title: Implementation of a high-dose-rate brachytherapy program for carcinoma of the cervix in Senegal: a pragmatic model for the developing world.
abstract: West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single (60)Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in the developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries.
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California. Electronic address: jeinck@ucsd.edu.
authors.forename: John P
authors.initials: JP
authors.lastname: Einck
authors.affiliation: Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alana
authors.initials: A
authors.lastname: Hudson
authors.affiliation: Overlook Medical Center, Summit, New Jersey.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Shulman
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California.
authors.forename: Catheryn M
authors.initials: CM
authors.lastname: Yashar
authors.affiliation: Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar, Senegal.
authors.forename: Mamadou M
authors.initials: MM
authors.lastname: Dieng
authors.affiliation: Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar, Senegal.
authors.forename: Magatte
authors.initials: M
authors.lastname: Diagne
authors.affiliation: Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar, Senegal.
authors.forename: Latifatou
authors.initials: L
authors.lastname: Gueye
authors.affiliation: Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar, Senegal.
authors.forename: Fama
authors.initials: F
authors.lastname: Gningue
authors.affiliation: Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar, Senegal.
authors.forename: Pape M
authors.initials: PM
authors.lastname: Gaye
authors.affiliation: GammaWest Cancer Services, Salt Lake City, Utah.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Fisher
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California.
authors.forename: Arno J
authors.initials: AJ
authors.lastname: Mundt
authors.affiliation: Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Derek W
authors.initials: DW
authors.lastname: Brown
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D003906:Developing Countries; D019583:Dose Fractionation, Radiation; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D009939:Organizations, Nonprofit; D016730:Program Development; D011859:Radiography; D011880:Radiotherapy Planning, Computer-Assisted; D012675:Senegal; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy*; D000078329:Workforce