abstract: 'Background The demand for radiotherapy in Brazil is unfulfilled, and the

  scarcity of data on the national network hampers the development of

  effective policies. We aimed to evaluate the current situation, estimate

  demands and requirements, and provide an action plan to ensure access to

  radiotherapy for those in need by 2030.Methods The Brazilian Society for

  Radiation Oncology created a task force (RT2030) including physicians,

  medical physicists, policy makers, patient advocates, and suppliers, all

  of whom were major stakeholders involved in Brazilian radiotherapy care.

  The group was further divided into seven working groups to address

  themes associated with radiotherapy care in Brazil. From March 1, 2019,

  to Aug 3, 2020, there were monthly meetings between the group''s leaders

  and the Central Committee and six general meetings. First, a

  comprehensive search of all different national databases was done to

  identify all radiotherapy centres. Questionnaires evaluating

  radiotherapy infrastructure and human resources and assing the

  availability, distribution, capacity, and workload of resources were

  created and sent to the radioprotection supervisor of each centre.

  Results were analysed nationally and across the country''s regions and

  health-care systems. A pre-planned review of available databases was

  done to gather data on active radiation oncology centres and the

  distribution of radiotherapy machines (linear accelerators {[}LINACs])

  across Brazil. We used national population and cancer incidence

  projections, recommended radiotherapy usage from the medical literature,

  and national working patterns to project radiotherapy demands in 2030.

  An action plan was established with suggestions to address the gaps and

  meet the demands.Findings The database search yielded 279 centres with

  an active radiotherapy registry. After applying predefined exclusion

  criteria, 263 centres were identified that provided external beam

  radiotherapy machines with or without brachytherapy. All 263 operational

  centres answered the questionnaires sent on Dec 9, 2019, which were then

  returned between Jan 1 and June 30, 2020. There were 409 therapy

  machines, 646 radiation oncologists, 533 physicists, and 230 989

  patients undergoing radiotherapy (150 628 {[}65 \& BULL;2\%] in the

  public health-care system and 80 937 {[}35 \& BULL;0\%] in private). The

  mean annual occupation rate was 566 patients per treatment machine (SD

  250). The number of residents per treatment machine ranged from 258 333

  to 1 800 000. Technology availability varied considerably among regions

  and systems. In 2030, 639 994 new cancer cases are expected, which will

  require 332 797 radiotherapy courses. Therefore, 530 LINACs, 1079

  radiation oncologists, and 1060 medical physicists will be needed.

  Interpretation The expected increase in cancer incidence in the coming

  years will probably increase the disparities in cancer care and the

  burden for Brazilian patients. We provide a roadmap of the current

  situation and the particularities of the Brazilian radiotherapy network,

  which can serve as a starting point for cancer policy planning to

  improve this scenario.Copyright \& COPY; 2023 Elsevier Ltd. All rights

  reserved.'
affiliation: 'Moraes, FY (Corresponding Author), Queens Univ, Kingston Gen Hosp, Dept
  Oncol, Div Radiat Oncol, Kingston, ON K7L 5P9, Canada.

  Rosa, Arthur Accioly, Grp Oncoclin, Salvador, BA, Brazil.

  Rosa, Arthur Accioly; Moraes, Fabio Ynoe; Marta, Gustavo Nader, Latin Amer Cooperat
  Oncol Grp, Porto Alegre, Brazil.

  de Sousa, Cecilia Felix Penido Mendes; Marta, Gustavo Nader, Hosp Sirio Libanes,
  Dept Radiat Oncol, Sao Paulo, Brazil.

  Pimentel, Leonardo Cunha Furbino; Castilho, Marcus Simoes, Hosp Felicio Rocho, Dept
  Radiat Oncol, Belo Horizonte, Brazil.

  Martins, Homero Lavieri, Brazilian Assoc Phys \& Rehabil Med, Sao Paulo, Brazil.

  Moraes, Fabio Ynoe, Queens Univ, Kingston Gen Hosp, Dept Oncol, Div Radiat Oncol,
  Kingston, ON K7L 5P9, Canada.'
author: Rosa, Arthur Accioly and de Sousa, Cecilia Felix Penido Mendes and Pimentel,
  Leonardo Cunha Furbino and Martins, Homero Lavieri and Moraes, Fabio Ynoe and Marta,
  Gustavo Nader and Castilho, Marcus Simoes
author-email: fydm@queensu.ca
author_list:
- family: Rosa
  given: Arthur Accioly
- family: de Sousa
  given: Cecilia Felix Penido Mendes
- family: Pimentel
  given: Leonardo Cunha Furbino
- family: Martins
  given: Homero Lavieri
- family: Moraes
  given: Fabio Ynoe
- family: Marta
  given: Gustavo Nader
- family: Castilho
  given: Marcus Simoes
da: '2023-09-28'
eissn: 1474-5488
files: []
issn: 1470-2045
journal: LANCET ONCOLOGY
keywords-plus: 'MIDDLE-INCOME COUNTRIES; RADIATION-THERAPY; CANCER; ACCESS; RETREATMENT;

  FRACTIONS; PATTERNS; DEMAND; NUMBER; TOOL'
language: English
month: AUG
number: '8'
number-of-cited-references: '44'
pages: 903-912
papis_id: 4c4c04a24484ab88badfff843134f458
ref: Rosa2023radiotherapyresource
times-cited: '0'
title: 'Radiotherapy resources in Brazil (RT2030): a comprehensive analysis and projections
  for 2030'
type: article
unique-id: WOS:001053116500001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '24'
web-of-science-categories: Oncology
year: '2023'