Addressing the shortage of radiotherapy machines for low and middle income countries

 The annual global incidence of cancer is expected to rise up to 25 million cases (13 million deaths) by 2035 with 70% of these new cases from Low- and Middle-Income Countries (LMICs). Many LMICs lack the healthcare programmes required to effectively manage their cancer burden.

Radiotherapy (RT) is a fundamental component of effective cancer treatment and control and it is estimated that about half of all cancer patients would benefit from radiotherapy for treatment of localised disease, local control, and palliation. 

However there is a major shortage of radiotherapy machines beyond high income countries; with only 10% of patients in low-income and 40% in middle-income countries having access to it.

The ITAR project, led by the Cockcroft Institute, designed a radiotherapy machine to address the shortage of linear accelerators in LMIC. This included the first comprehensive survey of the challenges of radiotherapy provision in Africa. 

The survey highlighted that the high cost of maintenance and the associated downtime is a significant factor. Hence the ITAR linac design focussed on robust technology that is simpler to repair and has a longer lifetime.

This work utilised the Cockcroft’s expertise in low-energy radio frequency linear accelerators, beam dynamics, electron sources and vacuum systems. 

The end goal of the project is to increase the number of operating radiotherapy machines in LMICs and hence save lives. 

The planned next stage of work is to build a prototype radiotherapy system based on the patented design of linear accelerators developed within the ITAR project. 

This work is being progressed as a collaboration with the International Cancer Expert Corps (ICEC). 

“The ITAR Project is part of a larger global health collaboration for cancer and healthcare capacity building in LMICs. The goal is a transformative approach to greatly enhance access in LMICs to the full spectrum of cancer care from prevention to screening to diagnosis, to treatment and to follow-up care. The overall technology project is called Project “STELLA” (Smart Technology by Extend Lives with Linear Accelerators) organized by ICEC, CERN, Oxford University, STFC, and Lancaster University. The project’s progress to date has been due to the remarkable investigators working on this project with the medical and healthcare experts in ICEC. The Cockcroft Institute’s talented scientists, researchers and engineers are remarkably creative and are dedicated to the mission of increasing access to high quality radiotherapy which is an essential component in the spectrum of effective cancer care. As shown in the map, there are entire countries with almost no access to radiation therapy who will benefit from Cockcroft Institute’s ingenuity to develop technology suitable to challenging environments albeit it in LMICs, and Middle- and High-income countries where remote geography can limit access to cancer treatment. This will support the ICEC capacity-building mentorship approach to build on-the-ground expertise for and by the local community.”

Nina Wendling, Executive Director, ICEC