Re-engineering the Next Generation of Medical Linear Accelerators for Use in Challenging Environments
The STELLA collaboration has the goal to enhance access to cancer radiation therapy in Low- and Mid-Income Countries (LMICs). In the face of this growing burden there is a global shortage of radiation therapy equipment, staff, opportunities for education and training as well as innovation in treatment technology. This lack of access to RT in Low- and Mid-Income Countries (LMICs) was articulated in 2015 by the Lancet Commission on Radiation Therapy.
Ideally, the RT service would be provided with linear accelerators (LINACs) that offer state-of-the-art treatment. It is safer than treatment with cobalt-60 sources, with the added benefit that LINACs have no radioactive sources thereby avoiding security risks. Currently, RT technology built for the developing world is of high cost to acquire and is complex to operate and service. Africa, a continent with over 1.2 billion inhabitants has just over 400 linacs .The population served by each linac is a critical factor in evaluating the RT services provided by countries. The IAEA recommendation is 1 unit for every 250,000 people and yet none of the 54 countries in Africa is even close to being able to satisfy this recommendation. The lack of RT capacity is especially pronounced in the Sub-Saharan region where most of the 27 African countries that do not have linacs are located. As a quick comparison, Switzerland with a population of 8.8 million has 85 LINAC (1 LINAC per 96,600 people), UK with 67.8 million has 357 LINAC (1 LINAC per 190,000 people), and the USA with 341.6 million have 3879 (1 LINAC per 88,000 people).
In recognition of both the shortfall of RT services in LMICs and the poor performance in LMICs of LINACs currently designed for use in high income countries, Project STELLA was initiated by ICEC in collaboration with CERN, STFC, UK universities and African partners.