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Current and Future Challenges of Radiation Oncology in Iran: A Report from the Iranian Society of Clinical Oncology

Published:January 15, 2018DOI:https://doi.org/10.1016/j.clon.2017.12.021

      Highlights

      • This is the first comprehensive study of radiotherapy infrastructure in Iran.
      • There is a significant gap between available facilities for radiation therapy in Iran and international standards.
      • Unequal distribution of equipment restricts access to cancer treatment, remarkably.
      • International economic sanctions endngered cancer treatment, by restrcting access to cobalt-60.

      Abstract

      Aims

      Growth of the cancer incidence rate in Iran has been very high in recent years. Therefore, the Iranian health care system should be prepared for the treatment of a huge number of patients in the foreseeable future. One of the most important treatment options for cancer is radiation. However, there is no comprehensive information on infrastructure for radiation oncology in this country.

      Materials and methods

      In 2015, a questionnaire was designed by the Iranian Society of Clinical Oncology (ISCO) and all radiation oncology centres in the country were visited to determine four important components of radiation oncology services, including facilities, equipment, personnel and patients.

      Results

      In 2015, 94 radiotherapy centres were identified in Iran. Sixty-one centres were fully operational, six centres were commissioning, 26 centres were under construction and one was inactive. Among the fully operational radiotherapy centres, 54 offered three-dimensional conformal radiotherapy and two-dimensional radiotherapy, eight offered brachytherapy, two intensity-modulated radiotherapy, two intraoperative radiotherapy, ostereotactic radiosurgery, two hyperthermia and 59 chemotherapy. Moreover, the survey identified 110 linear accelerators, 25 cobalt-60, one gamma knife, 21 remote brachytherapy afterloaders and six orthovoltage units. Treatment planning equipment included 15 graphy simulators, 19 dedicated computed tomography simulators, 22 multileaf collimator and 12 electronic portal imaging devices. Moreover, in 2015, 243 clinical oncologists participated in the treatment of 42 350 cancer patients in need of radiotherapy, which is about one radiation oncologist for 175 patients. During 2010–2015, number of cobalt-60 reduced 70%, from 25 units to 8 units.

      Conclusions

      There is a significant gap between Iran's available facilities for radiation therapy and international standards. Moreover, during international economic sanctions against Iran this gap widened.

      Key words

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