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Expanding Access to Radiotherapy for Low Resource Countries Using Stereotactic Body Radiation Therapy

J Chin1*, O Irabor2 , W Ngwa1,2 , (1) University of Massachusetts Lowell, Lowell, MA (2) Dana Farber Cancer Institute, Harvard Medical School, Boston, MA


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: Studies have shown that stereotactic body radiation therapy (SBRT) reduces time in treatment compared to conventional radiotherapy (RT).² This study investigates the potential benefits of using SBRT versus conventional RT in low resource settings including low and middle income countries (LMIC).

Methods: Using an accepted value of 9700 fractions as the annual treatment capacity of a LINAC, the number of courses a LINAC can deliver at the conventional fractions (CF) and SBRT protocols for lung cancer is estimated. The departmental costs of each protocol were estimated using IAEA RTE cost estimator with the following considerations. With the use of SBRT except CF, the number of fractions is reduced from 31 fractions (fr.) to up to 5fr. and given treatment time per fraction increases from 15 to 30 minutes. This means a single LINAC would deliver 4 CF and 2 SBRT per working hour. The cost of a LINAC was obtained from literature to range from US$1.5m to US$2.8m. Analysis was conducted for Kenya as an example LMIC.

Results: There is an estimate of 39,000 new cases of cancer each year in Kenya with more than 27,000 deaths per year.³ Calculations show an SBRT LINAC would deliver 970 SBRT courses per year with a 210% increase in annual treatment capacity for lung cancer patients in LMICs. Based on RTE computation, departmental cost for a CF course and SBRT course is US$3,992 and US$1,904 respectively, representing a 110% cost savings with SBRT.

Conclusion: SBRT technique could significantly increase access to treatment in low resource settings and reduce treatment time and costs. Ongoing studies are conducting specific analysis for each LMIC and resource poor settings in high income countries like the USA. The findings provide impetus for greater investment in SBRT technology capable LINACs and associated technologies in LMIC.


Treatment Techniques, Treatment Planning, Image-guided Therapy


TH- External beam- photons: extracranial stereotactic/SBRT

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