AbstractIntroduction Cambodia and Mongolia, both low-middle-income countries (LMICs) within the Asia-Pacific (APAC) region, face significant challenges regarding geographical accessibility to radiotherapy facilities (RTFs). This study aims to quantify the current accessibility of RTFs in Cambodia and Mongolia, evaluating the potential benefits and challenges of establishing RTFs in regional provinces. Methods Population and RTF location data were sourced from online databases. Local radiation oncologists identified potential sites for future RTF development. Geographic accessibility was determined by Euclidean distances from province centroids to existing and proposed RTFs. Isochrone maps were generated to measure the percentage of the population residing within two hours of driving time to RTFs. Results In Cambodia, existing RTFs are centralised in Phnom Penh. With proposed developments in Siem Reap and Kampong Cham, the median Euclidean distance would decrease from 135km to 99km. The Cambodian population within two-hours of an RTF is projected to rise from 37% to 50%. The sole RTF in Mongolia is in Ulaanbaatar. A first regional RTF is planned in the Western regional province of Khovd. Three additional sites were modelled in Khangai, Central and Eastern regions. The current median Euclidean distance of 439km would decrease to 273km with the planned RTF in Khovd and to 186km with developments across all health regions. The Mongolian population within a two-hour driving time increases from a baseline of 55% to 56% with the development in Kohvd and 63% should all regional RTFs be developed. Conclusion Geospatial modelling demonstrated an improvement in geographic accessibility with proposed RTF development in regional areas. Improvements in driving time are more significant in Cambodia; however, this still leaves a large proportion of the population with unacceptable travel burden. This study demonstrates the utility and limitations of geospatial analysis in resource planning for APAC LMICs and advocates for further research into the relationship between accessibility and oncological outcomes in such settings.
Leow et al. (Sun,) studied this question.