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Advanced Centre for Treatment, Research & Education in Cancer (ACTREC). TATA MEMORIAL CENTRE. Tata Memorial Hospital (TMH). Grant in Aid Institution of The Dept. Of Atomic Energy (DAE), Govt. of India. New Case File Registrations State-wise Distribution. Total - 62162. Patients - 35199.
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Advanced Centre for Treatment, Research & Education in Cancer (ACTREC) TATA MEMORIAL CENTRE Tata Memorial Hospital (TMH) Grant in Aid Institution of The Dept. Of Atomic Energy (DAE), Govt. of India
New Case File Registrations State-wise Distribution Total - 62162 Patients - 35199 Preventive - 5739 Referals- 16444 Himachal Pradesh 10 Jammu & Kashmir 175 Haryana 70 Chandigarh 20 Uttaranchal 82 Punjab 89 Arunachal Pradesh 41 Delhi 94 Sikkim 10 Rajasthan 672 Nagaland 22 Uttar Pradesh 4630 Assam 720 Bihar 2694 Meghalaya 27 Manipur 244 Jharkhand 1120 Gujarat 485 Daman & Diu 11 Madhya Pradesh 2018 W. Bengal 3643 Tripura 139 Mizoram 47 Dadra & Nagar Haveli 19 Orissa 1029 Chhattisgarh 492 Maharashtra (excl. Mumbai) 15030 Mumbai 5383 Andhra Pradesh 201 Karnataka 275 Goa 199 Tamil Nadu 59 Kerala 86 Andaman & Nicobar 3 Pondicherry 3
Quality Manager Legal Advisor Clinical Research Secretariat (CRS) IEC I/ II/ III DSMSC • Institutional Ethics • Committee (IEC) • Review • Monitoring (DSMSC) TMH Research Admin. Council (TRAC) HRPP Co-ordinator • Institutional • Administrative Support • Financial support • Admin / Policy • Research Infrastructure • Designated space • Personnel • Pharmacy/ Labs • Logistic support etc TMC “Human Research Protection Program (HRPP)” DCGI, SIDCER, AAHRPP Accredited
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 RESEARCH AREAS
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 Pradesh Chief Ministers Health Insurance Scheme – Tamil Nadu Vajpayee Arogyashree Scheme – Karnataka Self 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
Radiography: 3 • Ultrasonography : 5 • Mammography : 2 • CT Scan : 3 • MRI : 2 • Interventional Radiology :2 • PET CT : 2 • SPECT CT: 1 • OPG : 1 • Surgical Pathology • Hemato Pathology • Biochemistry • Cytopathology • Molecular Pathology • Microbiology • Transfusion Medicine • Cancer Cytogenetics 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 MONGOLIA NIGERIA ZAMBIA
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”
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)
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 NATIONAL SIGNIFICANCE • TMC RT Infrastructure • Cobalt: 5 • Linac: 6 • Tomo: 2 • Brachytherapy • Ref. for RT: 12000 (Approx) • Pts. Treated / Year: 6000
Clinical Research Centre • Cancer Research Institute • Centre for Cancer Epidemiology • Proton Therapy Centre • Hematolymphoid & Pediatric • Radiation Research Unit • Phase I Clinical Trials Facility Advanced Centre for Treatment, Research & Education in Cancer (ACTREC) Proposed Hemat & Paediatric Block
National Hadron Beam Therapy Facility Tata Memorial Centre, Mumbai