National Radiotherapy Service Planning

Introduction

All countries should ensure the accessibility and effectiveness of radiotherapy services by adopting evidence-based clinical and management guidelines and by establishing good referral, follow-up and evaluation systems, and continuous training of the different health professionals involved.

Before initiating a radiotherapy programme, the numbers of annual patient treatments need to be estimated. The population within the area from which the institution will draw patients and the annual cancer ratio for that area will yield the approximate number of new cancer patients per year. Approximately 50–60% of these patients will require radiation therapy, alone or as an alternative or adjuvant treatment to surgery.

The planning of radiotherapy services at a national level can be approached following the stepwise framework devised by WHO for the development of national cancer control programmes. The assessment includes an epidemiological map of the incidence, types and geographical distribution of cancer, the infrastructure and resources currently available to cope with these patients and the current radiotherapy utilization rate (RUR) in a country. The resources that need to be quantified include the number of existing teletherapy machines and radiotherapy fractions given per year per million people, the number of fractions delivered per year by each machine and variation in protocols treatment as measured by the number of fractions given for common indications

National cancer control plans

In response to the developing world's growing cancer crisis, the IAEA established the Programme of Action for Cancer Therapy (PACT) in 2004 to realize fully the public health impact obtained through technology transfer in radiation therapy and nuclear medicine. PACT was launched as an IAEA initiative, but its vision is for a global public-private partnership and fund to confront the cancer crisis, including the formation of a joint programme on cancer control with the World Health Organization (WHO). This joint programme will allow close collaboration with WHO and other key international health organizations through a coordinated global response in developing strategies and specific plans for working with low and middle income (LMI) Member States in the design and implementation of comprehensive cancer control programmes.

PACT presents ambitious long-term goals for the next 20 years. These principal goals are:

1. To build a global public-private partnership of interested organizations committed to addressing the challenge of cancer in LMI Member States in all its aspects;
2. To mobilize resources from charitable trusts, foundations, and others in the public and private sectors to assist LMI Member States to develop and implement their radiation medicine capacities within a national cancer control programme (NCCP); and
3. To ensure the effective and sustainable transfer of radiation medicine technologies or knowledge to all LMI Member States where unmet needs exist.

In the short term, the IAEA is working through PACT with WHO and other partners to raise cancer awareness on a global scale, assess needs in individual countries or regions and develop successful demonstration projects that will attract donors to support these life-saving initiatives to help sustain and replicate positive outcomes.