A Systematic Review of Radiotherapy Capacity in Low- and Middle-Income Countries
Identifieur interne : 000413 ( Pmc/Curation ); précédent : 000412; suivant : 000414A Systematic Review of Radiotherapy Capacity in Low- and Middle-Income Countries
Auteurs : Surbhi Grover [États-Unis] ; Melody J. Xu [États-Unis] ; Alyssa Yeager [États-Unis] ; Lori Rosman [États-Unis] ; Reinou S. Groen [États-Unis] ; Smita Chackungal [Canada] ; Danielle Rodin [Canada] ; Margaret Mangaali [États-Unis] ; Sommer Nurkic [États-Unis] ; Annemarie Fernandes [États-Unis] ; Lilie L. Lin [États-Unis] ; Gillian Thomas [Canada] ; Ana I. Tergas [États-Unis]Source :
- Frontiers in Oncology [ 2234-943X ] ; 2015.
Abstract
Url:
DOI: 10.3389/fonc.2014.00380
PubMed: 25657930
PubMed Central: 4302829
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,<addr-line>Philadelphia, PA</addr-line>
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<author><name sortKey="Xu, Melody J" sort="Xu, Melody J" uniqKey="Xu M" first="Melody J." last="Xu">Melody J. Xu</name>
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<author><name sortKey="Chackungal, Smita" sort="Chackungal, Smita" uniqKey="Chackungal S" first="Smita" last="Chackungal">Smita Chackungal</name>
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<author><name sortKey="Rodin, Danielle" sort="Rodin, Danielle" uniqKey="Rodin D" first="Danielle" last="Rodin">Danielle Rodin</name>
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<author><name sortKey="Mangaali, Margaret" sort="Mangaali, Margaret" uniqKey="Mangaali M" first="Margaret" last="Mangaali">Margaret Mangaali</name>
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<author><name sortKey="Nurkic, Sommer" sort="Nurkic, Sommer" uniqKey="Nurkic S" first="Sommer" last="Nurkic">Sommer Nurkic</name>
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<author><name sortKey="Fernandes, Annemarie" sort="Fernandes, Annemarie" uniqKey="Fernandes A" first="Annemarie" last="Fernandes">Annemarie Fernandes</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Lin, Lilie L" sort="Lin, Lilie L" uniqKey="Lin L" first="Lilie L." last="Lin">Lilie L. Lin</name>
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,<country>USA</country>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Thomas, Gillian" sort="Thomas, Gillian" uniqKey="Thomas G" first="Gillian" last="Thomas">Gillian Thomas</name>
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,<addr-line>Toronto, ON</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tergas, Ana I" sort="Tergas, Ana I" uniqKey="Tergas A" first="Ana I." last="Tergas">Ana I. Tergas</name>
<affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York, NY</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Systematic Review of Radiotherapy Capacity in Low- and Middle-Income Countries</title>
<author><name sortKey="Grover, Surbhi" sort="Grover, Surbhi" uniqKey="Grover S" first="Surbhi" last="Grover">Surbhi Grover</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Xu, Melody J" sort="Xu, Melody J" uniqKey="Xu M" first="Melody J." last="Xu">Melody J. Xu</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Yeager, Alyssa" sort="Yeager, Alyssa" uniqKey="Yeager A" first="Alyssa" last="Yeager">Alyssa Yeager</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rosman, Lori" sort="Rosman, Lori" uniqKey="Rosman L" first="Lori" last="Rosman">Lori Rosman</name>
<affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Johns Hopkins School of Public Health</institution>
,<addr-line>Baltimore, MD</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Groen, Reinou S" sort="Groen, Reinou S" uniqKey="Groen R" first="Reinou S." last="Groen">Reinou S. Groen</name>
<affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Gynecology and Obstetrics, Johns Hopkins Hospital</institution>
,<addr-line>Baltimore, MD</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Chackungal, Smita" sort="Chackungal, Smita" uniqKey="Chackungal S" first="Smita" last="Chackungal">Smita Chackungal</name>
<affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Surgery, University of Western Ontario</institution>
,<addr-line>London, ON</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rodin, Danielle" sort="Rodin, Danielle" uniqKey="Rodin D" first="Danielle" last="Rodin">Danielle Rodin</name>
<affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Radiation Oncology, University of Toronto</institution>
,<addr-line>Toronto, ON</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mangaali, Margaret" sort="Mangaali, Margaret" uniqKey="Mangaali M" first="Margaret" last="Mangaali">Margaret Mangaali</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nurkic, Sommer" sort="Nurkic, Sommer" uniqKey="Nurkic S" first="Sommer" last="Nurkic">Sommer Nurkic</name>
<affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Johns Hopkins School of Public Health</institution>
,<addr-line>Baltimore, MD</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fernandes, Annemarie" sort="Fernandes, Annemarie" uniqKey="Fernandes A" first="Annemarie" last="Fernandes">Annemarie Fernandes</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lin, Lilie L" sort="Lin, Lilie L" uniqKey="Lin L" first="Lilie L." last="Lin">Lilie L. Lin</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thomas, Gillian" sort="Thomas, Gillian" uniqKey="Thomas G" first="Gillian" last="Thomas">Gillian Thomas</name>
<affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Radiation Oncology, University of Toronto</institution>
,<addr-line>Toronto, ON</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tergas, Ana I" sort="Tergas, Ana I" uniqKey="Tergas A" first="Ana I." last="Tergas">Ana I. Tergas</name>
<affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York, NY</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Frontiers in Oncology</title>
<idno type="eISSN">2234-943X</idno>
<imprint><date when="2015">2015</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><p><bold>Objectives:</bold>
The cancer burden in low- and middle-income countries (LMIC) is substantial. The purpose of this study was to identify and describe country and region-specific patterns of radiotherapy (RT) facilities in LMIC.</p>
<p><bold>Methods:</bold>
A systematic review of the literature was undertaken. A search strategy was developed to include articles on radiation capacity in LMIC from the following databases: PubMed, Embase, CINAHL Plus, Global Health, and the Latin American and Caribbean System on Health Sciences Information. Searches included all literature up to April 2013.</p>
<p><bold>Results:</bold>
A total of 49 articles were included in the review. Studies reviewed were divided into one of four regions: Africa, Asia, Eastern Europe, and South America. The African continent has the least amount of resources for RT. Furthermore, a wide disparity exists, as 60% of all machines on the continent are concentrated in Egypt and South Africa while 29 countries in Africa are still lacking any RT resource. A significant heterogeneity also exists across Southeast Asia despite a threefold increase in megavoltage teletherapy machines from 1976 to 1999, which corresponds with a rise in economic status. In LMIC of the Americas, only Uruguay met the International Atomic Energy Agency recommendations of 4 MV/million population, whereas Bolivia and Venezuela had the most radiation oncologists (>1 per 1000 new cancer cases). The main concern with the review of RT resources in Eastern Europe was the lack of data.</p>
<p><bold>Conclusion:</bold>
There is a dearth of publications on RT therapy infrastructure in LMIC. However, based on limited published data, availability of RT resources reflects the countries’ economic status. The challenges to delivering radiation in the discussed regions are multidimensional and include lack of physical resources, lack of human personnel, and lack of data. Furthermore, access to existing RT and affordability of care remains a large problem.</p>
</div>
</front>
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<journal-id journal-id-type="iso-abbrev">Front Oncol</journal-id>
<journal-id journal-id-type="publisher-id">Front. Oncol.</journal-id>
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<article-id pub-id-type="doi">10.3389/fonc.2014.00380</article-id>
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<given-names>Gillian</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tergas</surname>
<given-names>Ana I.</given-names>
</name>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/124526"></uri>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup>
<institution>Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania</institution>
,<addr-line>Philadelphia, PA</addr-line>
,<country>USA</country>
</aff>
<aff id="aff2"><sup>2</sup>
<institution>Johns Hopkins School of Public Health</institution>
,<addr-line>Baltimore, MD</addr-line>
,<country>USA</country>
</aff>
<aff id="aff3"><sup>3</sup>
<institution>Department of Gynecology and Obstetrics, Johns Hopkins Hospital</institution>
,<addr-line>Baltimore, MD</addr-line>
,<country>USA</country>
</aff>
<aff id="aff4"><sup>4</sup>
<institution>Department of Surgery, University of Western Ontario</institution>
,<addr-line>London, ON</addr-line>
,<country>Canada</country>
</aff>
<aff id="aff5"><sup>5</sup>
<institution>Department of Radiation Oncology, University of Toronto</institution>
,<addr-line>Toronto, ON</addr-line>
,<country>Canada</country>
</aff>
<aff id="aff6"><sup>6</sup>
<institution>Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York, NY</addr-line>
,<country>USA</country>
</aff>
<author-notes><fn fn-type="edited-by"><p>Edited by: Daniel Grant Petereit, Rapid City Regional Hospital, USA</p>
</fn>
<fn fn-type="edited-by"><p>Reviewed by: Tim Williams, Boca Raton Regional Hospital, USA; David Andrew Pistenmaa, University of Texas Southwestern Medical Center, USA</p>
</fn>
<corresp content-type="corresp" id="cor1">*Correspondence: Surbhi Grover, University of Pennsylvania, Perelman Center for Advanced Medicine, Department of Radiation Oncology, 3400 Civic Boulevard, Philadelphia, PA 19104-6021, USA e-mail: <email>surbhigrover@gmail.com</email>
</corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Radiation Oncology, a section of the journal Frontiers in Oncology.</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>22</day>
<month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2014</year>
</pub-date>
<volume>4</volume>
<elocation-id>380</elocation-id>
<history><date date-type="received"><day>18</day>
<month>11</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>18</day>
<month>12</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015 Grover, Xu, Yeager, Rosman, Groen, Chackungal, Rodin, Mangaali, Nurkic, Fernandes, Lin, Thomas and Tergas.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract><p><bold>Objectives:</bold>
The cancer burden in low- and middle-income countries (LMIC) is substantial. The purpose of this study was to identify and describe country and region-specific patterns of radiotherapy (RT) facilities in LMIC.</p>
<p><bold>Methods:</bold>
A systematic review of the literature was undertaken. A search strategy was developed to include articles on radiation capacity in LMIC from the following databases: PubMed, Embase, CINAHL Plus, Global Health, and the Latin American and Caribbean System on Health Sciences Information. Searches included all literature up to April 2013.</p>
<p><bold>Results:</bold>
A total of 49 articles were included in the review. Studies reviewed were divided into one of four regions: Africa, Asia, Eastern Europe, and South America. The African continent has the least amount of resources for RT. Furthermore, a wide disparity exists, as 60% of all machines on the continent are concentrated in Egypt and South Africa while 29 countries in Africa are still lacking any RT resource. A significant heterogeneity also exists across Southeast Asia despite a threefold increase in megavoltage teletherapy machines from 1976 to 1999, which corresponds with a rise in economic status. In LMIC of the Americas, only Uruguay met the International Atomic Energy Agency recommendations of 4 MV/million population, whereas Bolivia and Venezuela had the most radiation oncologists (>1 per 1000 new cancer cases). The main concern with the review of RT resources in Eastern Europe was the lack of data.</p>
<p><bold>Conclusion:</bold>
There is a dearth of publications on RT therapy infrastructure in LMIC. However, based on limited published data, availability of RT resources reflects the countries’ economic status. The challenges to delivering radiation in the discussed regions are multidimensional and include lack of physical resources, lack of human personnel, and lack of data. Furthermore, access to existing RT and affordability of care remains a large problem.</p>
</abstract>
<kwd-group><kwd>radiation capacity</kwd>
<kwd>global health</kwd>
<kwd>low- and middle-income countries</kwd>
<kwd>radiation oncology access</kwd>
<kwd>systematic review</kwd>
<kwd>systematic review</kwd>
</kwd-group>
<counts><fig-count count="1"></fig-count>
<table-count count="2"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="64"></ref-count>
<page-count count="11"></page-count>
<word-count count="8648"></word-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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