B Jeremic1, V Vanderpuye2, S Abdel-Wahab3, P Gaye4, L Kochbati5, M Diwani6, P Emwula7, B Oro8, K Lishimpi9, J Kigula-Mugambe10, D Dawotola11, T Wondemagegnehu12, C Nyongesa13, N Oumar14, A El-Omrani15, T Shuman16, L Langenhoven17, L Fourie17. 1. Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa. Electronic address: bjeremic@sun.ac.za. 2. National Center for Radiotherapy, Accra, Ghana. 3. Ain Shams University, Cairo, Egypt. 4. Institut de Curie, Dakar, Senegal. 5. Salah Aziz Institute of Cancer, Tunis, Tunisia. 6. Ocean Road Cancer Institute, Dar es Sala'am, Tanzania. 7. Windhoek Central Hospital, Windhoek, Namibia. 8. Radiotherapy Centre, Parirenyatwa Group of Hospitals, Harare, Zimbabwe. 9. Cancer Diseases Hospital, Lusaka, Zambia. 10. Mulago Hospital, Makerere University, Kampala, Uganda. 11. A B University Teaching Hospital, Zaria, Nigeria. 12. Addis Ababa University, Addis Ababa, Ethiopia. 13. Kenyatta National Hospital, Nairobi, Kenya. 14. Centre National d'Oncologie, Mauritania. 15. Mohammed VI University Hospital, Marrakech, Morocco. 16. National Cancer Institute, Cairo, Egypt. 17. Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Abstract
AIMS: To investigate patterns of practice in palliative radiotherapy in Africa. MATERIALS AND METHODS: Fifteen centres in Africa provided detailed information about radiotherapy in both metastatic and locally advanced disease via a questionnaire. Information included general information (institution status, equipment, staff, patient number), radiotherapy and other treatment characteristics in bone metastasis, brain metastasis, metastatic spinal cord compression, lung and liver metastasis, as well as locally advanced tumours. RESULTS: The number of patients annually seen/treated ranged from 285 to 5000. Breast, cervix, head and neck, gastrointestinal and prostate cancer were the top five cancers overall. Eight (53%) institutions were without linear accelerators, four (27%) had a single one, whereas one institution each had two, three and four linear accelerators. The number of cobalt machines ranged from 0 to 2 (median 1). Most centres still prefer to use fractionated radiotherapy regimens over single-fraction regimens in bone metastasis, although most centres are now using single-fraction radiotherapy in retreatments. Radiotherapy in brain metastasis and metastatic spinal cord compression mostly conform to worldwide standards. Lung and liver metastases are rarely irradiated, largely as a consequence of the lack of modern radiotherapy technology. Locally advanced disease in various tumour sites was mostly palliated, in agreement with current evidence-based practices. CONCLUSIONS: African countries still lack adequate staffing and equipment to adequately address their clinical burden, being palliative in most cases. Emphasis should also be made on more rationally using existing capacities by using more of the single-fraction radiotherapy regimens, especially in bone metastasis.
AIMS: To investigate patterns of practice in palliative radiotherapy in Africa. MATERIALS AND METHODS: Fifteen centres in Africa provided detailed information about radiotherapy in both metastatic and locally advanced disease via a questionnaire. Information included general information (institution status, equipment, staff, patient number), radiotherapy and other treatment characteristics in bone metastasis, brain metastasis, metastatic spinal cord compression, lung and liver metastasis, as well as locally advanced tumours. RESULTS: The number of patients annually seen/treated ranged from 285 to 5000. Breast, cervix, head and neck, gastrointestinal and prostate cancer were the top five cancers overall. Eight (53%) institutions were without linear accelerators, four (27%) had a single one, whereas one institution each had two, three and four linear accelerators. The number of cobalt machines ranged from 0 to 2 (median 1). Most centres still prefer to use fractionated radiotherapy regimens over single-fraction regimens in bone metastasis, although most centres are now using single-fraction radiotherapy in retreatments. Radiotherapy in brain metastasis and metastatic spinal cord compression mostly conform to worldwide standards. Lung and liver metastases are rarely irradiated, largely as a consequence of the lack of modern radiotherapy technology. Locally advanced disease in various tumour sites was mostly palliated, in agreement with current evidence-based practices. CONCLUSIONS: African countries still lack adequate staffing and equipment to adequately address their clinical burden, being palliative in most cases. Emphasis should also be made on more rationally using existing capacities by using more of the single-fraction radiotherapy regimens, especially in bone metastasis.
Authors: Shekinah N C Elmore; Surbhi Grover; Jean-Marc Bourque; Supriya Chopra; Anna Mary Nyakabau; Christian Ntizimira; Eric L Krakauer; Tracy A Balboni; Mary K Gospodarowicz; Danielle Rodin Journal: Ann Palliat Med Date: 2019-02-23
Authors: Anita J W M Brouns; Ben H De Bie; Marieke H J van den Beuken-van Everdingen; Anne-Marie C Dingemans; Lizza E L Hendriks Journal: Front Oncol Date: 2020-10-22 Impact factor: 6.244