A review published in The Lancet Oncology reveals significant shortfalls in radiotherapy equipment and manpower across Europe.
The study reports on information in the Directory of Radiotherapy Centres (DIRAC) for 1286 radiotherapy centers in 33 European countries as of July 2012.
There was 5.3 external beam (teletherapy) machines per million residents in Europe, but significant variation between countries, from fewer than two machines per million residents in Macedonia and Romania to over eight machines per million in Denmark, Switzerland, Belgium, Finland, and Sweden.
Of concern, there was an apparent shortage of machines in many countries. Unmet needs - defined as the proportion of patients who would not receive recommended radiotherapy - was particularly high across eastern and southern European countries, such as Bulgaria (64%), Macedonia (67%), and Romania (72%). Other countries with a significant deficit include Germany (20%), Italy (16%), Austria (20%), Portugal (19%), and the UK (21%).
The researchers note that radiotherapy services are fragmented, with 28 of the 33 countries having fewer than four machines per site, and six countries having no more than two machines. Sites often have only one or two types of equipment and specialize in treating specific cancers.
By contrast, there were equipment clusters of four to 10 machines and personnel in Sweden, the UK, the Netherlands, Denmark, and Slovenia.
"The fragmentation in radiotherapy services that prevails in many European countries might affect the economic burden of radiotherapy and its quality," say Eduardo Rosenblatt, from the International Atomic Energy Agency in Vienna, Austria, and co-authors.
The researchers recommend further investigation on how radiotherapy equipment and organization impact on cancer treatment outcomes, and how best to optimize radiotherapy service efficiency.
"Despite being more cost-effective than surgery and chemotherapy for treating cancer, the building and running of a radiotherapy centre requires substantial financial and technical investment, so countries need to plan ahead," explained Rosenblatt in a press release.
"Our data should enable governments, European Union bodies, and international organisations to see at a glance how adequate the provision of radiotherapy is in each European country. For the first time, it gives countries the ability to plan investment objectively and ensure the building and maintenance of sufficient capacity to meet the ever-increasing demand," he added.
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