Comparative analysis of radiotherapy LINAC downtime and failure modes in
the UK, Nigeria and Botswana
Clinical Oncology Springer Verlag
Authors:
Laurence M Wroe, Taofeeq A Ige, Obinna C Asogwa, Simeon C Aruah, Surbhi Grover, Remigio Makufa, Suzanne L Sheehy, Matthew Fitz-Gibbon
Abstract:
The lack of radiotherapy linear accelerators (LINACs) in Low- and
Middle-Income countries (LMICs) has been recognised as a major barrier to
providing quality cancer care in these regions, along with a shortfall in the
number of highly qualified personnel. It is expected that additional challenges
will be faced in operating precise, high tech radiotherapy equipment in these
environments, and anecdotal evidence suggests that LINACs have greater downtime
and higher failure rates of components than their counterparts in High-Income
Countries. To guide future developments such as the design of a LINAC tailored
for use in LMIC environments, it is important to take a data-driven approach to
any re-engineering of the technology. However, no detailed statistical data on
LINAC downtime and failure modes has been previously collected or presented in
the literature.
This work presents the first known comparative analysis of failure modes and
downtime of current generation LINACs in radiotherapy centres in Oxford (UK),
Abuja, Enugu, Lagos, Benin (Nigeria) and Gaborone (Botswana). By deconstructing
the LINAC into 12 different subsystems, it is shown that the failure rate in an
LMIC environment compared to the High Income Country (HIC) is more than twice
as large in 7 of the 12 subsystems. The results of this study inform future
attempts to mitigate the problems affecting LINACs in LMIC environments.