External Beam Radiotherapy in Western Africa: 1969–2019 |
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| Institution: | 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA;2. Applied Radiation Biology and Radiotherapy Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria;3. State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, India;1. Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia;2. South Western Sydney Clinical School, University of New South Wales, New South Wales, Australia;3. School of Medicine, Western Sydney University, New South Wales, Australia;4. Department of Radiation Oncology, Sunshine Coast University Hospital, Queensland, Australia;5. Faculty of Science, Health, Education and Engineering, University of Sunshine Coast, Queensland, Australia;7. Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia;11. Department of Anatomical Pathology, Liverpool Hospital, Liverpool, New South Wales, Australia;12. Central Clinical School, University of Sydney, New South Wales, Australia;1. Mount Vernon Cancer Centre, Northwood, UK;2. University of Manchester, Manchester, UK;3. Addenbrooke''s Hospital, Cambridge, UK;1. Cancer Centre Belfast City Hospital, Belfast, UK;2. Patrick G Johnston Centre for Cancer Research, Queen''s University Belfast, Belfast, UK;1. Centre for Trials Research, Cardiff University, Cardiff, UK;2. Addenbrookes Hospital, Cambridge, UK;1. Alfred Health Radiation Oncology, Melbourne, Victoria, Australia;2. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia;3. Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia;4. School of Clinical Medicine, University of Cambridge, Cambridge, UK;5. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;7. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia;11. Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia;12. Precision Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Victoria, Australia;8. Central Clinical School, Monash University, Melbourne, Victoria, Australia;1. Institute of Cancer Research, London, UK;2. Royal Marsden Hospital NHS Foundation Trust, London, UK |
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| Abstract: | AimsWe describe the absolute and per capita numbers of megavoltage radiotherapy machines (MVMs) in Western Africa from 1969 to 2019.Materials and methodsWestern Africa was defined in accordance with the United Nations' delineation and inclusive of 16 countries. A literature search for publications detailing the number of cobalt-60 machines (COs) and linear accelerators (LINACs) in radiotherapy centres was carried out. Population data from the World Bank Group and crude cancer rates from the International Agency for Research on Cancer were used to calculate ratios of million persons per MVM and MVMs per 1000 cancer cases.ResultsThe numbers of MVMs in Western Africa in 1969, 1979, 1989, 1999 and 2009 were zero, two, three, six and nine, respectively. In 2019 there were 22 MVMs distributed across Ghana (five), Côte d’Ivoire (two), Mali (one), Mauritania (two), Nigeria (nine) and Senegal (three). Nine countries (56.3%) had no history of external beam radiotherapy (EBRT). The largest increase in absolute EBRT capacity occurred from 2017 to 2019, during which 13 MVMs were commissioned. The largest decrease in EBRT capacity occurred from 2015 to 2017, during which four LINACs and three COs were rendered non-operational. The ratio of million persons per MVM improved from 67.0 in 1979 to 17.8 in 2019. As of 2019, there was 0.09 MVM per 1000 cancer cases.ConclusionsWestern African nations have experienced an increase in the absolute number of MVMs and per capita radiotherapy capacity during the last 50 years, especially in the last decade. As non-functional LINACs contributed to a temporary decline in the EBRT infrastructure, dual use of CO/LINAC technologies may act to promote the availability of EBRT treatment in centres with capacity for multiple MVMs. |
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| Keywords: | Cobalt-60 linear accelerator radiotherapy West Africa |
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