REFLECTIONS ON RADIOTHERAPY IN VIETNAM - POLITICAL LESSONS STILL TO BE LEARNED

Radiotherapy in Vietnam represents a stark contrast to the level of ca re available in the United States. The issue of efficient administrati on of cancer care with available resources is common to both nations. The challenge for each country is to develop treatment strategies and political policies for effective and accessible care within budgetary constraints. Results of therapy, defined as the restoration of functio n, must be the measure of efficacy and efficiency. This demands a bala nce between control of tumor-related symptoms and treatment-related mo rbidity. The most inefficient use of resources is an ineffective treat ment that results in complications, as we observed in Vietnam. As heal th care policies continue to develop in the United States, we must not fail to focus upon therapeutic outcome as the single most important p arameter for measuring success relative to the personal and public inv estment in medicine.