doi:10.1016/j.radonc.2018.05.014

Cited by 36 publications

(21 citation statements)

References 24 publications

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“…Requirements for radiotherapy are considered much higher in low-income countries due to late stage presentation and thus, more commonly used palliative therapy concepts including radiotherapy [39]. A recent IAEA study showed a median unmet need for radiation in developing countries of 47% [40]. Having only one single Cobalt-60 machine in use for the whole of Ethiopia, waiting time will continue to increase due to the increasing patient load and prolonged radiation-times resulting from the decreasing efficacy of the machine.…”

Section: Discussionmentioning

confidence: 99%

Addis Ababa population-based pattern of cancer therapy, Ethiopia

et al. 2019

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Cancer in Sub-Saharan Africa is becoming an important challenge for health services due to rising numbers of patients. In Addis Ababa with around 3.5 million inhabitants, more than 2000 cases are diagnosed annually. In this retrospective population-based cohort study we assessed completeness of and waiting time for cancer-therapy among patients registered in the Addis Ababa City Cancer Registry (AACCR), Ethiopia. Patient hospital files were retrieved to complete the data from AACCR. A total of 588 files were found (51% of those diagnosed from January to March 2012 and 2014). We analyzed completeness and waiting time of chemotherapy and radiotherapy; with completeness defined as ≥85% therapy received according to local guidelines. Analysis was done for the five most common cancer-types commonly treated with chemotherapy (breast, colorectal, non-Hodgkin`s lymphoma, lung and ovarian) and the four most common cancer-types commonly treated with radiotherapy (breast, cervical, head and neck and rectal). In our study, half of the patients (54.1%) received adequately dosed chemotherapy and 24.5% of patients received adequately dosed radiotherapy. The median waiting time was 2.1 months (Range: 0 to 20.72) for chemotherapy and 7 months (Range: 0.17 to 21.8) for radiotherapy. This study underscores the need for health system measures to improve cancer-directed therapy in Ethiopia, especially concerning radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Addis Ababa population-based pattern of cancer therapy, Ethiopia

et al. 2019

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“…Retreatment is less common in lowand middle-income countries. Retreatment ranged from 7 to 24% in a study of middle-income countries by the International Atomic Energy Agency [12].…”

Section: Demand For Palliative Radiotherapymentioning

confidence: 99%

Health Economic and Health Service Issues of Palliative Radiotherapy

2020

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“… 8 , 9 , 10 Even today, the available RT infrastructure and complementary human resources is insufficient to meet the growing RT demands, especially in the low- and middle-income economies. 11 , 12 , 13 , 14 , 15 , 16 , 17 The situation is likely to worsen as most countries may find it difficult to designate adequate finances for establishing new RT infrastructure in the post COVID-19 era.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Maximize Available Resources With Minimum Cost Escalation for Improving Radiation Therapy Accessibility in the Post–Coronavirus Disease 2019 Era: An Analysis for Asia

Datta

Samiei

2021

Advances in Radiation Oncology

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Purpose There is widespread accord among economists that the COVID-19 pandemic will have a severe negative impact on the global economy. Establishing new radiotherapy (RT) infrastructure may be significantly compromised in the post COVID-19 era. Alternative strategies are needed to improve the existing RT accessibility without significant cost escalation. The outcomes of these approaches on the RT availability has been examined for Asia. Methods and Materials The details of RT infrastructures in 2020 for 51 countries in Asia were obtained from the Directory of Radiotherapy Centers of the International Atomic Energy Agency (IAEA). Using the IAEA guidelines, the %RT accessibility and the additional requirements of teletherapy (TRT) units were computed for these countries. To maximize the utilization of the existing RT facilities, five options were evaluated, namely, hypofractionation RT (HFRT) alone, with/without 25% or 50% additional working hours. The impact of these strategies on the %RT access and additional TRT unit requirements to achieve 100% RT access were estimated. Results 4617 TRT units are available in 46 countries. The mean %RT accessibility is 62.4% in 43 countries (TRT units =4491) where the information on cancer incidence was also available and these would need an additional 6474 TRT units for achieving 100% RT accessibility. By adopting HFRT alone, increasing the working hours by 25% alone, 25% with HFRT, 50% alone and 50% with HFRT; the %RT access could improve to 74.9%, 78%, 90.5%, 93.7% and 106.1% respectively. Correspondingly, the need for additional TRT units would progressively decrease to 4646, 4284, 3073, 2820 and 1958 units. Conclusion The economic slowdown in the post Covid-19 period could severely impend establishment of new RT facilities. Thus, maximal utilization of the available RT infrastructure with minimum additional costs could be possible by adopting HFRT with or without increased working hours to improve the RT coverage.

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Radiotherapy utilization in developing countries: An IAEA study

Abstract: The optimal RTU rate in middle-income countries did not differ significantly from that previously found in high-income countries. The actual RTU rates were consistently lower than the optimal, in particular in countries with limited resources and a large population.

Cited by 36 publications

References 24 publications

Addis Ababa population-based pattern of cancer therapy, Ethiopia

Addis Ababa population-based pattern of cancer therapy, Ethiopia

Health Economic and Health Service Issues of Palliative Radiotherapy

Strategies to Maximize Available Resources With Minimum Cost Escalation for Improving Radiation Therapy Accessibility in the Post–Coronavirus Disease 2019 Era: An Analysis for Asia

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