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