Radiotherapy resources in the Philippines: A 2022 update.

ABSTRACT

BACKGROUND: Cancer is the third leading cause of death in the Philippines. Radiotherapy (RT) is integral to the treatment and palliation of cancer. Therefore, RT resources across the country must be surveyed and optimized. METHODS: Online surveys were sent to the heads of all 50 RT facilities in the Philippines. The survey included items regarding the facility itself, personnel, and available services. FINDINGS: The survey had a 98% response rate. 76% of RT facilities in the Philippines are privately owned; 12 are government/public institutions and 8 are academic centers. Over a third are in the National Capital Region; three regions are without a single RT facility. For a population of >110 million, the Philippines has 53 linear accelerators, 125 radiation oncologists, 56 residents, 114 medical physicists, 113 radiation oncology nurses, and 343 radiation therapists. Nine radiation oncology residency programs are active. All facilities are capable of 3D conformal radiotherapy, and 96% are capable of intensity modulated radiotherapy. <30% offer stereotactic radiotherapy, and <50% offer HDR brachytherapy. CONCLUSION: While there has been significant expansion of RT resources over the years, RT remains inaccessible for many in the Philippines. Urgent investment in training and retaining RT personnel is needed as well. Policy summary: With its current cancer burden, the Philippines needs at least 170 linear accelerators, 300 radiation oncologists, and 150 medical physicists. Public/government cancer centers must be built, with priority given to regions without RT facilities. HDR brachytherapy and stereotactic radiotherapy services must also be expanded. A national RT task force must be created to ensure the quality, availability, and accessibility of RT in the Philippines. Further work exploring payment schemes that improve access to RT and mitigate financial toxicity is needed, as well as integration of radiation oncology providers and health policy experts into national health system decision making.