IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
INTRODUCTION TO THE IAEA RCA
RAS 6065 PROJECT
Dr Daniel Tan
Course Director
Associate Consultant
Department of Radiation Oncology
National Cancer Centre Singapore
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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
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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 Mr Kesrat Sukasam
Technical Officer IAEA/HH Dr Rajiv Ranjan Prasad
Lead Country Coordinator KIRAMS Dr Cho Chul-Koo
Meeting Rapporteurs Dr Fiona Hegi (Sydney) and myself
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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
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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.
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Project
management
Officer: IAEA/TC Mr
Kesrat Sukasam
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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
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IAEA – RCA 6065 Project
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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
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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:
RCA for 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)
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care

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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Project
management
Officer: IAEA/TC Mr
Kesrat Sukasam


Technical Officer:
IAEA/HH Dr Rajiv
Ranjan Prasad
IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Division of Human Health:
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Division of Human Health:
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Division of Human Health:
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
RCA 6065:
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
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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,
Korea Cancer Center Hospital
President, Korea Heavy Ion
Medical Accelerator Project
Korea Institute of Radiological
& Medical Sciences (KIRAMS)
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
RCA RAS6065:
Project Planning
Meeting, Seoul
June 11-15
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
RCA RAS6065:
Meeting June 11-15
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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.
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IAEA – RCA 6065 Project
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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
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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
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IAEA – RCA 6065 Project
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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
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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
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Strengthening the Application of SBRT to Improve Cancer Care
Regional Training Hubs
 Sustain technical cooperation among developing countries after completion of the
project.
 To reduce cost of training on SBRT
 To overcome the language barrier, especially for radiation technicians/therapists and
thereby promote more efficient education.
 To propagate the objectives of our project more efficiently
 To mobilise more resources for neighbouring countries with a better rationale.
 To facilitate research activities on SBRT, by collecting and reviewing clinical data
The regional hub should facilitate and promote excellence in scientific research.
IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Regional Training Hubs
 India for south-west Asia,
 China for North-East Asia, and
 Singapore for other surrounding countries.
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
RTC: Focus
Basic concept of SBRT
(beginning)-including QA/QC,
immobilization, image,
radiation biology
(experts also provided by AUL)
Expectations/target groups
Understanding of concept /
Radiation Oncologists, Medical
Physicists
Tentative schedule
3~7 Dec 2012
Potential host
SIN
(Back-up: IND)
Clinically oriented, various
indication of SBRT
(liver, lung)
*Protocol development should be
done before
Clinically oriented, various
indication of SBRT
(Another tumor type: Head &
Neck, liver)
Implementation of clinical
study /
Radiation Oncologists
7~11 Oct 2013
ROK
(Back-up: JPN)
Implementation of clinical
study /
Radiation Oncologists,
medical physicists,
radiation technologist
Implementation of clinical
study /
Radiation Oncologists,
Radiation Therapists, Physicist
4Q 2014
CPR
(Back-up: THA)
TBD 2015
AUL
(Back-up: JPN, ROK)
Clinically oriented, various
indication of SBRT
(Another tumor type: Lung,
spine, prostate)
*topics needs further
discussion at the mid-term
meeting
IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
1st RTC:
BASIC CONCEPTS AND EARLY IMPLEMENTATION
Introduction to the concept of SBRT
Demonstrate its use and potential in oncology
Demonstrate its highly complex nature
Demonstrate the breadth of knowledge required
Provide a starting point for future development
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IAEA – RCA 6065 Project
Strengthening the Application of SBRT to Improve Cancer Care
Summary:
As members of the RCA, we have the privilege and
opportunity to tap on the framework and resources of IAEA
to advance collaboration and cooperation between our
institutions, with the end point of building up our
oncological capabilities to better serve our people.
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