Tata Memorial Hospital (TMH)

Advanced Centre for Treatment, Research & Education in

Cancer (ACTREC)

Grant in Aid Institution of The Dept. Of Atomic Energy (DAE), Govt. of India

TATA MEMORIAL CENTRE

TMH Commissioned by the House of TATAs 1941

CRI Commissioned 1952

TMH transferred under administrative control of DAE 1962

Tata Memorial Centre (TMC) – TMH and CRI 1966

ACTREC – CRI moves to new campus 2002

ACTREC – CRC inaugurated 2005

Homi Bhabha Block 2011

Centre for Women and Children 2020

TMC Proton Therapy Centre 2020

New Case File

Registrations

State-wise Distribution Jammu & Kashmir175

Himachal Pradesh10

Chandigarh20

Delhi94

Punjab89

Haryana70

Rajasthan672

W. Bengal3643

Tripura139

Meghalaya27

Assam 720

Arunachal Pradesh41

Nagaland22

Manipur244

Mizoram47

Orissa1029

Gujarat485

Maharashtra (excl. Mumbai)

15030

Mumbai5383

Goa199

Kerala86

Tamil Nadu59

Karnataka275

Andhra Pradesh201

Uttaranchal82

Uttar Pradesh4630 Bihar

2694

Madhya Pradesh2018

Jharkhand1120

Chhattisgarh492

Sikkim10

Total - 62162

Patients - 35199

Preventive - 5739

Referals- 16444

Andaman & Nicobar 3

Pondicherry 3

Dadra & Nagar Haveli 19

Daman & Diu 11

Clinical Research

Secretariat (CRS)

Legal Advisor

Research Infrastructure

•Designated space

•Personnel

•Pharmacy/ Labs

•Logistic support etc

Institutional Ethics

Committee (IEC)

•Review

•Monitoring (DSMSC)

Institutional

Administrative Support

•Financial support

•Admin / Policy

IEC I/ II/ III

DSMSC

TMH Research

Admin. Council (TRAC)

HRPP Co-ordinator

Quality Manager

TMC

“Human Research Protection Program (HRPP)”

DCGI, SIDCER, AAHRPP Accredited

RESEARCH AREAS

● Efficacy

● Multicentre Randomized trials

● Screening trials

● Effectiveness

● Quality of life studies

● Epidemiological studies

● Cost effectiveness analysis

• Hypothesis testing

• Audits

• Retrospective studies

• New Drugs

• New Treatment

• Lab studies

• Overviews

• Meta-analysis

● Problems unique to our country/developing countries

● Development of Low Cost technology: Broad Applicability

● Test new technology

● Challenging existing dogma

Total Area : 3,287,263 Sq. km

Total Population (X1000) : 1.2 Billion

Official languages : 14

Life Expectancy : 64.7 years

Rural/urban population : 70/30

Literacy Rate : 59%

Infant Mort. Rate : 54.6 deaths /1000 Live Births

Infectious Diseases : Still major heath care burden

New Cancer Cases/ Yr : 1 million (approx)

Health Insurance coverage: 15%

Governmental Initiatives:Rashtrya Swasthiya Bima Yojana (RSBY) - 302 million citizens (National Scheme)Rajiv Arogyasri Scheme – Andhra PradeshChief Ministers Health Insurance Scheme – Tamil NaduVajpayee Arogyashree Scheme – KarnatakaSelf Employed Women’s Organization

Limited funding

Lancet Oncology 2014

The “Hub & Spoke Model” & National Cancer Grid (NCG)

Established in August 2012 – At the Tata Memorial Center, Mumbai

Funded by The Govt. of India through the Dept. of Atomic Energy (DAE)

Objective –

Patient Care:

Link Cancers Centers across the country

Evolving uniform standards of care across India

Adopt evidence based management guidelines

Peer review of centers for self-evaluation & improvement

Education & Training:

Exchange of expertise & mentoring

Manpower training

Creation of “National Cancer Library” – Share journals/ e-resources

Collaborative Research:

Multicentric studies

Basic, Translational & Clinical research – Common cancers

Currently – 105 Centres Networked

Category No. of Beds

Inpatients 477

Day Care 96

ICU & Recovery 56

Casualty 11

Total Beds 640

• Surgical Pathology

• Hemato Pathology

• Biochemistry

• Cytopathology

• Molecular Pathology

• Microbiology

• Transfusion Medicine

• Cancer Cytogenetics

• Radiography: 3

• Ultrasonography : 5

• Mammography : 2

• CT Scan : 3

• MRI : 2

• Interventional Radiology :2

• PET CT : 2

• SPECT CT: 1

• OPG : 1

Infrastructure at TMH

Surgical Oncology Radiation Oncology Medical Oncology

TMH Infrastructure

Cobalt: 5

Linac: 6

Tomo: 2

Brachytherapy

Patients/ Year: 6000

Indigenous Technology Development

VIETNAM

NIGERIA

MONGOLIA

ZAMBIA

Indigenous Technology Development

PROTON BEAM THERAPY EQUIPMENT

Most advanced PT system

• 3 treatment rooms (Gantries)

• Pencil Beam Scanning (PBS)

• Intensity Modulated Proton Therapy (IMPT)

• 6D patient couch

• Image guidance

• Anaesthesia for children

“20% Equipment Manufactured in India”

PTCOG Database Updated July 2016

Proton Carbon

Functional 59 10Under Construction 29 3Under Planning 17 0Pts Treated Till Date 1,18,195 15,736

Functional Facilities:

Proton: 59 (Japan – 8, China – 1, S Korea – 1)

Carbon: 10 (Japan – 4, China – 1)

Facilities Under Construction:

Proton: 29 (Japan – 4, China – 1, S Arabia – 1, S Korea – 1, Taiwan – 1, India - 2)

Carbon: 4 (Japan – 1, China – 2)

NATIONAL SIGNIFICANCE

TMC RT Infrastructure

Cobalt: 5

Linac: 6

Tomo: 2

Brachytherapy

Ref. for RT: 12000 (Approx)

Pts. Treated / Year: 6000

Service

• In India 30-40% of all Pts. receive RTh with Curative Intent

• 10-20% of pts. receiving RTh would benefit with Proton Beam Therapy

Total Number to be treated at TMC Proton Therapy facility = 800 Pts. Yearly (Approx)

• Cost of Proton Therapy: In USA / Course (100 -150 thousand USD) = 1Cr INR (Approx)

Research

• Opportunity to generate robust scientific evidence (PTCOG, RTOG, COG, EORTC)

• Radiation Biology Research (BARC, TIFR, NCI)

• Heavy Particle Accelerator Technology (IIT, RRCAT, C-DAC, CERN)

• Indigenous Technology Development (Indian Industries)

Education

• National Centre for Training in Hadron Beam Therapy

• Human Resource Development

Proposed Hemat &

Paediatric Block

Advanced Centre for Treatment, Research & Education in Cancer

(ACTREC)

• Clinical Research Centre

• Cancer Research Institute

• Centre for Cancer Epidemiology

• Proton Therapy Centre

• Hematolymphoid & Pediatric

• Radiation Research Unit

• Phase I Clinical Trials Facility

National Hadron Beam Therapy Facility

Tata Memorial Centre, Mumbai

MILESTONES

Jan 2013 1st Mtg with Vendors

July 2014 Global Tender Floated

Mar 2015 Contract Signed with IBA

Aug 2016 Civil Tender Floated

Nov 2017 Expected Construction Start

Early 2020 Expected Commissioning