Radiotherapy and the SUS: A collapse foretold

Abstract

RadiotheRapy and the SUS: a collapSe foRetold rEv assoc mEd Bras 2017; 63(2):93-94 93

Prioritising locations for radiotherapy equipment in Brazil: a cross-sectional, population-based study and development of a LINAC shortage index

“…The possible explanation is that regions with a higher LS Index have longer waiting times compared to other regions; this leads to patients travelling to large urban centers with more RT machines and capacity to absorb the demand. This referral process was possibly aggravated with the publication of the SUS 60 days law from May 2013, which decreed that patients with cancer must start their cancer treatment within 60 days of diagnosis [6][7][8]. The law is well-intentioned, but without infrastructure and a uniform distribution of LINACs, it compels physicians to send their patients to other regions for timely treatments.…”

“…prostate, breast, and lung [3,4]) where it has a substantial impact on clinical outcomes [4][5][6]. In Brazil, 80% of the RT is delivered in the public health system (Sistema Unico de Saude, SUS) which also serves about 80% of Brazil's total population (211 million people) [7,8]. Brazil has 363 LINACs, with 252 dedicated to the SUS and 111 to the private sector, unevenly distributed across the country [9].…”

“…We examined the correlations between the LS index and traveled distances and LS index and access to RT using the state of São Paulo as the benchmark. When developing our model, we assumed that 50% of all newly diagnosed patients would need RT at some point in their disease trajectory based on previous needs assessments [3][4][5][6], and 80% of patients being treated in the public system [7,8]. Based on these estimates, the number of patients from SUS who would require the radiotherapy 'new cases for RT' was calculated using the formula: (Incidence of cancer x 80%) x 50%.…”

Cost-effectiveness of hypofractionated versus conventional fractionated radiotherapy for the treatment of men with early glottic cancer: a study in the Brazilian public and private health system

“…Brazil is a large upper-middle-income country with a shortage of LINACs to treat cancer patients [ 10 , 11 ]. Larynx cancer is ranked among the top 10 most incident cancer in the Brazilian population, with 6000 cases in 2020[ 12 ].…”

Hypofractionated radiotherapy recommendations for localized prostate cancer in Brazil

“…This may benefit patients, the radiation oncology (RO) department, and the public health system: the smaller number of patient's visits to the clinic may reduce logistical challenges, increase patient's adherence and reduce the treatment costs; from the RO department and health system perspective, mHypo and uHypo may increase machine capacity due to the shorter treatment schedule and increased turnover. This is especially important in low and middle income countries (LMIC), where the majority of the population depends on the public health system and where there is a shortage of linear accelerators slots 6,[26][27][28][29] .…”