TY - JOUR
T1 - Challenges and opportunities for implementing hypofractionated radiotherapy in Africa
T2 - lessons from the HypoAfrica clinical trial
AU - Olatunji, Elizabeth
AU - Swanson, William
AU - Patel, Saloni
AU - Adeneye, Samuel Olaolu
AU - Aina-Tofolari, Funmilayo
AU - Avery, Stephen
AU - Kisukari, Jumaa Dachi
AU - Graef, Katy
AU - Huq, Saiful
AU - Jeraj, Robert
AU - Joseph, Adedayo O.
AU - Lehmann, Joerg
AU - Li, Heng
AU - Mallum, Abba
AU - Mkhize, Thokozani
AU - Ngoma, Twalib Athumani
AU - Studen, Andrej
AU - Wijesooriya, Krishni
AU - Incrocci, Luca
AU - Ngwa, Wilfred
N1 - Funding Information:
Research reported in this publication was partially supported by the National Institutes of Health under Award Number R01CA239042 and supplement for implementation research and R13 grant supporting the Global Health Catalyst summits R13CA257481. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. The authors acknowledge support from members of the AAPM international council.
Publisher Copyright:
© the authors;
PY - 2023/2/16
Y1 - 2023/2/16
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85151332527&partnerID=8YFLogxK
U2 - 10.3332/ecancer.2023.1508
DO - 10.3332/ecancer.2023.1508
M3 - Article
C2 - 37113724
AN - SCOPUS:85151332527
SN - 1754-6605
VL - 17
JO - ecancermedicalscience
JF - ecancermedicalscience
M1 - 17:1508
ER -
