IAEA – RCA 6065 Project

IAEA – RCA 6065 ProjectStrengthening the Application of SBRT to Improve Cancer Care

INTRODUCTION TO THE IAEA RCA RAS 6065 PROJECT

Dr Daniel TanCourse DirectorAssociate ConsultantDepartment of Radiation OncologyNational Cancer Centre Singapore


Aim:

To help Participants understand the Origins and Purpose of this Project


Acknowledgements:

The contents of this presentation include a combination of presentations and discussions made/held during the project planning meeting held on 11-15th June 2012.

Project management Officer IAEA/TC Mr Kesrat SukasamTechnical Officer IAEA/HH Dr Rajiv Ranjan PrasadLead Country Coordinator KIRAMS Dr Cho Chul-KooMeeting Rapporteurs Dr Fiona Hegi (Sydney) and myself


Scope:

IAEA and Radiation OncologyOrganizational Structure of RCA ProjectsRCA 6065 Project Meeting1st RTCSummary


IAEA and Radiation Oncology:

The IAEA is the world's center of cooperation in the nuclear field. It was set up as the world´s "Atoms for Peace" organization in 1957 within the United Nations family. The Agency works with its Member States and multiple partners worldwide to promote safe, secure and peaceful nuclear technologies.



Project management Officer: IAEA/TC Mr Kesrat Sukasam

Technical Officer:IAEA/HH Dr Rajiv Ranjan Prasad


Technical Cooperation:

to increasingly promote tangible socio-economic impact by contributing directly in a cost-effective manner to the achievement of the major sustainable development priorities of each country


Technical Cooperation:develop human capacities in Member States

advise Member States on technical and managerial matters, and

establish/upgrade physical facilities, including legislation and regulations

with the ultimate objective to support countries in their efforts towards using nuclear science and technology and applying nuclear techniques to address developmental problems


TCDC: Technical cooperation among developing countries (TCDC) – draws on regionally available skills and facilities, and strengthens links between institutions in a region. Through participation in regional TC projects, IAEA Member States with more developed nuclear sectors share their knowledge and amenities with other countries with less advanced nuclear sectors.> Regional Cooperative Agreements build national and regional ownership and encourage economies of scale and the efficient use of limited resources> Provide a basis for intensified collaboration among countries through programs and projects that are focused on their specific shared needs.


Technical Cooperation:

32 Recipient Member States/TerritoriesSize of TC programme for 2010: @ $32 millionAnnual disbursement: over $24 million through national and regional projects

Two Regional Agreements:

RCA for East Asia (Regional Cooperative Agreement for Research, Development and

Training Related to Nuclear Science and Technology: 17 member states)ARASIA for West Asia (Cooperative Agreement for Arab States in Asia for Research,

Development and Training related to Nuclear Science and Technology: 8 member states)







Project management Officer: IAEA/TC Mr Kesrat Sukasam

Technical Officer:IAEA/HH Dr Rajiv Ranjan Prasad



Division of Human Health:






RCA 6065:





















PROJECT 6065

LEAD COUNTRY COORDINATORChul-Koo CHO, M.D., Ph.DDirector General, Korea Cancer Center HospitalPresident, Korea Heavy IonMedical Accelerator ProjectKorea Institute of Radiological& Medical Sciences (KIRAMS)


RCA RAS6065:

Project Planning Meeting, Seoul June 11-15


RCA RAS6065:

Meeting June 11-15


Category A: Active SBRT programmes.Includes Australia, China, India, Indonesia, Japan, Korea, Singapore, Thailand.

Category B: Equipment in place for SBRT and planned implementation of SBRT within the near future.

Includes Bangladesh, Malaysia, the Philippines, Pakistan, Sri Lanka.

Category C: Lack basic physical infrastructure and human resources to implement SBRT with no immediate plans for SBRT implementation.

Includes Mongolia, Myanmar and Vietnam.


Key areas identified for work-plans:

Training and education of radiation oncology workforce in the clinical evidence base and technical delivery of SBRT.

Development of education materials, with either hard-copy or online publicationRegional training courses Development of expertise, with collaboration between centres to raise the level of technical expertise and clinical knowledge.


Key areas identified for work-plans:

Education of broader community, including referring clinicians, patients and government about the benefits of SBRT.

Advocacy for greater financial and human capital investment by Governments to facilitate the implementation of SBRT.

Development of evidence based guidelines and protocols for clinical and technical implementation. This should include formal frameworks for identification of suitable patients, safe delivery of SBRT, and ongoing quality assurance.

Research collaborations with data pooling to facilitate quality assurance, and publication of local control and toxicity outcomes.


Site and Clinical Focus:

Liver ( HCC and metastases)Lung ( Early stage NSCLC and Metastases)Prostate (Early prostate cancer)Spine ( Vertebral metastases and primary spinal tumours)Retreatment


HOW?

Development of treatment protocols, and review of established protocols (at a regional level). This will also include formulation of a report assessing the utility and cost-benefit implications of the implementation of SBRT in the region.

Regional Training Course to provide training of radiation oncology professional to increase the understanding of the concept of SBRT.

Advocacy with education of Government bodies responsible for policy making and funding of advanced radiotherapy technologies, and education of the wider medical community and public about the benefits of SBRT.


HOW?

Expert Missions to enhance the implementation of SBRT with on-site training in selected countries.

Publication:

Hard –copy and web-based publication of education materials on SBRT, specifically developed for the region; Publication on the status of the project, and the results of implementation including SBRT utilisation rates before and after the project, local control and toxicity figures.

Formation of Regional Training Hubs.


Regional Training Hubs

Sustain technical cooperation among developing countries after completion of the project.

To reduce cost of training on SBRT To overcome the language barrier, especially for radiation technicians/therapists and

thereby promote more efficient education. To propagate the objectives of our project more efficiently To mobilise more resources for neighbouring countries with a better rationale. To facilitate research activities on SBRT, by collecting and reviewing clinical data

The regional hub should facilitate and promote excellence in scientific research.


Regional Training Hubs

India for south-west Asia, China for North-East Asia, and Singapore for other surrounding countries.


RTC: Focus Expectations/target groups Tentative schedule Potential hostBasic concept of SBRT(beginning)-including QA/QC, immobilization, image, radiation biology(experts also provided by AUL)

Understanding of concept / Radiation Oncologists, Medical Physicists

3~7 Dec 2012 SIN(Back-up: IND)

Clinically oriented, variousindication of SBRT(liver, lung)*Protocol development should be done before

Implementation of clinical study /Radiation Oncologists

7~11 Oct 2013 ROK(Back-up: JPN)

Clinically oriented, various indication of SBRT(Another tumor type: Head & Neck, liver)

Implementation of clinical study /Radiation Oncologists, medical physicists, radiation technologist

4Q 2014 CPR(Back-up: THA)

Clinically oriented, variousindication of SBRT(Another tumor type: Lung, spine, prostate)*topics needs further discussion at the mid-term meeting

Implementation of clinical study /Radiation Oncologists, Radiation Therapists, Physicist

TBD 2015 AUL(Back-up: JPN, ROK)


1st RTC:

BASIC CONCEPTS AND EARLY IMPLEMENTATION

Introduction to the concept of SBRT Demonstrate its use and potential in oncologyDemonstrate its highly complex natureDemonstrate the breadth of knowledge requiredProvide a starting point for future development


Summary:

As members of the RCA, we have the privilege and opportunity to tap on the framework and resources of IAEA to advance collaboration and cooperation between our institutions, with the end point of building up our oncological capabilities to better serve our people.

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IAEA – RCA 6065 Project