scholarly journals Analysis of the status of radiotherapy care provided to the population of Ukraine. Part 1. Analyzing morbidity and technical supply of radiation therapy in Ukraine

2020 ◽  
Vol 28 (4) ◽  
pp. 337-352
Author(s):  
V. Р. Starenkiy ◽  
O. M. Sukhina ◽  
L. L. Stadnyk ◽  
L. O. Averyanova
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Low Income ◽  
Gamma Ray ◽  
Background Radiation ◽  
Radiation Treatment ◽  
Low Income Countries ◽  
Number Of Patients ◽  
Clinical Consequences ◽  
Low Efficiency

Background. Radiation therapy is an essential in the complex of modern cancer care methods, since it is needed by more than half of cancer patients worldwide. However, each year more than 2 million people from low-income countries are unable to access modern radiotherapy technologies [1]. Thus, the urgent task in the field of radiation oncology is to increase the availability, quality and efficiency of radiotherapy, monitoring the level of technical, methodological and human resourcing of radiation therapy in Ukraine in accordance with trends in Europe and the world. The actual task of the study is to review and analyze the existing level, availability and effectiveness of applying the modern technologies of radiation therapy in the regions of Ukraine. Purpose – analyzing the current state and level of availability of radiotherapy in Ukraine, seeking for opportunities to expand applying it. Materials and methods. Analyzing and comparing statistical data of the National Cancer Registry of Ukraine and the information of IARC GLOBOCAN, IAEA DIRAC Database, summarizing the results. Results. The level of technical and technological equipment as well as staffing of oncology centers of Ukraine has been analyzed, along with assessing quantitative and qualitative components of radiotherapy care in comparison with the average European indicators. The assessment of the state of radiotherapy care in Ukraine was carried out with due regard for the increasing number of patients. Conclusions. According to the WHO, the structure of cancer incidence in Ukraine is similar to the European one, however higher specific mortality rate indicates, first of all, the insufficient level of covering the population of Ukraine by specialized diagnosis and oncological care, its low efficiency and engineering backwardness. It has been determined that radiation therapy in Ukraine is needed annually by at least 90 thousand cancer patients. In fact, only about 44 thousand of them are provided with tele-radiation therapy. First of all, this is due to extremely insufficient radiotherapy equipment available in Ukraine and using outdated radiation treatment technologies in gamma-ray teletherapy that result in its low quality and aggravating the clinical consequences. Given the growing number of cancer patients in 2022, Ukraine will need about 160 machines for tele-radiotherapy. The rise and adjusting the clinical and technical capabilities of regional oncology centers in terms of quality and efficiency of radiation therapy is possible under the conditions of their rapid technical.

scholarly journals Radiation-Induced Erectile Dysfunction in Prostate Cancer Patients: Up-to-Date View on Pathogenesis

2021 ◽  
Vol 102 (1) ◽  
pp. 66-74
Author(s):  
R. V. Novikov ◽  
S. N. Novikov ◽  
V. V. Protoshchak ◽  
I. B. Dzhalilov ◽  
S. S. Litinskiy
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Erectile Dysfunction ◽  
Literature Review ◽  
Cancer Patients ◽  
Radiation Treatment ◽  
Sexual Disorders ◽  
Number Of Patients ◽  
Radical Therapy ◽  
Radiation Induced

The true causes of sexual disorders after radiation treatment of prostate cancer, among which the central role is occupied by erectile dysfunction, are still not fully clarified. The number of patients who undergo various radiation-exposure options as a radical therapy is steadily increasing, which makes the issue very relevant. This literature review provides up-to-date data on the most studied probable mechanisms of the erectile function status decline after radiation therapy for prostate cancer.

scholarly journals Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mariah P. Gesink ◽  
Robert M. Chamberlain ◽  
Julius Mwaiselage ◽  
Crispin Kahesa ◽  
Kahima Jackson ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Population Based ◽  
Capital City ◽  
Low Income Countries ◽  
Treatment Center ◽  
Large Country ◽  
Number Of Patients ◽  
Sub Saharan ◽  
Radiotherapy Treatment

Abstract Background Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions. Methods The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya. Conclusions Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.

Global Health Perspective in Sarcomas and Other Rare Cancers

2018 ◽  
pp. 916-924 ◽  
Author(s):  
Vaia Florou ◽  
Antonio G. Nascimento ◽  
Ashish Gulia ◽  
Gilberto de Lima Lopes
Keyword(s):  
Radiation Therapy ◽  
Global Health ◽  
Low Income ◽  
Multidisciplinary Approach ◽  
Low Income Countries ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Management Guidelines ◽  
Systemic Treatments ◽  
Poor Outcomes

Sarcomas, rare and heterogenous malignancies that comprise less than 1% of all cancers, have poor outcomes in the metastatic and refractory setting. Their management requires a multidisciplinary approach that consists of medical and surgical oncologists, radiation oncologists, and pathologists as well as ancillary support. In addition to systemic treatments, most patients will require surgical resection and radiation therapy, which mandates the use of the latest technologies and specialized expertise. Management guidelines have been developed in high-income countries, but their applicability in low-income countries, where resources may be limited, remains a challenge. In this article, we propose the best possible evidence-based practices specifically for income-constrained settings to overcome this challenge. In addition, we review the different methods that can be used in low-income countries to access new and expensive treatments, which often times carry prohibitive costs for these areas.

scholarly journals Peritoneal Dialysis Utilization Globally and Opportunities in Lower Income Countries

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Fredric Finkelstein ◽  
Qamar Khan
Keyword(s):  
Peritoneal Dialysis ◽  
Low Income ◽  
Low Income Countries ◽  
Dramatic Improvement ◽  
Middle Income ◽  
Low Resource ◽  
Number Of Patients ◽  
The Government ◽  
Global Increase ◽  
End Stage

There has been an expansion of peritoneal dialysis (PD) utilization globally over the past several years. This has occurred for several reasons. First, there has been a global increase in the number of patients receiving end-stage kidney disease (ESKD) treatment in high income, middle income and low income countries. Second, recent studies have emphasized the reduced cost of PD compared to hemodialysis (HD) if PD supplies can be acquired at a reasonable cost.  Thirdly, it is now widely accepted that since PD is much simpler to do than HD (that is, it does not require large amounts of water, complex water treatment systems, electricity, and machinery), the use of PD in low resource countries has certain obvious advantages. Fourthly, it has become clear from experiences in Hong Kong and Thailand that have developed PD First programs (i.e. the government paying for ESKD care only if PD eligible patients start on PD rather than HD) and programs in Mexico (where there has been limited availability of HD centers) that the vast majority of patients with ESKD, even in low resource countries, are able to successfully be cared for with PD.  And, importantly, as programs expand in low resource countries and experience is gained, outcomes of  PD improve.  Lastly, the International Society of Peritoneal Dialysis (ISPD) has developed comprehensive guidelines for the care of PD patients that has resulted in a dramatic improvement in outcomes for PD patients over the last several years.

scholarly journals IMMUNE EFFECTS OF STEREOTACTIC ABLATIVE RADIATION THERAPY IN PATIENTS WITH MALIGNANT TUMORS: LITERATURE REVIEW

2020 ◽  
Vol 19 (5) ◽  
pp. 108-113
Author(s):  
A. Yu. Zozulya ◽  
I. A. Baldueva ◽  
S. N. Novikov
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Radiation Treatment ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Systemic Effect ◽  
Stereotactic Ablative Radiotherapy ◽  
Systematic Analysis ◽  
Combined Use ◽  
Abscopal Effects

The purpose of the study was to conduct a systematic analysis of the data available in the modern literature on the systemic (abscopal) effects in radiation therapy, which are mediated by immunological phenomena.Material and Methods.A structured search for articles published in peer-reviewed journals between January 2000 and February 2019 was conducted using MEDLINE database. The review included data from registered clinical trials at Clinicaltrials.gov, showing the results of the combined use of immunotherapy and radiation therapy.Results. There is an opinion that the systemic effect of radiotherapy is mediated by immunological phenomena. In connection with the recent data, there is a growing interest in the combined use of immunotherapy with radiation therapy in order to increase the efficacy of systemic therapy. However, the incidence of abscopal effects after standard radiation treatment is very low. In this regard, stereotactic ablative radiotherapy, due to its high immunogenic potential, low toxicity and short duration of the treatment, is apparently an attractive partner for immunotherapy in patients with metastatic disease.Conclusion. In view of the variety of the immunological effects of radiotherapy, further studies of the effect of radiation therapy on the immune system of cancer patients are needed, and the use of various combinations of immunotherapy and radiation therapy should be continued. All this, ultimately, will help improve the survival rates of cancer patients. 

scholarly journals NEOADJUVANT RADIATION THERAPY FOR RECTAL CANCER WITH SYNCHRONOUS LIVER METASTASES (LITERATURE REVIEW)

2021 ◽  
Vol 20 (5) ◽  
pp. 123-137
Author(s):  
T. P. Pochuev ◽  
A. A. Nevolskikh ◽  
L. O. Petrov ◽  
L. N. Titova ◽  
A. A. Karpov
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Distant Metastases ◽  
Point Of View ◽  
Surgical Approaches ◽  
Primary Tumors ◽  
Synchronous Liver Metastases ◽  
Number Of Patients

Background. In Russia, synchronous distant metastases are annually detected in approximately 6,200 patients and synchronous liver metastases in 4,000 patients. To plan treatment for rectal cancer with synchronous liver metastases, it is necessary to consider the location of the tumor, extent of the primary tumor involvement, tumor-related complications, and resectability of metastases.The purpose of this review was to analyze the results of studies aimed at finding the best regimens for treating rectal cancer patients with synchronous liver metastases.Material and Methods. The review includes both retrospective and prospective studies devoted to treatment of rectal cancer with synchronous liver metastases. Previous reviews and clinical recommendations were analyzed.Results. Most oncologists are in favor of preoperative radiotherapy, especially when rectal cancer is located in the lower-and middle-ampullary regions. However, there are no randomized trials with a representative number of patients to confirm or refute this point of view. Due to the increased life expectancy of patients and introduction of modern minimally invasive surgical approaches, there is an urgent need for radical treatment of rectal cancer patients. Thus, the approaches to the treatment of primary tumors with synchronous metastatic liver damage should be the same as in stage II–III of the disease, and neoadjuvant radiation therapy is an integral part of this strategy. 

scholarly journals Gender Disparity in Cardiovascular Mortality following Radiation Therapy for Hodgkin's Lymphoma: A Systematic Review

2020 ◽  
Author(s):  
Yaser Khalid ◽  
Michael Fradley ◽  
Neethi Dasu ◽  
Kirti Dasu ◽  
Ankit Shah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Background Radiation ◽  
Radiation Treatment ◽  
Hodgkin's Lymphoma ◽  
Secondary Outcome ◽  
All Cause Mortality ◽  
Radiation Induced ◽  
Meta Regression

Abstract Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there has been very little investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. PubMed, google scholar, and Cochrane databases were searched to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.

Abstract W P318: Declining Mortality in Cerebral Venous Thrombosis: A Systematic Review

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jonathan M Coutinho ◽  
Susanna M Zuurbier ◽  
Jan Stam
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Low Income ◽  
Cerebral Venous Thrombosis ◽  
Inverse Correlation ◽  
Low Income Countries ◽  
Single Center ◽  
Clear Trend ◽  
Only Children ◽  
Number Of Patients

Introduction: Cerebral venous thrombosis (CVT) is nowadays considered a disease with a good outcome in most cases, but in the past these patients were believed to have a grave prognosis. This apparent decline in mortality has not been investigated systematically Methods: We performed a systematic review of the literature. Older studies were identified from books and by scanning reference lists. Studies with 40 CVT patients or more that minimally reported mortality at discharge were eligible. Care was taken to exclude duplicate publications based on the same patient cohort. Studies were ranked according to the year halfway the period of patient inclusion. If no time span was reported, we assumed a period of inclusion of 10 years prior to the year of publication. Results: Of 4.585 potentially eligible studies, 74 fulfilled the selection criteria and were included in the analysis. The majority of studies were retrospective (80%) and single-center (59%). In total, 23.031 patients were included in the analysis. The number of patients per study varied from 40 to 11.400 (median 79). Seven studies included only children. There was a significant inverse correlation between mortality and year of patient recruitment (Pearson’s correlation coefficient -0.70, p<0.001, figure). In a sensitivity analysis, exclusion of retrospective studies, pediatric studies, single-center studies, or studies from low income countries did not significantly alter the correlation. Conclusions: There is a clear trend in declining mortality among patients with CVT over time. Possible explanations include better diagnosis (with identification of less severe cases), improved treatment and a declining incidence of infection related CVT.

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