Datta Niloy Ranjan, Heuser Michael, Samiei Massoud, Shah Ragesh, Lutters Gerd, Bodis Stephan
1 Centre for Radiation Oncology, KSA-KSB, Kantonsspital Aarau , Aarau, Switzerland .
2 Formerly, PACT Section, International Atomic Energy Agency , Vienna, Austria .
Telemed J E Health. 2015 Jul;21(7):523-32. doi: 10.1089/tmj.2014.0154. Epub 2015 Mar 12.
Globally, new cancer cases will rise by 57% within the next two decades, with the majority in the low- and middle-income countries (LMICs). Consequently, a steep increase of about 40% in cancer deaths is expected there, mainly because of lack of treatment facilities, especially radiotherapy. Radiotherapy is required for more than 50% of patients, but the capital cost for equipment often deters establishment of such facilities in LMICs. Presently, of the 139 LMICs, 55 do not even have a radiotherapy facility, whereas the remaining 84 have a deficit of 61.4% of their required radiotherapy units. Networking between centers could enhance the effectiveness and reach of existing radiotherapy in LMICs. A teleradiotherapy network could enable centers to share and optimally utilize their resources, both infrastructure and staffing. This could be in the form of a three-tier radiotherapy service consisting of primary, secondary, and tertiary radiotherapy centers interlinked through a network. The concept has been adopted in some LMICs and could also be used as a "service provider model," thereby reducing the investments to set up such a network. Teleradiotherapy networks could be a part of the multipronged approach to address the enormous gap in radiotherapy services in a cost-effective manner and to support better accessibility to radiotherapy facilities, especially for LMICs.
在全球范围内，未来二十年新癌症病例将增加57%，其中大部分在低收入和中等收入国家（LMICs）。因此，预计这些国家的癌症死亡人数将急剧增加约40%，主要原因是缺乏治疗设施，尤其是放疗设施。超过50%的患者需要放疗，但设备的资本成本往往阻碍了在LMICs建立此类设施。目前，在139个LMICs中，55个甚至没有放疗设施，而其余84个的所需放疗设备短缺61.4%。各中心之间的联网可以提高LMICs现有放疗的有效性和覆盖范围。远程放疗网络可以使各中心共享并优化利用其基础设施和人员等资源。这可以采用由通过网络相互连接的一级、二级和三级放疗中心组成的三层放疗服务形式。这一概念已在一些LMICs中采用，也可以用作“服务提供商模式”，从而减少建立此类网络的投资。远程放疗网络可以成为多管齐下方法的一部分，以具有成本效益的方式解决放疗服务方面的巨大差距，并支持更好地获得放疗设施，特别是对于LMICs而言。
