Radiotherapy and radiosurgery for intracranial lesions in Africa: Insights from 3 country case studies: A systematic review.

Background: Radiotherapy (RT) and stereotactic radiosurgery (SRS) are important treatment options for central nervous system (CNS) lesions. This review explores the current evidence on the use of radiotherapy and SRS for CNS lesions across Africa.

Methods: A systematic review of the literature was completed according to the PRISMA guidelines. The results were synthesized to provide an overview of the current landscape of RT and SRS, highlighting treatment gaps and areas for further research and collaboration.

Results: Nine studies, involving a total of 397 patients, were included. South Africa contributed the most studies with 4 (44.4%), followed by Nigeria with 3 studies (33.3%). Brain tumors were the most common lesion type, found in 88.8% of cases (95% CI: 66.9-100.0) with metastatic tumors being prevalent in 37.5% of cases (95% CI: 1.6-73.4). The breast was the most frequent origin of metastases seen in 93.67% (95% CI: 80-100). Whole brain radiation therapy was used in 33.3% of patients (95% CI: 0.7-66.0), stereotactic proton beam therapy in 33.3% (95% CI: 0.7-66.1), and gamma knife radiosurgery in 22.3% (95% CI: 0-51.1).

Conclusion: RT and SRS are being implemented for CNS lesions in settings across Africa. Improving access and efficiency of these treatments will require both local and international collaboration to address challenges related to resource management and distribution.