Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Elmore, Shekinah N.C.; Grover, Surbhi; Bourque, Jean‐Marc; Chopra, Supriya; Nyakabau, Anna Mary; Ntizimira, Christian; Krakauer, Eric L.; Balboni, Tracy A.; Gospodarowicz, Mary K.; Rodin, Danielle

doi:10.21037/apm.2019.02.02

Cited by 20 publications

(18 citation statements)

References 67 publications

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“…Besides that there are disparities in the access to radiotherapy facilities in high and low-income countries. For example, in Central Africa 0.05 machines are available per million people versus 11.4 machines in North-America (39). Furthermore, even if there is access, older, multi-fractionated radiotherapy schedules for treatment of painful bone metastases are often used, instead of the recommended single-fraction radiotherapy, as was shown in a survey on radiation facilities in African countries (40).…”

Section: Discussionmentioning

confidence: 99%

Non-Radiation Based Early Pain Relief Treatment Options for Patients With Non-Small Cell Lung Cancer and Cancer Induced Bone Pain: A Systematic Review

et al. 2020

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Introduction: Cancer induced bone pain (CIBP) is frequent in patients with non-small cell lung cancer (NSCLC). Radiation therapy continues to be the gold standard for treatment of painful bone metastases, however only a limited number of metastases can be irradiated. We evaluated non-radiation based early CIBP relief options in NSCLC through a systematic review. Methods: Systematic review including all prospective articles published between 01-1994 and 06-2020 on Pubmed, Cochrane Library and ClinicalTrials.gov database. Inclusion: nonradiation based trials evaluating CIBP early pain relief options (initially defined as pain score evaluated within two weeks, because of no randomized trials, later inclusion broadened to pain score evaluated within six weeks) in ≥10 NSCLC patients. Radioisotope trials were excluded as these treatments have interactions with systemic anticancer therapy. Results: 188 articles were found; 10 articles (6 randomized controlled (4 double blinded), 1 phase II single-arm, and 3 prospective trials) fulfilled the inclusion criteria. Six of these trials consisted of ≥2 treatment arms, whereas the others were single-arm studies. In total, 554 NSCLC patients were evaluated in these trials. The included trials were very heterogeneous regarding evaluated treatment options, methods of pain measuring, and endpoints. No high-level evidence for specific early pain relief treatment options was found. Discussion: Non-radiation based studies evaluating treatment options to rapidly reduce CIBP in NSCLC are scarce. This systematic review shows that there is no high-level evidence to recommend a specific treatment for early pain relief. Future research should focus on early pain relief treatment options for CIBP in NSCLC.

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Section: Discussionmentioning

confidence: 99%

Non-Radiation Based Early Pain Relief Treatment Options for Patients With Non-Small Cell Lung Cancer and Cancer Induced Bone Pain: A Systematic Review

et al. 2020

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“…Trials comparing palliative fractionation schedules would help to define the optimum strategy for palliation [74]. A summary of ongoing initiatives to overcome barriers for the integration of radiotherapy into palliative care has recently been published [75]. A formal initiative is needed to appropriately define the role of palliative radiotherapy for locally advanced and metastatic cervical cancer.…”

Section: Palliative Care In Cervical Cancermentioning

confidence: 99%

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

et al. 2019

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Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and lowemiddle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and lowemiddle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.

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“…14 This is especially relevant in low-and middle-income countries (LMICs), where availability of machines is limited and the presentation of patients with disease is often delayed. 9,15 Adopting hypofractionation has also been found to be the most efficient treatment option by reducing treatment time and reducing costs associated with daily treatment. 16 Shorter treatment courses also liberates machine time, thereby improving access to radiotherapy for a greater number of patients.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated radiotherapy in the real-world setting: An international ESTRO-GIRO survey

Rodin

Tawk

Mohamad

et al. 2021

Radiotherapy and Oncology

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Global palliative radiotherapy: a framework to improve access in resource-constrained settings

Cited by 20 publications

References 67 publications

Non-Radiation Based Early Pain Relief Treatment Options for Patients With Non-Small Cell Lung Cancer and Cancer Induced Bone Pain: A Systematic Review

Non-Radiation Based Early Pain Relief Treatment Options for Patients With Non-Small Cell Lung Cancer and Cancer Induced Bone Pain: A Systematic Review

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

Hypofractionated radiotherapy in the real-world setting: An international ESTRO-GIRO survey

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