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INTERNATIONAL ATOMIC ENERGY AGENCY

INTERNATIONAL ATOMIC ENERGY AGENCY . The IAEA will “-- accelerate and enlarge the contribution of atomic energy to health and prosperity ---”. United Nations Organisations. The International Atomic Energy Agency is a Nuclear Technology organisation; not primarily a cancer organisation.

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INTERNATIONAL ATOMIC ENERGY AGENCY

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  1. INTERNATIONAL ATOMIC ENERGY AGENCY • The IAEA will “-- accelerate and enlarge the contribution of atomic energy to health and prosperity ---”

  2. United Nations Organisations The International Atomic Energy Agency is a Nuclear Technology organisation; not primarily a cancer organisation

  3. NUCLEAR POWER Nuclear Energy Safeguards NUCLEAR TECHNOLOGY Technical Co-operation (TC) Radiation Safety Nuclear Applications (NA) (including Health) IAEA Cancer diagnosis and management are supported by TC & NA

  4. Overall Cancer Problem Ref. M. Parkin IARC Globocan

  5. Cancer Control Prevention Early diagnosis MANAGEMENT Palliation With a rising incidence of cancer in developing countries, management becomes increasingly important to the Health ministries Cancer in Developing Countries Radiotherapy is a major nuclear technology in the management of cancer

  6. Applied Radiobiology & Radiotherapy (ARBR) Research & Development through • Individual Research Contracts • Coordinated (Group) Research • Advisory Group Meetings etc.

  7. RESEARCH PROJECTS Research directed at clinical problems of developing countries • Oesophagus: Brachytherapy +/- teletherapy • Nasopharynx: Teletherapy + brachytherapy • 5 or 6 fractions per week? • Cervix: HIV pos: Addition chemo? • Cervix (HIV-) 2 or 4 fractions HDR brachytherapy • Economics of Radiotherapy

  8. DEVELOPMENT COMPONENT Head & Neck immobilisation A cost-effective alternative to the current swing to disposable thermoplastic masks

  9. ADVISORY GROUP PUBLICATIONS On demand from member states: • Introduction of micro- HDR brachytherapy for developing countries • Mould-room techniques • The role of radiotherapy in HIV-related cancers • Design & implementation of a radiotherapy program • Audit of radiotherapy: methodology for developing countries related to sustainability

  10. JOURNAL PUBLICATIONS • Radiotherapy in Africa: R&O 52, (1999) 70-84 • S-E Asia & Pacific R&O 60 (2001) 81-89 • Latin America R&O 2004 In press • Economics & radiotherapy R&O 63 (2002) 147-150 • Cost of teletherapy R&O 71 (2004) 347-355

  11. SPECIAL INTEREST SERVICES • Directory of Radiotherapy Services [DIRAC] • Dosimetry intercomparison • Radiotherapy Cost Evaluator software

  12. TECHNICAL CO-OPERATION Promotion of nuclear technology in developing countries by National Projects

  13. Europe 250,000/machine No functional equipment New Projects 2005/6 RT Services in Africa < 2 million/machine 2 - 10 million/machine > 10million/machine No known operational machines Ref. Radiotherapy in Africa: R&O 52, (1999) 70-84: Updated 2004

  14. INITIATE RADIATION ONCOLOGY • Uganda • Ethiopia • Namibia • Mongolia • GHANA (Accra) Building • Zambia • Yemen • Borneo In planning: Angola, Haiti, Eritrea

  15. UPGRADING RADIOTHERAPY Concentrate on establishing one aspect of radiotherapy at one centre. ~ Teletherapy ~ Brachytherapy ~ Treatment Planning ~ Imaging ~ Immobilisation About 50 national projects each biennium

  16. AGENCY TOOLSfor radiotherapy implementation • Equipment • Training • Expert visits

  17. SCHEMATIC OF CANCER MANAGEMENT

  18. EQUIPMENT TREATMENT ~ Teletherapy ~ Brachytherapy CLINICAL QA ~ Treatment Planning ~ Imaging ~ Immobilisation

  19. TRAINING • Long Term Training for Degree purposes • Specialised Training • Fellowships 3 to 6 months • Training courses 1 to 2 weeks

  20. 10 2 radiation oncologist/1000 cancer 1 0.1 0.1 1 10 megavoltage machine/1000 cancer Limitation by Personnel OK Machines OK Staff Staff OK Too few machines OK Machines Understaffed Too few machines Understaffed for these Ref. Tatsuzaki & Levin: Radiotherapy & Oncology 60 (2001) 81-89

  21. PERSONNEL LIMITATIONS

  22. RT Education in Africa Education for Radiation Oncologists & Medical Physicists ?

  23. CLINICAL Develop in-house procedures/protocols Instruction on clinical QA in the use of specialised equipment MEDICAL PHYSICS Commissioning of new equipment Calibration and dosimetry EXPERT VISITS

  24. TECHNICAL CO-OPERATION Promotion of nuclear technology in developing countries by • Regional Projects

  25. REGIONAL PROJECTS Regional projects confine themselves to regional needs: Primarily training courses with some minor equipment. • Africa [AFRA] • Eastern Europe • Latin America [ARCAL] • South East Asia

  26. AFRICA AGREEMENT • 56 Countries • 23 with RT • 17 in AFRA • 155 Teletherapy machines • Training in 6 countries Radiotherapy in Africa: R&O 52, (1999) 70-84

  27. TRAINING COURSES • Radiation Oncologists • Medical Physicists • Therapy Radiographers • Gynae Nurses

  28. Total Agency Involvement • Clinical • Dosimetry • Dose Quality Control • Radiation protection • Radioactive waste management • etc. as needed

  29. medicalphysicist radiationoncologist biologist radiationtechnologist Government commitment Mrs. Patient Agency commitment

  30. THE INTERNATIONAL ATOMIC ENERGY AGENCY ARBR A PARTNER IN HEALTH

  31. http://www.iaea.org/worldatom

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