Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery
Cervical cancer in low and middle income countries: Addressing barriers to radiotherapy delivery
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DOI：
10.1016/j.gore.2017.08.004
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发表时间：
2017-11-01
影响因子：
1.2
通讯作者：
Viswanathan, Akila N.
中科院分区：
文献类型：
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作者：
LaVigne, Anna W.;Triedman, Scott A.;Viswanathan, Akila N.
全球宫颈癌的负担不成比例地落在低收入和中等收入国家的妇女身上。基础设施不足，缺乏获得预防性HPV疫苗、筛查和治疗的机会，以及训练有素的人员和培训机会有限，继续阻碍着这些国家降低发病率和死亡率的努力。这些障碍是对放射治疗的重大挑战，特别是对一种以放射治疗为基础的疾病的预防治疗。在这篇综述中，我们讨论了这些障碍的广度，同时通过提出在缺乏可用的外部放射治疗的情况下单独使用近距离治疗来说明适应性方法的必要性。在资源有限的情况下，对现行指导方针的这种修改对于最大限度地提高宫颈癌的放射治疗是必不可少的。
The global cervical cancer burden falls disproportionately upon women in low and middle-income countries. Insufficient infrastructure, lack of access to preventive HPV vaccines, screening, and treatment, as well as limited trained personnel and training opportunities, continue to impede efforts to reduce incidence and mortality in these nations. These hurdles have been substantial challenges to radiation delivery in particular, preventing treatment for a disease in which radiation is a cornerstone of curative therapy. In this review, we discuss the breadth of these barriers, while illustrating the need for adaptive approaches by proposing the use of brachytherapy alone in the absence of available external beam radiotherapy. Such modifications to current guidelines are essential to maximize radiation treatment for cervical cancer in limited resource settings.