Establishing and Delivering Quality Radiation Therapy in Resource-Constrained Settings: The Story of Botswana Radiation Oncology

There is a global cancer crisis, and it is disproportionately affecting resource-constrained settings, especially in low- and middle-income countries (LMICs). Radiotherapy is a critical and cost-effective component of a comprehensive cancer control plan that offers the potential for cure, control, and palliation of disease in greater than 50% of patients with cancer. Globally, LMICs do not have adequate access to quality radiation therapy and this gap is particularly pronounced in sub-Saharan Africa. Although there are numerous challenges in implementing a radiation therapy program in a low-resource setting, providing more equitable global access to radiotherapy is a responsibility and investment worth prioritizing. We outline a systems approach and a series of key questions to direct strategy toward establishing quality radiation services in LMICs, and highlight the story of private-public investment in Botswana from the late 1990s to the present. After assessing the need and defining the value of radiation, we explore core investments required, barriers that need to be overcome, and assets that can be leveraged to establish a radiation program. Considerations addressed include infrastructure; machine choice; quality assurance and patient safety; acquisition, development, and retention of human capital; governmental engagement; public–private partnerships; international collaborations; and the need to critically evaluate the program to foster further growth and sustain...
Source: Journal of Clinical Oncology - Category: Cancer & Oncology Authors: Tags: Radiation Oncology Source Type: research

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ConclusionThe success rate and functional outcome after BMGU for radiation-induced strictures were reasonable. However, compared to existing long-term data on non-irradiated patients, the outcome is impaired and patients should be counseled accordingly.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
ConclusionFurther clinical trials are necessary to improve the identification of suitable patient cohorts and the extent of possible volume de-escalation that does not compromise tumor control.
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
MONDAY, Feb. 17, 2020 -- Radiation therapy that targets cancers in the chest area can tax the heart and trigger high levels of fatigue, breathing problems and a reduced ability to exercise, a new study suggests. However, doing more physical...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news
ConclusionsIn SLNB positive MCC, CLND alone is associated with worse survival compared with treatment with adjuvant radiation or both CLND and adjuvant radiation.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
AbstractObjectiveIntensity-modulated radiation therapy (IMRT) using a volumetric-modulated arc therapy technique may offer dosimetric and clinical benefits compared to the historical standard of care 3D conformal radiotherapy (3D-CRT) in definitive treatment of bladder cancer. We hypothesized that IMRT with CBCT would reduce dose to the rectum, bowel, and bladder compared to 3D-CRT.MethodsWe reviewed nineteen patients treated with maximal transurethral resection of bladder tumor followed by concurrent chemotherapy with IMRT. All patients received 45  Gy to the entire empty bladder followed by 19.8 Gy tumor boost ...
Source: Journal of Radiation Oncology - Category: Cancer & Oncology Source Type: research
Patients who are physically active before they undergo thoracic radiation therapy...Read more on AuntMinnie.comRelated Reading: ASTRO, ACR update RT practice parameters RT improves elderly brain cancer patient survival IMV: Imaging boosts precision in radiation therapy ASTRO: Whole, partial breast RT yield similar cosmetic results Varian to highlight RT management system at AAPM meeting
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
Conditions:   Malignant Female Reproductive System Neoplasm;   Stage I Cervical Cancer AJCC v8;   Stage I Uterine Corpus Cancer AJCC v8;   Stage I Vaginal Cancer AJCC v8;   Stage I Vulvar Cancer AJCC v8;   Stage IA Cervical Cancer AJCC v8;   Stage IA Uterine Corpus Canc er AJCC v8;   Stage IA Vaginal Cancer AJCC v8;   Stage IA Vulvar Cancer AJCC v8; &nb...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionPatients with metastatic disease who experience a relatively long survival may be prone to undergo disproportionate recurrent CT imaging. The non-negligible CT radiation-induced cancer risk and mortality should be taken into account in these patients, while the effect of cumulatively administered CT contrast agents on kidney function requires further investigation.
Source: European Journal of Radiology - Category: Radiology Source Type: research
(American College of Cardiology) Radiation doses to the heart that occur during radiation therapy treatments for lung cancer, breast cancer and lymphoma can increase fatigue, cause difficulty breathing and lower capacity for physical activity in patients with cancer, according to research presented at the American College of Cardiology's Advancing the Cardiovascular Care of the Oncology Patient course. The course examines new science and best practices in assessing, diagnosing and treating the unique cardiovascular concerns of patients with cancer and/or those requiring survivorship care.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
ConclusionOur study did not show any impact of treatment delay on survival end-points although prolonged TTR could moderate the benefit of radiotherapy on local control rate. Surgical route was not associated with TTR, particularly robot-associated laparoscopy did not lengthen treatment delay. TTR seems dependent of health-care organization and could represent a quality criterion of EC care for institutions.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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