Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Thorac Oncol. 2016 Jan;11(1):21-9. doi: 10.1016/j.jtho.2015.09.008.
Lung cancer is the most common cancer worldwide and the fifth most common cause of death globally. Its incidence continues to increase, especially within low- and middle-income countries (LMICs), which have limited capacity to address the growing need for treatment. The standard of care for lung cancer treatment often involves radiation therapy (RT), which plays an important therapeutic role in curative-intent treatment of early-stage to locally advanced disease, as well as in palliation. The infrastructure, equipment, and human resources required for RT may be limited in LMICs. However, this narrative review discusses the scope of the problem of lung cancer in LMICs, the role of RT technologies in lung cancer treatment, and RT capacity in developing countries. Strategies are presented for maximizing the availability and impact of RT in settings with minimal resource availability, and areas for potential future innovation are identified. Priorities for LMICs involve increasing access to RT equipment and trained health care professionals, ensuring quality of care, providing guidance on priority setting with limited resources, and encouraging innovation to increase the economic efficiency of RT delivery. Several international initiatives are currently under way and represent important first steps toward scaling up RT in LMICs to treat lung cancer.
肺癌是全球最常见的癌症,也是全球第五大常见死因。其发病率持续上升,特别是在中低收入国家(LMICs),这些国家治疗需求不断增长,但应对能力有限。肺癌治疗的标准方案通常包括放射治疗(RT),它在根治性治疗早期到局部晚期疾病以及姑息治疗中发挥着重要的治疗作用。RT 所需的基础设施、设备和人力资源在 LMICs 可能有限。然而,本文综述讨论了 LMICs 中肺癌问题的范围、RT 技术在肺癌治疗中的作用以及发展中国家的 RT 能力。提出了在资源最少的情况下最大限度地提高 RT 的可用性和影响力的策略,并确定了潜在的未来创新领域。LMICs 的优先事项包括增加 RT 设备和训练有素的医疗保健专业人员的可及性,确保护理质量,在资源有限的情况下提供优先事项设置的指导,并鼓励创新以提高 RT 交付的经济效益。目前正在开展几个国际倡议,这是在 LMICs 中扩大 RT 治疗肺癌规模的重要第一步。