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Building Comprehensive Stereotactic Body Radiation Therapy Programs in a Limited-Resource Setting: Experience From
Luisa E Jacomina1, Paolo G Sogono2, Ryan Anthony F Agas3
1Department of Radiation Oncology, University of Santo Tomas Hospital, Manila, Philippines; Asian Cancer Institute, Asian Hospital and Medical Center, Muntinlupa, Metro Manila, Philippines; Department of Radiation Oncology, Healthway Cancer Care Hospital, Taguig City, Metro Manila.
None:
Stereotactic body radiation therapy (SBRT) is an emerging therapeutic modality in modern oncology, offering highly conformal, ablative radiation in a few fractions. However, implementing SBRT in limited-resource settings presents substantial challenges. This editorial describes the current SBRT landscape in the Philippines, a large lower-middle-income country in Southeast Asia with a rising cancer burden but constrained radiation therapy capacity. Of the 62 radiation therapy centers nationwide, only 14 (25%) have SBRT-capable technology, all privately operated and largely concentrated in the National Capital Region. SBRT remains markedly underutilized because of limitations in infrastructure, trained personnel, and patient access. As SBRT capacity continues to expand, we highlight the importance of establishing sustainable, comprehensive SBRT programs that incorporate robust clinical and technical quality assurance and outline practical strategies relevant to limited-resource settings, including streamlined workflows, hub-and-spoke care models, collaborative partnerships, strengthened data infrastructure, and equitable financing mechanisms. The commitment of dedicated practitioners and leadership from the national professional society will be essential to expanding safe, high-quality SBRT access in the Philippines.