Unfortunately, non-communicable diseases in Mozambique have not been given a proper attention, mostly due to the high incidence of infectious diseases like malaria and cholera, which are characteristic of tropical regions. However, the last years have witnessed a dramatic rise of reports on non-communicable diseases, including cancer, in various health facilities. In our previous publication entitled Cancer incidence and radiation therapy in Mozambique - a comparative study to Sweden, we noticed that the cancer of the cervix has the highest incidence in Mozambique. Several treatment options are available for this type of cancer. The main treatment modality for cervical cancer is surgery but for advanced cancer stage, which is often the case in Mozambique, radiation therapy (RT) is a well-established modality. In combination with surgery, RT can be administered either preoperative or postoperatively. Definitive RT alone includes external beam radiation therapy (EBRT) to the pelvis and intracavitary brachytherapy (BT). Even if EBRT is not available, BT alone can minimize the impact of cervical cancer. Brachytherapy is therefore a very important component of the treatment of cervical cancer and also an attractive option for a country impaired of financial resources. BT is inexpensive in relation to EBRT. The overall goal of this project is the optimization of brachytherapy for cervical cancer in order to improve the treatment not only in clinical terms but also in a cost-effective manner. The specific aims are focused on the comparison of different treatment planning approaches with the manual planning with respect to the dose to the target and the doses to the organs at risk. The comparison between inverse planning and manual optimization will also be performed with respect to radiobiological parameters combining the volumes and the doses received by either the target or the organs at risk (OARs) with parameters describing the sensitivity to radiation of the various tissues involved. The inverse planning techniques for brachytherapy will be further developed and optimised based on physical and radiobiological parameters. It is important to stress that optimization methods are the way to go for a country that has few human and financial resources, which appear to be the case of Mozambique. Optimization methods will allow the clinicians to treat more patients than if they had used conventional planning methods. In fact, Mozambique will have a radiation therapy center in a near future; therefore, this project may appear relevant. The nation will also host the first Linear accelerator at the Department of Physics of the University Eduardo Mondlane. The Linear accelerator project is partially supported by Sida. To conclude, novel and optimized ways of delivering brachytherapy of the cervical cancer have the potential to benefit the whole programme of radiation therapy in Mozambique and ultimately reduce the suffering and pain of many local women who cannot afford to travel abroad to receive radiation treatment.
