{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:04:12Z","timestamp":1774976652203,"version":"3.50.1"},"reference-count":46,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Radiation therapy is crucial in cancer treatment. However, low- and middle-income countries (LMICs), including Central Asia (Kazakhstan, Uzbekistan, Turkmenistan, Kyrgyzstan, Tajikistan), face increasing challenges because of limited radiation oncology resources, compounded by diverse health care systems and vast geography.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A longitudinal, registry-based review analyzed the state of radiation oncology resources in Central Asia to assess current conditions and future needs, considering projected regional growth. Data were sourced from the Directory of Radiotherapy Centres (DIRAC) and GLOBOCAN 2020. A simple linear regression evaluated the relationship between machine capacity rate and Gross National Income (GNI) per capita.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              As of 2022, the region has 75 megavoltage machines and 35 brachytherapy (BT) units, with all but two being high-dose rate BT. The number of megavoltage units per million population varies, ranging from 0.1 to 0.2 in Tajikistan, Kyrgyzstan, and Uzbekistan, and it is 2.3 in Kazakhstan. A significant correlation between GNI per capita and machine capacity was found (R\n              <jats:sup>2<\/jats:sup>\n              = 0.89,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = .014), indicating that higher GNI correlates with increased machine capacity. By 2030, a minimum of 115 megavoltage machines will be needed to meet demand, but only 75 are available as of 2022.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>While progress has been made, there remain significant challenges to ensuring equitable access to radiation therapy across Central Asia, underscoring the need for additional resources to meet growing demands.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/go-25-00271","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T19:59:14Z","timestamp":1758311954000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Radiotherapy Resources in Central Asia: An International Atomic Energy Agency Update"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9228-085X","authenticated-orcid":true,"given":"Sondos","family":"AlKhatib","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5667-8932","authenticated-orcid":true,"given":"Kamal","family":"Akbarov","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Centre of Oncology, Baku, Azerbaijan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9733-0895","authenticated-orcid":true,"given":"Varsha","family":"Hande","sequence":"additional","affiliation":[{"name":"Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9577-011X","authenticated-orcid":true,"given":"Olivera","family":"Ciraj-Bjelac","sequence":"additional","affiliation":[{"name":"Division of Human Health, Department of Nuclear Science and Application, International Atomic Energy Agency IAEA, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May","family":"Abdel-Wahab","sequence":"additional","affiliation":[{"name":"Division of Human Health, Department of Nuclear Science and Application, International Atomic Energy Agency IAEA, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/10732748221095955"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00452-2"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00222-3"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.03.024"},{"key":"e_1_3_5_7_2","article-title":"Global radiotherapy: Current status and future directions-white paper","author":"Abdel-Wahab M","unstructured":"Abdel-Wahab M, Gondhowiardjo SS, Rosa AA, et al: Global radiotherapy: Current status and future directions-white paper. JCO Glob Oncol 10.1200\/GO.21.00029","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_5_8_2","volume-title":"CENTRAL ASIA","author":"(UNCCD) SotUNCtCD","year":"2023","unstructured":"(UNCCD) SotUNCtCD: CENTRAL ASIA. 2023. https:\/\/www.unccd.int\/sites\/default\/files\/2023-11\/Fact%20sheet%20Central%20Asia%20EN.pdf"},{"key":"e_1_3_5_9_2","volume-title":"World Bank in Central Asia","author":"Bank W","year":"2022","unstructured":"Bank W: World Bank in Central Asia. 2022. https:\/\/www.worldbank.org\/en\/region\/eca\/brief\/central-asia"},{"key":"e_1_3_5_10_2","volume-title":"Roadmap for Health and Well-Being in Central Asia (2022\u20132025)","author":"(WHO) WHO","year":"2022","unstructured":"(WHO) WHO. Roadmap for Health and Well-Being in Central Asia (2022\u20132025). World Health Organization (WHO), 2022. Contract No: Document number: WHO\/EURO:2022-5905-45670-65601"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000992"},{"key":"e_1_3_5_12_2","volume-title":"Roadmap for Health and Well-Being in Central Asia (2022\u20132025)","year":"2022","unstructured":"Roadmap for Health and Well-Being in Central Asia (2022\u20132025). Copenhagen, Denmark: WHO Regional Office for Europe, 2022. Contract No: WHO\/EURO:2022-5905-45670-65601"},{"key":"e_1_3_5_13_2","unstructured":"(IAEA) IAEA: DIrectory of RAdiotherapy Centres 2023 [DIRAC] v2.0.7 (20486). https:\/\/dirac.iaea.org\/"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.52532\/2663-4864-2020-4-58-4-11"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100362"},{"key":"e_1_3_5_16_2","unstructured":"Sodikova N. Collaborative action for cancer care: Uzbekistan UNOPS and IsDB deliver a major oncology equipment initiative. 2024."},{"key":"e_1_3_5_17_2","volume-title":"World Bank Country and Lending Groups","year":"2022","unstructured":"World Bank Country and Lending Groups. 2022. https:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519-world-bank-country-and-lending-groups"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-009067"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33232"},{"key":"e_1_3_5_20_2","volume-title":"World Population Prospects","year":"2019","unstructured":"World Population Prospects. United Nations. 2019"},{"key":"e_1_3_5_21_2","unstructured":"WHO: WHO medical device technical series: WHO list of priority medical devices for cancer management. 2017"},{"key":"e_1_3_5_22_2","unstructured":"WHO: WHO model lists of essential medicines. 2019"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.09.001"},{"key":"e_1_3_5_24_2","unstructured":"World Bank estimates. https:\/\/datatopics.worldbank.org\/world-development-indicators\/"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.05.014"},{"key":"e_1_3_5_26_2","volume-title":"Radiotherapy in Cancer Care: Facing the Global Challenge","author":"International Atomic Energy Agency","year":"2017","unstructured":"International Atomic Energy Agency: Radiotherapy in Cancer Care: Facing the Global Challenge. Vienna, Austria: International Atomic Energy Agency. 2017 (IAEAL 17-01089). https:\/\/www-pub.iaea.org\/MTCD\/Publications\/PDF\/P1638_web.pdf"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00619-8"},{"key":"e_1_3_5_28_2","volume-title":"Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects","author":"I\u017cewska J","year":"2008","unstructured":"I\u017cewska J: Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects. 2008. https:\/\/www-pub.iaea.org\/MTCD\/Publications\/PDF\/pub1296_web.pdf"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00351-X"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.07.579"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2020.07.015"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.06.074"},{"key":"e_1_3_5_33_2","unstructured":"Roser M Rohenkohl B Arriagada P et al: Annual growth of GDP per capita. Economic Growth. Data adapted from World Bank and OECD national accounts. 2023. https:\/\/archive.ourworldindata.org\/20250903-083611\/grapher\/gdp-per-capita-growth.html"},{"key":"e_1_3_5_34_2","volume-title":"Cancer Tomorrow: GLOBOCAN","author":"International Agency for Research on Cancer","year":"2020","unstructured":"International Agency for Research on Cancer: Cancer Tomorrow: GLOBOCAN. 2020. https:\/\/gco.iarc.fr\/tomorrow\/en"},{"key":"e_1_3_5_35_2","unstructured":"World Health Organization Regional Office for Europe: Roadmap for health and wellbeing in Central Asia (2022\u20132025). 2022. https:\/\/www.who.int\/europe\/publications\/i\/item\/WHO-EURO-2022-5905-45670-65601"},{"key":"e_1_3_5_36_2","volume-title":"Central Asian Governments Discuss the Integration of Gender Equality into Climate Change Policies","year":"2022","unstructured":"Central Asian Governments Discuss the Integration of Gender Equality into Climate Change Policies. Ashgabat, Turkmenistan, United Nations Turkmenistan, 2022. https:\/\/turkmenistan.un.org\/en\/172094-central-asian-governments-discussintegration-gender-equality-climate-change-policies."},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2016.11.011"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2013.12.022"},{"key":"e_1_3_5_39_2","volume-title":"Sustainable Management of Radiotherapy Facilities and Equipment","author":"WHO","year":"2023","unstructured":"WHO: Sustainable Management of Radiotherapy Facilities and Equipment. Geneva, Switzerland, World Health Organization, 2023"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30751-8"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100292"},{"key":"e_1_3_5_42_2","volume-title":"tc-kyrgyzstan","author":"IAEA","year":"2019","unstructured":"IAEA: tc-kyrgyzstan. 2019"},{"key":"e_1_3_5_43_2","unstructured":"Yusuf O: Tajikistan inaugurates its first radiotherapy centre in its Northern Province with IAEA support 2019. https:\/\/www.iaea.org\/newscenter\/news\/tajikistan-inaugurates-its-first-radiotherapy-centre-in-its-northern-province-with-iaea-support"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.07.006"},{"key":"e_1_3_5_45_2","volume-title":"This Action is Funded by the European Union Annex I","author":"EU Commission\/European Union","year":"2023","unstructured":"EU Commission\/European Union: This Action is Funded by the European Union Annex I. 2023. Contract No: 2"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00407-8"},{"key":"e_1_3_5_47_2","article-title":"Benefits of adopting hypofractionated radiotherapy as a standard of care in low-and middle-income countries","author":"Kraus RD","unstructured":"Kraus RD, Weil CR, Abdel-Wahab M: Benefits of adopting hypofractionated radiotherapy as a standard of care in low-and middle-income countries. JCO Glob Oncol 10.1200\/GO.22.00215","journal-title":"JCO Glob Oncol"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-25-00271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T19:59:23Z","timestamp":1758311963000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-25-00271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1200\/GO-25-00271"],"URL":"https:\/\/doi.org\/10.1200\/go-25-00271","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-16","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500271"}}