Swanson William, Kamwa Francesca, Samba Richard, Ige Taofeeq, Lasebikan Nwamaka, Mallum Abba, Ngoma Twalib, Sajo Erno, Elzawawy Ahmed, Incrocci Luca, Ngwa Wilfred
Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, United States.
Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.
Front Oncol. 2021 Feb 19;10:618641. doi: 10.3389/fonc.2020.618641. eCollection 2020.
In the advent of the coronavirus disease (COVID-19) pandemic, professional societies including the American Society for Radiation Oncology and the National Comprehensive Cancer Network recommended adopting evidence-based hypofractionated radiotherapy (HFRT). HFRT benefits include reduction in the number of clinical visits for each patient, minimizing potential exposure, and reducing stress on the limited workforce, especially in resource-limited settings as in Low-and-Middle-Income Countries (LMICs). Recent studies for LMICs in Africa have also shown that adopting HFRT can lead to significant cost reductions and increased access to radiotherapy. We assessed the readiness of 18 clinics in African LMICs to adopting HFRT. An IRB-approved survey was conducted at 18 RT clinics across 8 African countries. The survey requested information regarding the clinic's existing equipment and human infrastructure and current practices. Amongst the surveyed clinics, all reported to already practicing HFRT, but only 44% of participating clinics reported adopting HFRT as a common practice. Additionally, most participating clinical staff reported to have received formal training appropriate for their role. However, the survey data on treatment planning and other experience with contouring highlighted need for additional training for radiation oncologists. Although the surveyed clinics in African LMICs are familiar with HFRT, there is need for additional investment in infrastructure and training as well as better education of oncology leaders on the benefits of increased adoption of evidence-based HFRT during and beyond the COVID-19 era.
在冠状病毒病（COVID-19）大流行之际，包括美国放射肿瘤学会和国家综合癌症网络在内的专业协会建议采用基于证据的短程放疗（HFRT）。短程放疗的益处包括减少每位患者的临床就诊次数、将潜在暴露降至最低以及减轻有限劳动力的压力，特别是在低收入和中等收入国家（LMICs）等资源有限的环境中。最近针对非洲低收入和中等收入国家的研究还表明，采用短程放疗可大幅降低成本并增加放疗可及性。我们评估了非洲低收入和中等收入国家的18家诊所采用短程放疗的准备情况。在非洲8个国家的18家放疗诊所进行了一项经机构审查委员会批准的调查。该调查要求提供有关诊所现有设备、人力基础设施和当前做法的信息。在接受调查的诊所中，所有诊所都报告已经在实施短程放疗，但只有44%的参与诊所报告将短程放疗作为常规做法。此外，大多数参与的临床工作人员报告已接受与其角色相称的正规培训。然而，关于治疗计划和其他轮廓勾画经验的调查数据凸显了放射肿瘤学家需要额外培训。尽管非洲低收入和中等收入国家接受调查的诊所熟悉短程放疗，但仍需要在基础设施和培训方面进行额外投资，以及对肿瘤学领导者进行更好的教育，使其了解在COVID-19时代及之后更多采用基于证据的短程放疗的益处。
