Datta Niloy R, Datta Sneha, Samiei Massoud
Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Switzerland.
Independent Researcher, London, United Kingdom.
Adv Radiat Oncol. 2021 Jan-Feb;6(1):100565. doi: 10.1016/j.adro.2020.09.005. Epub 2020 Sep 24.
There is widespread accord among economists that the corona virus disease 2019 (COVID-19) pandemic will have a severe negative effect on the global economy. Establishing new radiation therapy (RT) infrastructure may be significantly compromised in the post-COVID-19 era. Alternative strategies are needed to improve the existing RT accessibility without significant cost escalation. The outcomes of these approaches on RT availability have been examined for Asia.
The details of RT infrastructures in 2020 for 51 countries in Asia were obtained from the Directory of Radiotherapy Centers of the International Atomic Energy Agency. Using the International Atomic Energy Agency guidelines, the percent of RT accessibility and the additional requirements of teletherapy (TRT) units were computed for these countries. To maximize the utilization of the existing RT facilities, 5 options were evaluated, namely, hypofractionation RT (HFRT) alone, with/without 25% or 50% additional working hours. The effect of these strategies on the percent of RT access and additional TRT unit requirements to achieve 100% RT access were estimated.
In 46 countries, 4617 TRT units are available. The mean percent of RT accessibility is 62.4% in 43 countries (TRT units = 4491) where the information on cancer incidence was also available, and these would need an additional 6474 TRT units for achieving 100% RT accessibility. By adopting HFRT alone, increasing the working hours by 25% alone, 25% with HFRT, 50% alone, and 50% with HFRT, the percent of RT access could improve to 74.9%, 78%, 90.5%, 93.7%, and 106.1%, respectively. Correspondingly, the need for additional TRT units would progressively decrease to 4646, 4284, 3073, 2820, and 1958 units.
The economic slowdown in the post-COVID-19 period could severely impend establishment of new RT facilities. Thus, maximal utilization of the available RT infrastructure with minimum additional costs could be possible by adopting HFRT with or without increased working hours to improve the RT coverage.
经济学家们普遍认为，2019年冠状病毒病（COVID-19）大流行将对全球经济产生严重负面影响。在COVID-19后的时代，建立新的放射治疗（RT）基础设施可能会受到重大影响。需要替代策略来在不显著增加成本的情况下改善现有的放射治疗可及性。已针对亚洲研究了这些方法对放射治疗可用性的影响。
从国际原子能机构放射治疗中心名录中获取了2020年亚洲51个国家放射治疗基础设施的详细信息。根据国际原子能机构的指南，计算了这些国家的放射治疗可及性百分比和远距离治疗（TRT）设备的额外需求。为了最大限度地利用现有的放射治疗设施，评估了5种方案，即单独采用大分割放射治疗（HFRT），增加25%或50%的工作时间（有或无HFRT）。估计了这些策略对放射治疗可及性百分比以及实现100%放射治疗可及性所需额外TRT设备数量的影响。
在46个国家有4617台TRT设备。在43个国家（TRT设备 = 4491台）中，放射治疗可及性的平均百分比为62.4%，这些国家也有癌症发病率信息，要实现100%的放射治疗可及性还需要额外6474台TRT设备。单独采用HFRT、仅将工作时间增加25%、HFRT与增加25%工作时间结合、仅增加50%工作时间以及HFRT与增加50%工作时间结合，放射治疗可及性百分比分别可提高到74.9%、78%、90.5%、93.7%和106.1%。相应地，对额外TRT设备的需求将逐步减少到4646台、4284台、3073台、2820台和1958台。
COVID-19后时期的经济放缓可能严重阻碍新放射治疗设施的建立。因此，通过采用HFRT（有或无增加工作时间）以提高放射治疗覆盖范围，有可能在成本增加最少的情况下最大限度地利用现有的放射治疗基础设施。
