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Anakwenze CP, Ewongwo A, Onyewadume L, Oyekan A, Chigbo CO, Valle L, Geng Y, Olapade P, Okwunze K, Lasebikan N, Jhingran A, Balogun OD, Ntekim A. A systematic review of endometrial cancer clinical research in Africa. Infect Agent Cancer 2024; 19:2. [PMID: 38217018 PMCID: PMC10787484 DOI: 10.1186/s13027-023-00563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Women in Africa are experiencing a rising burden of endometrial cancer. Research and investment to improve treatment and outcomes are critically needed. We systematically reviewed and characterized endometrial cancer-related research within a clinically relevant context to help organize and assess existing endometrial cancer research in Africa. METHODS According to PRISMA guidelines, we searched online databases for published endometrial cancer articles from African countries from January 1, 2011, to July 20, 2021. Based on our inclusion and exclusion criteria, independent reviewers documented the study design, country/region, human development index, focus of research, type of interventions performed, and histologic and molecular type to illustrate the breadth of research coverage in each region. RESULTS A total of 18 research articles were included. With an average Human Development Index (HDI) in Africa of 0.536, the average HDI of the represented countries in this study was 0.709. The majority (88.9%) of prospective endometrial cancer research articles in Africa were from North Africa, with Egypt encompassing 83.3% of the papers. Most of these studies focused on endometrial cancer diagnosis. Research on the treatment of endometrial cancer is still emerging (33% of papers). Of all included articles, only 11.1% represented Sub-Saharan Africa, where the majority population of black Africans reside. CONCLUSIONS Endometrial cancer research in Africa is extremely limited, with the majority being concentrated in African countries with higher HDIs. As the incidence of endometrial cancer rises in Sub-Saharan Africa, there is a pressing need for more prospective clinical research to tackle the growing disease burden and improve outcomes.
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Affiliation(s)
| | - Agnes Ewongwo
- Department of Radiation Oncology, Stanford University, Palo Alto, CA, USA
| | | | - Ademola Oyekan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chinelo Onwualu Chigbo
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Luca Valle
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Yimin Geng
- Research Medical Library, MD Anderson Cancer Center, Houston, TX, USA
| | - Paul Olapade
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Nwamaka Lasebikan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Anuja Jhingran
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Onyinye D Balogun
- Department of Radiation Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Eckstein J, Taylor P, Zheng R, Lee L, Chen W, Potters L, Evans C. Implementation of External Beam Five-Fraction Adjuvant Breast Irradiation in a US Center. Cancers (Basel) 2022; 14:1556. [PMID: 35326707 PMCID: PMC8945963 DOI: 10.3390/cancers14061556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 12/04/2022] Open
Abstract
Five-fraction adjuvant whole breast radiation has been shown to be a safe and effective alternative to longer fractionation regimens. Given the lack of international consensus on patient selection for the protocol, we developed a consensus protocol to guide patient selection and facilitate safe and efficient five-fraction radiation in our radiation medicine department. In developing the directive, we surveyed departmental physicians about their choice of adjuvant breast regimen for various clinical scenarios. Patient travel burden was the factor most strongly impacting radiation oncologists’ decision-making when considering prescribing a five-fraction course of adjuvant breast radiation; the length of clinical trial follow-up data and acute and late normal tissue effects also impacted it, along with personal clinical experience and experience of dosimetry and physics personnel. Relative value unit (RVU) reimbursement and financial toxicity to the patient were reported to be less important in decision-making. Physicians were most comfortable using five-fraction radiation in women >50 years of age with low-risk cancer and for patients unable to attend for longer treatment courses. Eight months after implementation, the protocol accounts for 4.7% of breast irradiation delivered in our department.
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Affiliation(s)
- Jacob Eckstein
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
| | - Peter Taylor
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
| | - Ruqin Zheng
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
| | - Lucille Lee
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
- Zucker School of Medicine, Hofstra University, Hempstead, NY 11549, USA
| | - William Chen
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
- Zucker School of Medicine, Hofstra University, Hempstead, NY 11549, USA
| | - Louis Potters
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
- Zucker School of Medicine, Hofstra University, Hempstead, NY 11549, USA
| | - Clary Evans
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY 11042, USA; (J.E.); (P.T.); (R.Z.); (L.L.); (W.C.); (L.P.)
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