The Cockcroft Institute engineer from Lancaster University, Prof Graeme Burt, has taken part in the Lancet Oncology Commission on Radiotherapy and Theranostics. The Commission, established by the renowned medical journal, aims to assess the current status of access to radiotherapy and theranostics at a global level.
A new report published by the Commission highlights the persistent global disparities in access to radiotherapy and theranostics, especially in low- and middle-income countries (LMICs), and proposes a series of actions to address these challenges.
This work follows on from the STFC funded ITAR (Innovative Technologies towards building Affordable and equitable global Radiotherapy capacity) project, in collaboration with the International Cancer Expert Corps (ICEC), which investigated radiotherapy access in Africa, with a major study of 28 African countries, and the development of a conceptual design for a radiotherapy machine to address issues related to maintenance and downtime (https://esmed.org/MRA/mra/article/view/5530).
The Lancet report underscores a significant gap in the availability of radiotherapy machines between high-income and LMICs, with limited access remaining a major obstacle to effective cancer treatment in many regions. One of the key issues identified is the shortage of trained and credentialed healthcare professionals in LMICs, which hinders the implementation of radiotherapy services.
To address these issues, the Commission explored several potential solutions. One notable finding is that the broad implementation of hypofractionation protocols—where fewer, larger doses of radiation are given—could extend the reach of existing radiotherapy resources. Specifically, adopting these techniques in the treatment of prostate and breast cancers could provide an additional 2.2 million treatments annually, offering critical care to patients with limited access to radiotherapy.
The report also examined the growing field of theranostics, particularly the use of radiopharmaceutical therapies beyond the commonly used iodine-131. Access to these therapies varies widely between high-income countries and LMICs, with challenges such as supply chain issues, workforce limitations, and regulatory hurdles affecting availability. The Commission highlights the importance of improving radioisotope production capabilities and expanding the training and credentialing of health professionals involved in theranostics to ensure equitable access.
To address these gaps, the Commission calls for continued support for initiatives such as the International Atomic Energy Agency’s Rays of Hope programme, which aims to increase radiotherapy access in underserved regions. It also encourages investment from international development banks and governments to accelerate progress in closing the global disparities in cancer treatment.
The Commission’s recommendations emphasize the need for global collaboration, investment in new technologies, and stronger healthcare systems to improve access to both radiotherapy and theranostics, ultimately reducing the global cancer burden and improving patient outcomes worldwide.
Reference:
Radiotherapy and theranostics: a Lancet Oncology Commission
Abdel-Wahab, May et al.
The Lancet Oncology, Volume 25, Issue 11, e545 – e580
https://doi.org/10.1016/S1470-2045(24)00407-8
