Eduardo Rosenblatt

Expanding global access to radiotherapy

Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US

Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis

26·6 billion in low-income countries,

International Atomic Energy Agency Randomized Phase III Study of Radiation Therapy in Elderly and/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme.

62·6 billion in lower-middle-income countries, and

Radiotherapy capacity in European countries: An analysis of the Directory of Radiotherapy Centres (DIRAC) database

94·8 billion in upper-middle-income countries, which amounts to

Need for Radiotherapy in Low and Middle Income Countries – The Silent Crisis Continues

184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower:

Adding external beam to intra-luminal brachytherapy improves palliation in obstructive squamous cell oesophageal cancer: A prospective multi-centre randomized trial of the International Atomic Energy Agency

14·1 billion in low-income,

Safety in radiation oncology: the role of international initiatives by the International Atomic Energy Agency.

33·3 billion in lower-middle-income, and

Brachytherapy boost in loco-regionally advanced nasopharyngeal carcinoma: A prospective randomized trial of the International Atomic Energy Agency

49·4 billion in upper-middle-income countries-a total of

International Conference on Advances in Radiation Oncology (ICARO): Outcomes of an IAEA Meeting

96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of

Global Task Force on Radiotherapy for Cancer Control.

278·1 billion in 2015-35 (