title: Radiotherapeutic Management of Non-Small Cell Lung Cancer in the Minimal Resource Setting.
abstract: Lung cancer is the most common cancer worldwide and the fifth most common cause of death globally. Its incidence continues to increase, especially within low- and middle-income countries (LMICs), which have limited capacity to address the growing need for treatment. The standard of care for lung cancer treatment often involves radiation therapy (RT), which plays an important therapeutic role in curative-intent treatment of early-stage to locally advanced disease, as well as in palliation. The infrastructure, equipment, and human resources required for RT may be limited in LMICs. However, this narrative review discusses the scope of the problem of lung cancer in LMICs, the role of RT technologies in lung cancer treatment, and RT capacity in developing countries. Strategies are presented for maximizing the availability and impact of RT in settings with minimal resource availability, and areas for potential future innovation are identified. Priorities for LMICs involve increasing access to RT equipment and trained health care professionals, ensuring quality of care, providing guidance on priority setting with limited resources, and encouraging innovation to increase the economic efficiency of RT delivery. Several international initiatives are currently under way and represent important first steps toward scaling up RT in LMICs to treat lung cancer.
authors.affiliation: Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Rodin
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Grover
authors.affiliation: Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, Kingston, ON, Canada.
authors.forename: Melody J
authors.initials: MJ
authors.lastname: Xu
authors.affiliation: Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, Kingston, ON, Canada.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hanna
authors.affiliation: Department of Radiation Oncology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Olson
authors.affiliation: Departments of Radiation Oncology and Physics, Queen's University, Kingston, ON, Canada.
authors.forename: L John
authors.initials: LJ
authors.lastname: Schreiner
authors.affiliation: Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, India.
authors.forename: Anusheel
authors.initials: A
authors.lastname: Munshi
authors.affiliation: Département de radiothérapie, Centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France.
authors.forename: Francoise
authors.initials: F
authors.lastname: Mornex
authors.affiliation: Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada. Electronic address: david.palma@lhsc.on.ca.
authors.forename: David
authors.initials: D
authors.lastname: Palma
authors.affiliation: Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Gaspar
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D003906:Developing Countries; D019468:Disease Management; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008507:Medically Underserved Area
keywords: Global health; Low- and middle-income countries; Lung cancer; Non–small cell lung cancer; Quality; Radiotherapy