Current status of availability of radiotherapy machines in Nepal.

Abstract

e18042 Background: Nepal is a developing country with about 29 million populations. The incidence of cancer is 100-120 per 100 thousand populations and the number is increasing. The most common cancers in Nepal are of lung (13.2%), cervix (9.5%) and breast (8.6%). More than 80% of cancer patients present in advanced or metastatic stage where palliation can only be the goal of treatment. Radiotherapy is one of the essential treatment modalities for cancer, for both curative and palliative intent. This study aims to find the availability of radiotherapy machines throughout the country. Methods: Data regarding Radiotherapy machines in the country were collected by on site visit and by telephone conversations. Results: There are only seven centers having radiotherapy machines. Bir hospital was the first to start radiotherapy with telecobalt machine. At present there are 4 Tele-Cobalt machines, 5 Linear Accelerators and 5 High Dose Rate (HDR) Brachytherapy machines in the country. Most of the centers do only conventional 2-dimensional radiotherapy treatment. Newer centers which are non-government centers have high end linear accelerators with IMRT and IGRT facilities. HDR brachytherapy are used for intracavitory radiotherapy for endometrial and cervical cancers only. Conclusions: Nepal is far below the World Health Organization (WHO) recommendation of one megavoltage machine per million populations which means that Nepal should have at least 29 megavoltage machines. Combined efforts of public, government and international agencies are required to upgrade the situation.[Table: see text]