IAEA – RCA 6065 Project

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care INTRODUCTION TO THE IAEA RCA RAS 6065 PROJECT DrDaniel Tan Course Director Associate Consultant Department of Radiation Oncology National Cancer Centre Singapore

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Aim: To help Participants understand the Origins and Purpose of this Project

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care 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 MrKesratSukasam Technical Officer IAEA/HH Dr Rajiv Ranjan Prasad Lead Country Coordinator KIRAMS Dr Cho Chul-Koo Meeting Rapporteurs Dr Fiona Hegi (Sydney) and myself

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Scope: IAEA and Radiation Oncology Organizational Structure of RCA Projects RCA 6065 Project Meeting 1st RTC Summary

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care 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.

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

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Project management Officer: IAEA/TC MrKesratSukasam Technical Officer: IAEA/HH Dr Rajiv Ranjan Prasad  

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

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care 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. 

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Technical Cooperation: 32 Recipient Member States/Territories Size of TC programme for 2010: @ $32 million Annual disbursement: over $24 million through national and regional projects Two Regional Agreements: RCAfor 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)

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Project management Officer: IAEA/TC MrKesratSukasam Technical Officer: IAEA/HH Dr Rajiv Ranjan Prasad  

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care Division of Human Health:

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care RCA 6065:

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care PROJECT 6065 • LEAD COUNTRY COORDINATOR • Chul-Koo CHO, M.D., Ph.D • Director General, • KoreaCancer Center Hospital • President, Korea Heavy Ion • Medical Accelerator Project • Korea Institute of Radiological • & Medical Sciences (KIRAMS)

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care RCA RAS6065: Project Planning Meeting, Seoul June 11-15

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care RCA RAS6065: Meeting June 11-15

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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.

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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 publication • Regional training courses • Development of expertise, with collaboration between centres to raise the level of technical expertise and clinical knowledge.

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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.

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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.

IAEA – RCA 6065 Project Strengthening the Application of SBRT to Improve Cancer Care • 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.

IAEA – RCA 6065 Project