Challenges and opportunities for implementing hypofractionated radiotherapy in Africa: lessons from the HypoAfrica clinical trial.

Autor:	Olatunji E; Johns Hopkins University School of Medicine, Baltimore, Maryland, MD 21205, USA.; Co-first authors., Swanson W; Department of Radiation Oncology, Weill Cornell Medicine, New York, NY 10065, USA.; Co-first authors., Patel S; Johns Hopkins University School of Medicine, Baltimore, Maryland, MD 21205, USA., Adeneye SO; NSIA-LUTH Cancer Treatment Center, Lagos University Teaching Hospital, Lagos 100254, Nigeria., Aina-Tofolari F; NSIA-LUTH Cancer Treatment Center, Lagos University Teaching Hospital, Lagos 100254, Nigeria., Avery S; Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA., Kisukari JD; Ocean Road Cancer Institute, Dar Es Salaam 3592, Tanzania., Graef K; BIO Ventures for Global Health, Seattle, WA 98121, USA., Huq S; Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA 15232, USA., Jeraj R; Department of Medical Physics, University of Wisconsin, Madison, WI 53705, USA.; University of Ljubljana, Faculty of Mathematics and Physics, Ljubljana 1000, Slovenia., Joseph AO; NSIA-LUTH Cancer Treatment Center, Lagos University Teaching Hospital, Lagos 100254, Nigeria., Lehmann J; Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW 2298, Australia.; Institute of Medical Physics, The University of Sydney, Sydney, NSW 2006, Australia.; Institute of Medical Physics, The University of Sydney, Sydney, NSW 2006, Australia., Li H; Johns Hopkins University School of Medicine, Baltimore, Maryland, MD 21205, USA., Mallum A; Department of Radiotherapy and Oncology, University of KwaZulu-Natal, Durban 4041, South Africa.; Department of Oncology, Inkosi Albert Luthuli Central Hospital, Durban 4091, South Africa., Mkhize T; Department of Radiotherapy and Oncology, University of KwaZulu-Natal, Durban 4041, South Africa.; Department of Oncology, Inkosi Albert Luthuli Central Hospital, Durban 4091, South Africa., Ngoma TA; Ocean Road Cancer Institute, Dar Es Salaam 3592, Tanzania.; Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, PO box 65001, Dar es Salaam, Tanzania., Studen A; University of Ljubljana, Faculty of Mathematics and Physics, Ljubljana 1000, Slovenia.; Jožef Stefan Institute, Ljubljana 1000, Slovenia., Wijesooriya K; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia., Incrocci L; Department of Radiotherapy, Erasmus MC, Rotterdam, Netherlands.; Co-senior authors., Ngwa W; Johns Hopkins University School of Medicine, Baltimore, Maryland, MD 21205, USA.; Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.; Co-senior authors.
Jazyk:	angličtina
Zdroj:	Ecancermedicalscience [Ecancermedicalscience] 2023 Feb 16; Vol. 17, pp. 1508. Date of Electronic Publication: 2023 Feb 16 (Print Publication: 2023).
DOI:	10.3332/ecancer.2023.1508
Abstrakt:	The rising cancer incidence and mortality in sub-Saharan Africa (SSA) warrants an increased focus on adopting or developing approaches that can significantly increase access to treatment in the region. One such approach recommended by the recent Lancet Oncology Commission for sub-Saharan Africa is hypofractionated radiotherapy (HFRT), which can substantially increase access to radiotherapy by reducing the overall duration of time (in days) each person spends being treated. Here we highlight challenges in adopting such an approach identified during the implementation of the HypoAfrica clinical trial. The HypoAfrica clinical trial is a longitudinal, multicentre study exploring the feasibility of applying HFRT for prostate cancer in SSA. This study has presented an opportunity for a pragmatic assessment of potential barriers and facilitators to adopting HFRT. Our results highlight three key challenges: quality assurance, study harmonisation and machine maintenance. We describe solutions employed to resolve these challenges and opportunities for longer term solutions that can facilitate scaling-up use of HFRT in SSA in clinical care and multicentre clinical trials. This report provides a valuable reference for the utilisation of radiotherapy approaches that increase access to treatment and the conduct of high-quality large-scale/multi-centre clinical trials involving radiotherapy. Trial Registration: Not available yet. Competing Interests: The authors declare that they have no conflicts of interest. (© the authors; licensee ecancermedicalscience.)
Databáze:	MEDLINE
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