{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:17:00Z","timestamp":1786976220613,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["UF160117"],"award-info":[{"award-number":["UF160117"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>The lack of equitable access to radiotherapy (RA) linear accelerators (LINACs) is a substantial barrier to cancer care in low\u2010 and middle\u2010income countries (LMICs). These nations are expected to bear up to 75% of cancer\u2010related deaths globally by 2030. State\u2010of\u2010the\u2010art LINACs in LMICs experience major issues in terms of robustness, with mechanical and electrical breakdowns resulting in downtimes ranging from days to months. While existing research has identified the higher failure frequency and downtimes between LMICs (Nigeria, Botswana) compared to high\u2010income countries (HICs, the UK), there has been a need for additional data and study particularly relating to multileaf collimators (MLCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This study presents for the first time the analysis of data gathered through a dedicated survey and workshop including participants from 14 Indonesian hospitals, representing a total of 19 LINACs. We show the pathways to failure of radiotherapy LINACs and frequency of breakdowns with a focus on the MLC subsystem.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This dataset shows that LINACs throughout Indonesia are out of operation for seven times longer than HICs, and the mean time between failures of a LINAC in Indonesia is 341.58 h or about 14 days. Furthermore, of the LINACs with an MLC fitted, % of all mechanical faults are due to the MLC, and  % of cases requiring a replacement component are related to the MLC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results highlight the pressing need to improve robustness of RT technology for use in LMICs, highlighting the MLC as a particularly problematic component. This work motivates a reassessment of the current generation of RT LINACs and demonstrates the need for dedicated efforts toward a future where cancer treatment technology is robust for use in all environments where it is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.13756","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T11:54:26Z","timestamp":1661342066000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Failure modes and downtime of radiotherapy LINACs and multileaf collimators in Indonesia"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5504-7995","authenticated-orcid":false,"given":"Gregory Sadharanu","family":"Peiris","sequence":"first","affiliation":[{"name":"School of Physics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriyanto Ardjo","family":"Pawiro","sequence":"additional","affiliation":[{"name":"Department of Physics, Faculty of Mathematics and Natural Sciences Universitas Indonesia  Depok City Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Firmansyah","family":"Kasim","sequence":"additional","affiliation":[{"name":"Department of Physics University of Oxford  Oxford England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-7205","authenticated-orcid":false,"given":"Suzie Lyn","family":"Sheehy","sequence":"additional","affiliation":[{"name":"Department of Physics University of Oxford  Oxford England"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(15)00222\u20103"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.18.00200"},{"key":"e_1_2_10_4_1","unstructured":"Targeting cancer. 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