2991 - Patterns and Early Outcome of Radiotherapy in Ethiopia: A Prospective Cohort Study

03:00pm - 04:00pm PT

Hall F

Screen: 27

POSTER

Presenter(s)

Ryan Smith, MD, PhD - University of Minnesota, Minneapolis, MN

B. Habtamu¹, T. Rick^2,3, R. Smith⁴, W. Heemsbergen⁵, and L. Incrocci⁶; ¹Department of Radiation Oncology, Hiwot Fana Comprehensive Specialized Hospital Haramaya University, Harar, Ethiopia, ²University of Minnesota, Minneapolis, MN, ³Erasmus MC, Rotterdam, Netherlands, ⁴University of Minnesota Department of Radiation Oncology, Minneapolis, MN, ⁵Erasmus Medical Centre, Rotterdam, Netherlands, ⁶Department of Radiotherapy, Erasmus Medical Center, Rotterdam, Netherlands

Purpose/Objective(s):

Ethiopia, a country with a population exceeding 100 million, had only a single cancer center providing 2D Cobalt-60 radiotherapy until 2019. In 2023, modern radiotherapy techniques—including 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT)—became available with the commissioning of linear accelerators. Our previous research documented the patterns of Cobalt-60 radiotherapy in Ethiopia, particularly highlighting wait time of 5 months for curative treatment¹?4 With the expansion of modern radiotherapy to four regions, little is known about radiotherapy outcomes. This study aims to describe the initial experiences with linear accelerator-based radiotherapy and initial 3-month patient status in Ethiopia, focusing on the Harari region in Eastern Ethiopia.

Materials/Methods:

This prospective cohort study included consecutive patients who completed curative-intent radiotherapy with 3D-CRT, VMAT, and IMRT for cancer at Haramaya University Hiwot Fana Comprehensive Specialized Hospital in Harar, Ethiopia, between January 2023 and July 2024. Data collected included patient demographics, tumor characteristics, and treatment details. Clinical outcomes were assessed at 3-months post treatment. Primary outcome patient status at 3 months: mortality, progression, lost to follow up, and not reported (not considered lost to follow yet). Descriptive statistics were computed using statistical software for data analysis.

Results:

Among 214 consecutively treated patients with curative intent who completed treatment, 69% were female (n=148) and the median age was 45 years (IQR 34-58). Breast cancer was the most frequent cancer treated (26%, n=56) followed by head and neck cancer (20%, n=42), and cervical cancer (18%, n=38). Fifty percent of patients presented at late stage (stage III/IV or inoperable) (50%, n=106). The most frequent radiotherapy regimen was 40 Gy in 15 fractions for breast cancer (53/214, 25%). Wait time was 7 days or less for a majority of patients (123/213, 58%) with nearly all patients being treated within 30 days (210/214, 98%). There was no documented grade 3-4 toxicity. At 3-months follow up there was missing data on 56 patients. For the remaining 158 patients, n=133 (62%) were progression free, n=14 (9%) were lost to follow up, n=8 (5%) had died, and n=3 (2%) had progression.

Conclusion:

Modern radiotherapy in Ethiopia has increased treatment capacity and reduced wait time from months to days. Efforts are curative despite late stage. Initial 3 month toxicity and rates of treatment failure is low and future efforts include assessment of long term outcome to assess efficacy.