Objectives: To assess whether the criteria for disinvestment in health technologies—clinical, technological advantage, safety, lifecycle, human factor and costs—are applicable for the withdrawal of cobalt-60 radiotherapy units (Co-60 RTUs) in Latin America, considering health outcomes, and that the economic context, replacing this technology with linear accelerators (LINACs) is not always feasible. Methods: A systematic review of articles published between 2003 and 2017 in PubMed, Cochrane Library and CRD on the current use of Co-60 RTUs and publications comparing them with LINACs has been made. With a manual search of the references of selected articles. Results: The clinical results indicate that Co-60 RTUs have a significant role in treatment of patients with tumors of head, neck, breast and some types of superficial soft tissue sarcomas of the extremities. The comparison between Co-60 RTUs and LINACs results in advantages for linear accelerators in: the variety of cancer type that can be treated, the delivery of treatment, lifecycle and safety. In terms of acquisition costs, although Co-60 RTUs are comparable to a low-energy LINACs. Considering the number of existing Co-60 RTUs in Latin America, their effectivity and safety in the treatment of some types of cancer and the shortage of skilled professionals, its use can still be beneficial. Conclusions: Whereas in Latin America more than 26% of radiotherapy equipment are Co-60 RTUs, available economic resources and staff are limited. A recommendation is to continue utilizing such equipment in some types of cancer where they can be used: head, neck, breast and superficial sarcomas extremity soft tissue and allocate the use of existing LINACs for other types of cancer and in special cases like pediatric patients.
CITATION STYLE
Aguilar, D. M., de la Rosa, A. P., Román, E. H. S., Vilchis, A. B., Gómez, F. R., & Yudiche, A. C. (2019). Cobalt-60 radiotherapy units, assessment of the utilization or disinvestment in Latin America. In IFMBE Proceedings (Vol. 68, pp. 407–412). Springer Verlag. https://doi.org/10.1007/978-981-10-9023-3_73
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