Introduction of afterloading low dose-rate brachytherapy for cervical cancer in Kenya

The Amersham afterloading low dose-rate brachytherapy system for cervical cancer was introduced in Kenya in 1986. The long intrauterine and medium size vaginal applicators were the most frequently used. Complications were generally few except for vesicovaginal fistulae (4%), some of which may not have been entirely due to irradiation. The system was acceptable to both patients and staff. The prolonged treatment times of approximately 50 hours was however, a drawback, and grossly limited the number of patients treatable per week. Low dose-rate brachytherapy is safe and acceptable but is not recommended for units with heavy patient loads. Constraints to establishment of radiotherapy facilities in developing countries are discussed and recommendations for further improvement of services in Kenya highlighted.