ReviewJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
Establishing and Delivering Quality Radiation Therapy in Resource-Constrained Settings: The Story of Botswana.
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Review in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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29citing papers in PubMed, 2 pooled it
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Access to Radiation Therapy and Related Clinical Outcomes in Patients With Cervical and Breast Cancer Across Sub-Saharan Africa: A Systematic Review.JCO global oncology · 2023Pooled it
- Barriers and facilitators to implementation of cancer treatment and palliative care strategies in low- and middle-income countries: systematic review.International journal of public health · 2018Pooled it
- Online adaptive radiotherapy: International strategies for AI-enabled workflow efficiency and radiation therapist-led delivery for sustainable practice.Technical innovations & patient support in radiation oncology · 2026Article
- Pace of Cervical Cancer Stage Progression Prior to Radiation Therapy Initiation, an Instrumental Variable Analysis.International journal of radiation oncology, biology, physics · 2026Article
- Adherence to Survivorship Care Visits in Patients With Cervical Cancer in Botswana.JCO global oncology · 2026Observational
- Improving Access to Radiotherapy in Gauteng: A Framework for Equitable Cancer Care.International journal of environmental research and public health · 2025Article
- Improving Access to Radiotherapy: Exploring Structural Quality Indicators for Radiotherapy in Gauteng Province, South Africa.International journal of environmental research and public health · 2025Article
- Improving Access to Radiotherapy Services in Gauteng: Quantitative Analysis of Key Time Intervals from Diagnosis to Treatment.International journal of environmental research and public health · 2025Article
- Efficacy of induction chemotherapy during the COVID-19 pandemic for treatment of locally advanced cervical cancer in Botswana.Gynecologic oncology · 2025Observational
- A qualitative study of patient experiences: socioeconomic barriers to radiotherapy access in Gauteng, South Africa.Ecancermedicalscience · 2025Article
- Empowering radiation therapists: The role of an African Community of Practice in developing radiation Therapist education curriculum.Technical innovations & patient support in radiation oncology · 2024Article
- Radiation-induced dermatitis among breast cancer patients undergoing adjuvant radiotherapy in Ghana.Translational oncology · 2024Article
- "A Soft Death": Perceptions and Attitudes Toward Palliative Care in Senegal.Innovation in aging · 2024Article
- Bibliometric analysis of cancer research outputs in Botswana between 2009 and 2021.Journal of cancer policy · 2023Review
- Evolving practice in global healthcare: Remote physics support for low- and middle-income countries.Journal of applied clinical medical physics · 2023Article
- Cancer in sub-Saharan Africa: a Lancet Oncology Commission.The Lancet. Oncology · 2022Review
- The relationship between urologic cancer outcomes and national Human Development Index: trend in recent years.BMC urology · 2022Article
- The Effect of PD-1 Inhibitor Combined with Irradiation on HMGB1-Associated Inflammatory Cytokines and Myocardial Injury.Journal of inflammation research · 2022Article
- Utilization and predictors of postmastectomy radiation receipt in an Oncology Center in Zimbabwe.Breast cancer research and treatment · 2021Article
- Radiotherapy resources in Africa: an International Atomic Energy Agency update and analysis of projected needs.The Lancet. Oncology · 2021Article
Corrections and comments
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Authors and funding
14 authors.
Jason A EfstathiouJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe. jefstathiou@partners.org.
Magda HeunisJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Talkmore KarumekayiJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Remigio MakufaJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Memory Bvochora-NsingoJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
David P GiergaJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Gita SunejaJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Surbhi GroverJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Joseph KaseseJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Mompati MmalaneJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Howard MoffatJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Alexander von PaleskeJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Joseph MakhemaJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Scott Dryden-PetersonJason A. Efstathiou, David P. Gierga, Massachusetts General Hospital, Harvard Medical School; Scott Dryden-Peterson, Brigham and Women's Hospital, Boston, MA; Magda Heunis, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa; Talkmore Karumekayi, Remigio Makufa, and Memory Bvochora-Nsingo, Gaborone Private Hospital; Joseph Kasese, Bokamoso Private Hospital; Mompati Mmalane, Joseph Makhema, and Scott Dryden-Peterson, Botswana Harvard AIDS Institute; Howard Moffat, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Huntsman Cancer Hospital, Salt Lake City, UT; Surbhi Grover, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Alexander von Paleske, Mpilo-Hospital, University of Zimbabwe, Bulawayo, Zimbabwe.
Funding
Risk factors for early morbidity and mortality of HIV-exposed uninfected infantsK23AI091434 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI DRYDEN-PETERSON, SCOTT · 2012 to 2016
$659kNIAID NIH HHS K23 AI091434
Abstract
There is a global cancer crisis, and it is disproportionately affecting resource-constrained settings, especially in low- and middle-income countries (LMICs). Radiotherapy is a critical and cost-effective component of a comprehensive cancer control plan that offers the potential for cure, control, and palliation of disease in greater than 50% of patients with cancer. Globally, LMICs do not have adequate access to quality radiation therapy and this gap is particularly pronounced in sub-Saharan Africa. Although there are numerous challenges in implementing a radiation therapy program in a low-resource setting, providing more equitable global access to radiotherapy is a responsibility and investment worth prioritizing. We outline a systems approach and a series of key questions to direct strategy toward establishing quality radiation services in LMICs, and highlight the story of private-public investment in Botswana from the late 1990s to the present. After assessing the need and defining the value of radiation, we explore core investments required, barriers that need to be overcome, and assets that can be leveraged to establish a radiation program. Considerations addressed include infrastructure; machine choice; quality assurance and patient safety; acquisition, development, and retention of human capital; governmental engagement; public-private partnerships; international collaborations; and the need to critically evaluate the program to foster further growth and sustainability.
Indexed as
BotswanaDelivery of Health CareDeveloping CountriesHumansNeoplasms
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