Clinical oncology最新文献

{"title":"Perspectives on Academic Training in Clinical Oncology in the United Kingdom: A National Cross-Sectional Analysis","authors":"C.M. Jones ,&nbsp;W.H. Ng ,&nbsp;K. Spencer ,&nbsp;G.M. Walls","doi":"10.1016/j.clon.2024.08.007","DOIUrl":"10.1016/j.clon.2024.08.007","url":null,"abstract":"<div><h3>Aims</h3><div>There are longstanding concerns relating to clinical academic training pipelines, with evidence for multiple barriers and enablers to clinical academic career progression. We sought to assess the extent to which these and other factors apply to academic training in clinical oncology in the United Kingdom.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional survey was undertaken using a bespoke, pre-piloted online electronic questionnaire that was distributed to clinical oncology specialty trainees and consultants who had at any point between January 2013–January 2024 commenced an academic post whilst in training. Collated information included demographic data, location and stage of training, research experience and ambitions, research skill confidence and academic career progression.</div></div><div><h3>Results</h3><div>Seventy eligible responses were included, representing 84% (n = 16/19) of UK training deaneries. Thirty-seven (53%) of the respondents had obtained their certificate of completion of training (CCT) whilst 11% (n = 8/70) and 40% (n = 28/70) were at specialty trainee level and respectively pre- or within-/post-doctoral studies. Of 34 post-CCT respondents, 58% (n = 20) had ongoing research commitments but this reached 30% of their overall activity for just 30% (n = 10). Barriers to academic progression included clinical training requirements, post availability and limited mentorship. Most (60%; n = 35/58) undertook doctoral studies in their final two training years. A majority of respondents lacked confidence in radiation oncology (RO) skills relevant to their career ambitions, with 60%, 40% and 30%, respectively, confident in RO clinical research outcome evaluation, <em>in vitro</em> radiation analyses and using RO animal models.</div></div><div><h3>Conclusion</h3><div>These data provide a granular, long-term analysis of academic clinical oncology training at a national level; identifying poor progression to research independence underlined by limited confidence in RO research skills and multiple barriers to academic career progression. These data provide areas in which policy makers, research funders and training programmes can focus to improve academic training in clinical oncology.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages 669-680"},"PeriodicalIF":3.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Constitutional Genomic Testing on Current Breast Cancer Care.","authors":"W Cheah, R I Cutress, D Eccles, E Copson","doi":"10.1016/j.clon.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.clon.2024.08.006","url":null,"abstract":"<p><p>The most commonly diagnosed cancer in women worldwide is cancer of the breast. Up to 20% of familial cases are attributable to pathogenic mutations in high-penetrance (BReast CAncer gene 1 [BRCA1], BRCA2, tumor protein p53 [TP53], partner and localizer of breast cancer 2 [PALB2]) or moderate-penetrance (checkpoint kinase 2 [CHEK2], Ataxia-telangiectasia mutated [ATM], RAD51C, RAD51D) breast-cancer-predisposing genes. Most of the breast-cancer-predisposing genes are involved in DNA damage repair via homologous recombination pathways. Understanding these pathways can facilitate the development of risk-reducing and therapeutic strategies. The number of breast cancer patients undergoing testing for pathogenic mutations in these genes is rapidly increasing due to various factors. Advances in multigene panel testing have led to increased detection of pathogenic mutation carriers at high risk for developing breast cancer and contralateral breast cancer. However, the lack of long-term clinical outcome data and incomplete understanding of variants, particularly for moderate-risk genes limits clinical application. In this review, we have summarized the key functions, risks, and prognosis of breast-cancer-predisposing genes listed in the National Health Service (NHS) England National Genomic Test Directory for inherited breast cancer and provide an update on current management implications including surgery, radiotherapy, systemic treatments, and post-treatment surveillance.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence for Radiation Treatment Planning: Bridging Gaps From Retrospective Promise to Clinical Reality","authors":"L. Conroy ,&nbsp;J. Winter ,&nbsp;A. Khalifa ,&nbsp;G. Tsui ,&nbsp;A. Berlin ,&nbsp;T.G. Purdie","doi":"10.1016/j.clon.2024.08.005","DOIUrl":"10.1016/j.clon.2024.08.005","url":null,"abstract":"<div><div>Artificial intelligence (AI) radiation therapy (RT) planning holds promise for enhancing the consistency and efficiency of the RT planning process. Despite technical advancements, the widespread integration of AI into RT treatment planning faces challenges. The transition from controlled retrospective environments to real-world clinical settings introduces heightened scrutiny from clinical end users, potentially leading to decreased clinical acceptance.</div><div>Key considerations for implementing AI RT planning include ensuring the AI model performance aligns with clinical standards, using high-quality training data, and incorporating sufficient data variation through meticulous curation by clinical experts. Beyond technical aspects, factors such as potential biases and the level of trust clinical end users place in AI may present unforeseen obstacles for real-world clinical use.</div><div>Addressing these challenges requires bridging education and expertise gaps among clinical end users, enabling them to confidently embrace and utilize AI for routine RT planning. By fostering a better understanding of AI capabilities, building trust, and providing comprehensive training, the promises of AI RT planning can be a reality in the clinical setting.</div><div>This article assesses the current clinical use of AI RT planning and explores challenges and considerations for bridging gaps in knowledge and expertise for AI operationalization, with focus on training data curation, workflow integration, explainability, bias, and domain knowledge. Remaining challenges in clinical implementation of AI RT treatment planning are examined in the context of trust building approaches.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103630"},"PeriodicalIF":3.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome Comparison between CT-Guided Versus all MRI-Guided Scenarios in Brachytherapy for Cervical Cancer: A Single-Institute Experience","authors":"P. Dankulchai,&nbsp;T. Prasartseree ,&nbsp;W. Sittiwong,&nbsp;Y. Chansilpa,&nbsp;N. Apiwarodom,&nbsp;J. Petsuksiri,&nbsp;K. Thephamongkhol,&nbsp;T. Treechairusame,&nbsp;T. Jitwatcharakomol,&nbsp;J. Setakornnukul,&nbsp;A. Teyateeti,&nbsp;W. Rongthong,&nbsp;W. Thaweerat,&nbsp;N. Suntornpong,&nbsp;V. Veerasarn,&nbsp;P. Tuntapakul,&nbsp;N. Chareonsiriwat,&nbsp;S. Manopetchkasem","doi":"10.1016/j.clon.2024.08.003","DOIUrl":"10.1016/j.clon.2024.08.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Image-guided adaptive brachytherapy (IGABT) is the standard of care for patients with cervical cancer. The objective of this study was to compare the treatment outcomes and adverse effects of computed tomography (CT)-guided and magnetic resonance imaging (MRI)-guided scenarios.</div></div><div><h3>Materials and Methods</h3><div>Data of patients with cervical cancer treated using external beam radiotherapy followed by IGABT from 2012 to 2016 were retrospectively reviewed. CT-guided IGABT was compared with the three modes of MRI-guided IGABT: pre-brachytherapy (MRI Pre-BT) without applicator insertion for fusion, planning MRI with applicator in-place in at least 1 fraction (MRI ≥1Fx), and MRI in every fraction (MRI EveryFx). Patient characteristics, oncologic outcomes, and late radiation toxicity were analyzed using descriptive, survival, and correlation statistics.</div></div><div><h3>Results</h3><div>Overall, 354 patients were evaluated with a median follow-up of 60 months. The 5-year overall survival (OS) rates were 61.5%, 65.2%, 54.4%, and 63.7% with CT-guided, MRI PreBT, MRI ≥1Fx, and MRI EveryFx IGABT, respectively with no significant differences (p = 0.522). The 5-year local control (LC) rates were 92.1%, 87.8%, 80.7%, and 76.5% (p = 0.133), respectively, with a significant difference observed between the CT-guided and MRI ≥1Fx (p = 0.018). The grade 3–4 late gastrointestinal toxicity rates were 6% in the CT-guided, MRI ≥1Fx, and MRI EveryFx, and 8% in MRI PreBT. The grade 3–4 late genitourinary toxicity rates were 4% in the CT-guided, 2% in MRI PreBT, 1% in MRI ≥1Fx, and none in MRI EveryFx. No significant differences were observed in the oncologic and toxicity outcomes among MRI PreBT, MRI ≥1Fx, and MRI EveryFx.</div></div><div><h3>Conclusions</h3><div>CT-guided IGABT yielded an acceptable 5-year OS, LC, and toxicity profile compared with all MRI scenarios and is a potentially feasible option in resource-limited settings.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages e456-e467"},"PeriodicalIF":3.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Conformal Radiotherapy Versus Image-Guided Intensity Modulated External Beam Radiotherapy in Locally Advanced Cervical Cancer: A Phase III Randomized Control Study","authors":"B. Rai ,&nbsp;T. Dey ,&nbsp;N. Ballari ,&nbsp;M. Singh ,&nbsp;R. Miryala ,&nbsp;G.Y. Srinivasa ,&nbsp;V. Kataria ,&nbsp;R. Naseem ,&nbsp;S. Thakur ,&nbsp;O. Arun Singh ,&nbsp;S. Ghoshal","doi":"10.1016/j.clon.2024.08.004","DOIUrl":"10.1016/j.clon.2024.08.004","url":null,"abstract":"<div><h3>Aims</h3><div>The standard treatment of locally advanced cervical carcinoma is radical chemoradiation followed by brachytherapy which has improved survival. Hence, a major concern is our attempt to reduce the incidence of acute and late toxicities. IMRT has been shown to reduce toxicities. In this study, we have compared 3DCRT with IG-IMRT using patient-specific margins to evaluate tumor control as well as OAR-related toxicities.</div></div><div><h3>Materials and Methods</h3><div>This was a single institution prospective phase III randomised control study including patients of squamous cell carcinoma of cervix (stage II–IIIB, FIGO 2009) without pelvic lymph node involvement. All patients were simulated using intermediate bladder filling protocol and those in the IG-IMRT arm, underwent additional scans with full and empty bladder to assess the range of internal motion and generate individualised ITV margin. EBRT dose of 46Gy/23#/4.5 weeks was delivered with weekly concurrent cisplatin followed by brachytherapy. All toxicities during EBRT and till 3 months post brachytherapy were considered acute toxicity. Post-treatment, patients were followed up every 2 months for first 2 years and then once every 6 months. Disease-related outcomes were assessed with clinical examination and symptom-directed imaging.</div></div><div><h3>Results</h3><div>Two hundred patients were screened for inclusion and of them, 89 patients in 3DCRT and 84 patients in IG-IMRT arms were considered for final analysis. The baseline characteristics were comparable in both arms, majority of patients in both arms having stage II disease. For OARs, all dosimetric parameters were significantly better in the IG-IMRT arm. Acute radiation induced toxicities (dermatitis, genito-urinary and gastrointestinal toxicities) were significantly less in the IG-IMRT arm. The local, pelvic, and distant control were comparable in both arms.</div></div><div><h3>Conclusion</h3><div>Based on our experience, the use of IG-IMRT with patient-specific ITV margins results in reduction in acute OAR toxicities in patients without compromising on tumor control.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages 728-737"},"PeriodicalIF":3.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Paired Whole Genome Sequencing Service for Children With Cancer.","authors":"L Sarkies, P Thomas, E A Edeko, S Leiter, J Trotman, R Armstrong, A Vedi","doi":"10.1016/j.clon.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.clon.2024.07.009","url":null,"abstract":"<p><strong>Background: </strong>The uniqueness of paired (tumor and germline) whole genome sequencing (PWGS) in cancer diagnosis and management lies in not just its ability to uncover oncogenic drivers and potential treatment targets but also on the identification of underlying cancer predisposition syndromes, which has significant implications for the patient and their family.</p><p><strong>Aims: </strong>This is a descriptive article highlighting the processes taken by our team to incorporate PWGS into routine National Health Service (NHS) clinical care for children with cancer. The main aim of this article is to share our experience with other centers that may wish to set up similar services and set the stage for future quantitative/qualitative research.</p><p><strong>Methods: </strong>This article is further supported by an audit focusing on children in whom an underlying cancer predisposition was confirmed.</p><p><strong>Results: </strong>The audit highlights the success of the program to date, with 100% of families identified as being at risk of a cancer predisposition syndrome being offered referral to clinical genetics and 100% of at-risk first-degree relatives being offered predictive counseling and testing. Areas requiring improvement included discussion of reproductive options as only six out of nine families (67%) had a documented discussion.</p><p><strong>Conclusions: </strong>Incorporation of the audit recommendations will improve our service, and sharing of our experience will hopefully encourage more pediatric oncology services to introduce PWGS into routine clinical care and reduce inequity of access. Further work is required to assess the long-term cancer risk reduction and establish the psychosocial impact of PWGS for the child and family.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Quality Indicators in Radiation Oncology: Insights and Implications.","authors":"N S Salma, R Vysakh, C P Ranjith, P T Anjana, T Gupta, S Laskar","doi":"10.1016/j.clon.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.clon.2024.07.010","url":null,"abstract":"<p><strong>Aims: </strong>Over the past two decades, significant progress has been made in the development of quality indicators (QIs) within the field of radiotherapy (RT). However, most of the literature has predominantly focused on process and outcome-related QIs, with limited attention given to structural QIs. This review aims to address this gap by providing insights into structural QIs in RT and examining the complexities and considerations involved in establishing universal standards for these indicators across RT facilities globally.</p><p><strong>Methods: </strong>An extensive review of published evidence in each sub-topic was performed using PubMed search strategies, current review papers, national and international guidelines and reports, and personal expertise in the field.</p><p><strong>Results: </strong>Considering their direct impact on treatment outcomes, this article identifies five structural QIs to ensure quality treatment in RT. They are workload, infrastructure, machine downtime, adequacy of training, and access to RT services.</p><p><strong>Conclusions: </strong>Developing international guidelines for structural QIs in RT can significantly enhance treatment outcomes. The first step toward achieving this goal is to assess the limitations faced by lower and middle-income countries (LMICs) and devise practical solutions to overcome these challenges.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best-Practice Biomarker Testing of Oesophago-Gastric Cancer in the UK: Expert Consensus Recommendations Developed Using a Modified Delphi","authors":"N.P. West ,&nbsp;W. Mansoor ,&nbsp;P. Taniere ,&nbsp;E. Smyth ,&nbsp;M. Rodriguez-Justo ,&nbsp;A. Oniscu ,&nbsp;P. Carter","doi":"10.1016/j.clon.2024.08.002","DOIUrl":"10.1016/j.clon.2024.08.002","url":null,"abstract":"<div><h3>Aims</h3><div>Oesophago-gastric cancers (OGCs) are amongst the most commonly diagnosed malignancies worldwide and are associated with high disease-related mortality. Predictive biomarkers are molecules that can be objectively measured and used to indicate a likely response to therapeutic intervention, thus facilitating individualised cancer therapy. However, there remains variation in uptake and implementation of biomarker testing across the UK.</div></div><div><h3>Materials and methods</h3><div>We conducted a modified Delphi study to formulate consensus recommendations for best-practice biomarker testing of OGC in the UK. We employed two rounds of online questionnaires followed by a virtual consensus meeting. Biomarkers for discussion included HER2, MSI/MMR, and PD-L1. Topics comprised the overall biomarker pathway, pre-analytical, analytical, and post-analytical considerations, including challenges in current practice.</div></div><div><h3>Results</h3><div>Twenty-six and eighteen participants completed the first and second round Delphi questionnaire, respectively, with an even split of pathologists and oncologists from across the UK. There was consensus (&gt;80% agreement) across several topics, including the requirements for standardisation of the pathway, which must include coordination throughout the tissue journey, requirements for a quality-assured process to ensure accuracy and validity of testing, plus the need for clear, detailed information on the pathology report to support treatment decisions. There was consensus amongst oncologists regarding reflex testing of all biomarkers depending on histology; however, concerns over capacity in relation to workload and availability of pathologists were evident among the pathologists. Overall, participants were in the opinion that reflex testing improves the speed of treatment decisions and improves patient care.</div></div><div><h3>Conclusion</h3><div>The recommendations reflect best-practices and should be implemented to support rapid multidisciplinary team decision-making within oesophago-gastric cancer. Results reflect the need for standardisation and demonstrate the challenges faced in clinical practice by those requesting and testing biomarkers for oesophago-gastric cancer, suggesting significant concerns relating to pathologist capacity.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages 701-709"},"PeriodicalIF":3.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on an Original Research Article, Post-irradiation Dysbiosis in Patients With Nasopharyngeal Carcinoma Having Received Radiotherapy–A Pilot Study","authors":"R.K. Gopal,&nbsp;P. Sankar Ganesh,&nbsp;N.N. Pathoor","doi":"10.1016/j.clon.2024.08.001","DOIUrl":"10.1016/j.clon.2024.08.001","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages e470-e471"},"PeriodicalIF":3.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future Needs of External Beam Radiotherapy in Portugal Until 2040","authors":"E.D. Rodrigues ,&nbsp;P. Almeida ,&nbsp;E. López Ramírez ,&nbsp;L. Teixeira","doi":"10.1016/j.clon.2024.07.011","DOIUrl":"10.1016/j.clon.2024.07.011","url":null,"abstract":"<div><h3>Aims</h3><div>External beam radiotherapy (EBRT) is essential to offer an effective cancer treatment, but it needs to be accessible, well-timed, and high-quality. There is a global lack of radiotherapy infrastructure and investment that compromises the cancer outcomes. The authors aim to quantify the future needs of EBRT until 2040 to cover the future demand.</div></div><div><h3>Materials and methods</h3><div>Based on the Global Cancer Observatory estimate for new cancer cases in Portugal for 2040 it was calculated the optimal number of EBRT courses. The OUP is the proportion of new cancer cases that should receive EBRT at least once. In line with the International Atomic Energy Agency (IAEA) DIrectory of RAdiotherapy Centres and European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology guidelines, we estimated the number of EBRT machines / Megavoltage (MV) units needed. Also, the authors followed the IAEA staffing guidelines.</div></div><div><h3>Results</h3><div>The calculated median increase in the optimal number of EBRT courses for the year 2040 was found to be 18% when compared to the requirements in 2020. The projected number of optimal EBRT courses for 2040 was estimated to be approximately 34.000. Consequently, a range of 18 to 30 new EBRT machines/ MV units will need to be installed to adequately address the growing demand. To meet this demand, it is anticipated that a total of 28 to 46 radiation oncologists, 22 to 36 medical physicists, and 61 to 102 radiation therapists will be required.</div></div><div><h3>Conclusion</h3><div>The deficit of EBRT machines / MV units in Portugal will require a change in the cancer related – policies and an investment to offer full access to EBRT treatments.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages e421-e428"},"PeriodicalIF":3.2,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}