External Radiotherapy in Mozambique: Report of the First Five Years of Activity of the Radiotherapy Service of the Maputo Central Hospital.

Background: A Radiotherapy Service (RS) started working in the Maputo Central Hospital (MCH), Mozambique, in August 2019. Here we describe its first 5 years of activity.

Methods: A total of 810 patients who underwent external radiotherapy between August 2019 and December 2023 were considered for the analysis. Sociodemographic and clinical data were retrieved from the RS database, and the MCH Cancer Registry was used to obtain cancer incidence data.

Results: There was an increase in newly admitted patients each year, except in 2023 (161 in 2020, 188 in 2021, 238 in 2022, and 185 in 2023). Patients admitted in 2019 were more likely to be from Maputo city and to receive palliative radiotherapy. The proportion of patients starting radiotherapy within 12, 24, 36, and 48 months after diagnosis was 38.8%, 78.1%, 91.7%, and 96.6%, respectively. There was an increasing trend (p for trend < 0.001) in the proportion of patients admitted with cervical cancer over time (from 34.2% in 2019 to 46.0% in 2023). Differences in radiotherapy initiation within 12 months were observed according to treatment intent (42.6% for palliative vs. 36.9% for curative; p = 0.014) and cancer site (64.5% for rectal/anal cancer vs. 34.8%, 29.5%, and 37.0% for cervical, breast and prostate cancer patients, respectively; p < 0.001).

Conclusions: The RS-MCH improved access to radiotherapy for cancer patients, particularly those with cervical and breast cancers. Patients undergoing palliative treatment and those with anal/rectal cancers started radiotherapy earlier. Further research is needed to evaluate the impact of radiotherapy on mortality, survival, and in patient-centered outcomes.