IAEA Report Highlights Benefits of Hypofractionation in Radiotherapy for Cancer Patients

The report emphasizes that hypofractionation offers multiple benefits, including lower costs, increased treatment precision, and reduced treatment time, which could free up machine time and enhance access to critical care.

A Lancet Oncology Commission report led by the International Atomic Energy Agency (IAEA) reveals that implementing hypofractionation—fewer but higher doses of radiation per treatment session over a shorter time frame—could extend radiotherapy access to an additional 2.2 million patients globally, particularly for those with prostate and breast cancer. The report emphasizes that hypofractionation offers multiple benefits, including lower costs, increased treatment precision, and reduced treatment time, which could free up machine time and enhance access to critical care. Key Findings and Recommendations:

Unveiled during the American Society for Radiation Oncology meeting in Washington, DC, the report underscores the need for cost-effective radiotherapy approaches, particularly in low- and middle-income countries (LMICs) where access to radiotherapy and theranostics remains limited. The insights stem from a comprehensive survey of 200 radiotherapy centers across 55 countries.

Treatment Needs: Approximately 50 to 70 percent of all cancer patients require radiotherapy, with over half of this population residing in LMICs. The report advocates for global efforts to strengthen infrastructure and build cancer care capacities, citing the IAEA’s Rays of Hope initiative as a vital step in addressing these gaps.

Projected Workforce Demand: By 2050, a projected surge in cancer cases necessitates a workforce increase of over 60 percent to meet the demand for 84,646 radiation oncologists, 47,026 medical physicists, and 141,077 radiotherapy technologists worldwide.

Economic Impact of Radiotherapy Investments

Investments in radiotherapy can yield significant economic benefits, estimated between $278.1 billion and $365.4 billion globally from 2015 to 2035. The report indicates that substituting 50 percent of conventional radiotherapy with hypofractionated methods could save approximately $2.76 billion for prostate and breast cancer treatments. If the substitution reaches 80 percent, savings could increase to $4.41 billion.

“For healthcare practitioners and policymakers, this report serves as a crucial evidence base to encourage the adoption of resource-sparing approaches that are both safe and effective,” said May Abdel-Wahab, co-lead author and Director of the IAEA Division of Human Health. She also highlighted the cost-effectiveness of advanced technologies like stereotactic body radiation therapy compared to conventional methods.

Access to Theranostics

Building on the 2015 Lancet Oncology Commission focused on expanding access to radiotherapy, the current report evaluates the availability of both radiotherapy and theranostics—a combination of diagnostic and therapeutic radionuclides. This approach demands specialized knowledge in radiation principles and imaging technologies.

Social Impact Analysis: Health economics modeling for radiopharmaceutical treatments for prostate cancer indicates a potential social impact of $725 million over seven years. However, the Commission's survey highlights significant challenges, including supply chain issues, workforce training, and regulatory hurdles.

“This report underscores the urgent need to ensure adequate supplies, equipment, infrastructure, and personnel for effective theranostics delivery,” said Andrew Scott, co-lead author and Professor at the University of Melbourne.

Calls to Action

The Commission advocates for targeted actions and investments to improve global access to radiotherapy and theranostics, especially in LMICs, to realize both health and economic benefits while reducing the cancer burden.

“Access to high-quality cancer care remains a pressing issue for many patients globally,” said IAEA Director General Rafael Mariano Grossi. “The Lancet Oncology Commission report presents compelling data and recommendations to enhance access to necessary care.”

The Rays of Hope initiative, launched in 2022, aims to broaden access to cancer care in LMICs by enhancing the availability of radiotherapy services, medical imaging, and nuclear medicine. A network of regional Anchor Centres has been established to offer specialized support and expertise to neighboring countries, emphasizing education, training, research, and quality assurance.

As the demand for effective cancer treatment continues to rise, embracing innovative strategies such as hypofractionation and expanding theranostics can play a crucial role in improving global health outcomes, especially in underserved regions. The IAEA's commitment to initiatives like Rays of Hope will be vital in ensuring that no patient is left behind in accessing the care they need.