Evidence map›Paper›PMID 41487700›Full record

ArticleAdvances in radiation oncology2026

Lessons Learned From an Epic Transformation of a Radiation Oncology Department in Guatemala: Keys to Success.

Edgar Ruiz, Hiram A Gay, Milton Ixquiac, Angel Velarde, Baozhou Sun, Jose García-Ramirez, Eric Laugeman, Benjamin Li, Jeff Michalski, Vicky de Falla and 2 more

Abstract read
In one paragraph

Article in Advances in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Edgar RuizLiga Nacional Contra el Cancer/INCAN, Guatemala City, Guatemala.
Hiram A GayDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Milton IxquiacLiga Nacional Contra el Cancer/INCAN, Guatemala City, Guatemala.
Angel VelardeLiga Nacional Contra el Cancer/INCAN, Guatemala City, Guatemala.
Baozhou SunDepartment of Radiation Oncology, Baylor College of Medicine, Houston, Texas.
Jose García-RamirezDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Eric LaugemanDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Benjamin LiDepartment of Radiation Oncology, Rayos Contra Cancer, Seattle, Washington.
Jeff MichalskiDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Vicky de FallaLiga Nacional Contra el Cancer/INCAN, Guatemala City, Guatemala.
Geoff HugoDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Jacaranda Van RheenenGlobal Health Center at the Institute of Public Health, Washington University in St. Louis, St. Louis, Missouri.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: We describe the radical modernization of a radiation oncology department in a developing country, Guatemala, from 2015 to the beginning of 2024. The Instituto de Cancerología y Hospital Dr. Bernardo del Valle S (INCAN) is the only public radiotherapy clinic serving patient referrals from the Ministry of Public Health and Social Assistance program. Methods and Materials: We describe the state of the radiation oncology department in 2015 versus 2024 while chronicling its gradual transformation. This multifaceted collaboration involved academic centers, government agencies, International Atomic Energy Agency (IAEA), industry, and nonprofits and continues to this day. We analyze the infrastructure, staff, radiotherapy equipment, physics equipment, patient careCo-60 decommissioning, and educational initiatives. Results: We graphically illustrate the impact of these changes in treatment delivery time, consults, follow-up visits, CT simulations, new patients treated in each linear accelerator, new patients treated with 2D, 3D, IMRT/VMAT, and superficial techniques, new patients treated with 2D LDR, 2D HDR, or 3D techniques, causes of linear accelerator downtime, and weekly patients on treatment. We provide a figure of the various sequential and parallel steps to modernize a radiation oncology department. We describe the complexities of radioisotope repatriation and safe disposal. We provide a comprehensive table of wisdom pearls regarding project governance, team, education, finances, culture, and language. We also discuss the impact of artificial intelligence in contouring. Conclusion: The transformation of the INCAN radiation oncology department in Guatemala is a testimony to many's hard work, vision, and perseverance for the betterment of Guatemalan patients while facing incredible financial hardship. We hope that what we have learned in the past nine years will help others achieve even greater success in a shorter time.

Identifiers

PMID41487700
PMCPMC12756540

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.