The Stagnation and Decay of Radiation Oncology Resources: Lessons From Nigeria

Irabor, Omoruyi Credit; Nwankwo, Kenneth Chima; Adewuyi, Sunday Adeyemi

doi:10.1016/j.ijrobp.2016.04.026

Cited by 28 publications

(38 citation statements)

References 14 publications

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“…In 2012, Nigeria alone accounted for 8.3% of cancer cases ( Irabor et al, 2016 ). Yet, a 2015 radiotherapy needs assessment found that only two out of the country's 9 radiation centers were operating at full capacity ( Irabor et al, 2016 ). A level of equipment less than that of one established US center is therefore providing radiotherapy for the entire country.…”

Section: Cervical Cancer Treatment In Lmicmentioning

confidence: 99%

“…Nigeria has roughly 1 radiation unit per 19.4 million people, in comparison to the recommended ratio of 1 to 120,000–250,000 people. Moreover, two of the linear accelerator radiotherapy units that Nigeria acquired in 2010 were out of service within one year ( Irabor et al, 2016 ). This result highlights the concern that even when machines are available, access to appropriate radiotherapy technology in LMIC may vary from day to day or month to month, in part due to the difficulty of maintaining proper equipment servicing.…”

Section: Cervical Cancer Treatment In Lmicmentioning

confidence: 99%

See 1 more Smart Citation

Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery

LaVigne

Triedman

Randall

et al. 2017

Gynecologic Oncology Reports

123

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The global cervical cancer burden falls disproportionately upon women in low and middle-income countries. Insufficient infrastructure, lack of access to preventive HPV vaccines, screening, and treatment, as well as limited trained personnel and training opportunities, continue to impede efforts to reduce incidence and mortality in these nations. These hurdles have been substantial challenges to radiation delivery in particular, preventing treatment for a disease in which radiation is a cornerstone of curative therapy. In this review, we discuss the breadth of these barriers, while illustrating the need for adaptive approaches by proposing the use of brachytherapy alone in the absence of available external beam radiotherapy. Such modifications to current guidelines are essential to maximize radiation treatment for cervical cancer in limited resource settings.

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Section: Cervical Cancer Treatment In Lmicmentioning

confidence: 99%

Section: Cervical Cancer Treatment In Lmicmentioning

confidence: 99%

Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery

LaVigne

Triedman

Randall

et al. 2017

Gynecologic Oncology Reports

123

View full text Add to dashboard Cite

show abstract

“…This scenario is common across Africa, as there is a global shortfall of radiotherapy services, with more than 90% of the population in lowincome countries lacking access to radiation services [23]. Nigeria is experiencing a decline in the provision of quality radiotherapy services to the increasing population of cancer patients who require it [12]. However, since Nigeria concluded a successful Democratic Government transition, the Federal Ministry of Health has proposed initiatives to improve existing radiotherapy services and provide seven new radiotherapy machines to different parts of the country [24].…”

Section: Discussionmentioning

confidence: 99%

“…Breast [12]. To date, thousands of breast cancer patients have been irradiated in all these centres with different techniques.…”

Section: Introductionmentioning

confidence: 99%

Techniques and Practice of Post Mastectomy Radiotherapy in Nigeria: A Multi-Centre Study

Omolola¹

2018

IJCOCR

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Breast cancer affect millions of women worldwide with an increasing incidence in developing countries. In Nigeria, late presentation is the norm, with most patients presenting at stages III and IV. Patients may be at risk of local recurrence after mastectomy due to areas of microscopic residual disease such as the chest wall and regional nodal basins. Post-mastectomy radiotherapy (PMRT) has been found to reduce this risk. The aim of the study was to evaluate the techniques and practice of post mastectomy radiotherapy among breast cancer patients treated in Nigeria. This descriptive retrospective study was carried out for all histologically confirmed breast cancer cases that had post mastectomy radiotherapy between 2004 and 2015, in all (8) centres in Nigeria. Information from patient's records were extracted using data proforma. Data of 2,143 patients were analysed. All patients received radiation to the chest wall. Thirty nine point one percent had two regional nodes irradiated, while 38% had only axilla treated, and 6.3% had three regional lymph nodes irradiated. All patients had treatment planning, majority (93.7%) with conventional technique. The primary beam used was photon with electron boost to the scar (62.8%). Fractionation method was mostly 50Gy in 25 fractions over 5 weeks (61.8%). Three fields were used in treating more than half of the patients (63.0%) while 30.9% were treated with 4 fields' techniques. The study revealed a short fall in access to radiotherapy within the study period. Two dimensional treatment planning method was the dominant with considerable variations across centres in terms of practice and techniques.

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“…Across Nigeria, there is currently a shortage of cancer specialists, such as surgeons, radiation oncologists, and medical oncologists—the physicians who recommend, prescribe, and administer chemotherapy—with less than five medical oncologists and approximately 100 radiation oncologists (consultants and residents in training) in the country. 8 The majority of radiation oncologists are practicing in radiotherapy centers and are trained in the administration of chemotherapy. 8 These radiation oncologists spend a significant portion of their training and practice prescribing and administering chemotherapy and managing adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Oncology Guidelines Usage in a Low- and Middle-Income Country

Ismaila

Salako

Jimoh

et al. 2018

JGO

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PurposeThere is a paucity of data about current usage of oncology guidelines in low- and middle-income countries (LMICs), specifically in terms of the availability and quality of those guidelines. Our objective was to determine usage of oncology guidelines and the barriers and facilitators to their usage among radiation oncologists in LMICs.MethodsAn online cross-sectional survey was conducted among practicing radiation oncologists in Nigeria via e-mail and the social media database of the Association of Radiation and Clinical Oncologists of Nigeria. In addition, paper questionnaires were administered at regional clinical meetings.ResultsThe survey response rate was 53.4% in a sample of 101 radiation oncologists from the database. Sixty-nine percent of respondents were consultants and 30% were residents. Approximately 43% had < 5 years’ experience. All of the respondents were involved in administering chemotherapy during the treatment of patients with cancer, whereas approximately half were involved in diagnosing cancer. Ninety-three percent reported using guidelines in treating patients, the top two guidelines being those from the National Comprehensive Cancer Network (90%) and the American Society of Clinical Oncology (50%). The two major barriers to guideline usage were that facilities were inadequate for proper guideline implementation and that the information in guidelines were too complex to understand. Potential facilitators included providing adequate facilities, developing local guidelines, and increasing awareness of guideline usage.ConclusionOur study shows that clinicians involved in the treatment of patients with cancer in LMICs are aware of cancer treatment guidelines. However, implementation of these guidelines hinders their usage because the facilities are inadequate, guidelines are not applicable to the local setting, and the information in the guidelines is too complex.

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The Stagnation and Decay of Radiation Oncology Resources: Lessons From Nigeria

Cited by 28 publications

References 14 publications

Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery

Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery

Techniques and Practice of Post Mastectomy Radiotherapy in Nigeria: A Multi-Centre Study

Oncology Guidelines Usage in a Low- and Middle-Income Country

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