Global Radiotherapy: Current Status and Future Directions-White Paper

Abstract

Recognizing the increase in cancer incidence globally and the need for effective cancer control interventions, several organizations, professional bodies, and international institutions have proposed strategies to improve treatment options and reduce mortality along with minimizing overall incidence. Despite these efforts, an estimated 9.6 million deaths in 2018 was attributed to this noncommunicable disease, making it the second leading cause of death worldwide. Left unchecked, this will further increase in scale, with an estimated 29.5 million new cases and 16.3 million deaths occurring worldwide in 2040. Although it is known and generally accepted that cancer services must include radiotherapy, such access is still very limited in many parts of the world, especially in low- and middle-income countries. After thorough review of the current status of radiotherapy including programs worldwide, as well as achievements and challenges at the global level, the International Atomic Energy Agency convened an international group of experts representing various radiation oncology societies to take a closer look into the current status of radiotherapy and provide a road map for future directions in this field. It was concluded that the plethora of global and regional initiatives would benefit further from the existence of a central framework, including an easily accessible repository through which better coordination can be done. Supporting this framework, a practical inventory of competencies needs to be made available on a global level emphasizing the knowledge, skills, and behavior required for a safe, sustainable, and professional practice for various settings. This white paper presents the current status of global radiotherapy and future directions for the community. It forms the basis for an action plan to be developed with professional societies worldwide.

FIG 1

Access to radiotherapy worldwide per million population.

FIG 2

Distribution of radiotherapy centers in high-income countries.

FIG 3

Distribution of radiotherapy centers in low- and middle-income countries.

FIG 4

Countries that replied to the survey.

FIG 5

IRIS survey results based on countries who responded to have educational and training program(s) for RO. IRIS, International Research Integration System; MP, medical physicists; ON, oncology nurses; RO, radiation oncologists; RTT, radiation therapists.

FIG 6

(A) Overview of the distribution of IAEA's CRPs and contracts worldwide. (B) Distribution of CRPs and contracts worldwide by specialty (updated on February 09, 2021; 13:46:45). CRPs, coordinated research projects; IAEA, International Atomic Energy Agency.

FIG 7

Coordinated research activities and in-country training, fellowship activities and expert support supported by IAEA Division of Human Health (NAHU). Color shows details about EventTopic. Size shows sum of number of records. IAEA, International Atomic Energy Agency; TC, technical cooperation. © 2021 Mapbox © OpenStreetMap.

FIG 8

Current MV and additional needed MV machines. MV, megavoltage; USD, US dollars.