Co- -60 60- - No Time for retirement? Co No Time for - - PowerPoint PPT Presentation

Co Co-

• 60

60-

• No Time for retirement?

No Time for retirement? Round Table Round Table

Pierre ALETTI Pierre ALETTI Centre A.Vautrin Centre A.Vautrin -

• Nancy

Nancy -

• France

France

ICARO 27 ICARO 27-

• 28

28-

• 29 Avril 2009

29 Avril 2009

Year 1950: Picker, Year 1950: Picker, AECL, Baraseti,.. AECL, Baraseti,.. Year 1970 : AECL, Year 1970 : AECL, Philips, CIS international, Philips, CIS international, … …. . Year 2009 : Best Theratronics, Year 2009 : Best Theratronics, Bhabhatron, Interaktif, Elekta (Gamma Bhabhatron, Interaktif, Elekta (Gamma knife), Medway Technologies knife), Medway Technologies , , Terabalt, Terabalt, …… ……

1 1-

• The Manufacturers of Co

The Manufacturers of Co-

• 60 Machines

60 Machines

1 1 ’ ’

• The Manufacturers of

The Manufacturers of pellets pellets Cobalt Sources:

Argentina Canada India?? Russia

Advantages Advantages

Low cost of the machine Low cost of the machine Robustness Robustness Reduced Reduced maintenance, maintenance, Low running costs Low running costs Not much downtime Not much downtime Easyness of the QC Easyness of the QC Well adapted Well adapted for : for :

• «

« Head and neck Head and neck » » and Breast localizations and Breast localizations

• the junction of fields

the junction of fields « « Large penumbra Large penumbra » »

2 2-

• Cobalt

Cobalt-

• 60 Machine

60 Machine

Disadvantages Disadvantages

Decay of the dose rate Decay of the dose rate Change of the source every 5 Change of the source every 5-

• 7 Years

7 Years Cost of the source Cost of the source Transportation of the source( Transportation of the source(Nuclear Safety Regulation) Nuclear Safety Regulation) Return of the old source Return of the old source Not adequate for the deap seated Tumors (Cervix, Lung, Not adequate for the deap seated Tumors (Cervix, Lung, … …) ) Not adequate for the treatment of the Children Not adequate for the treatment of the Children « « Large Large penumbra penumbra » »

2 2’ ’-

• Cobalt

Cobalt-

• 60 Machine

60 Machine

2003 2003 – – 2007 Cancer Plan 2007 Cancer Plan

• Change of the

Change of the « «

• ld
• ld

» » equipment ( old Linac and all Cobalt equipment ( old Linac and all Cobalt machines ) before 2007 machines ) before 2007

• Evaluation of the IMRT (prostate and

Evaluation of the IMRT (prostate and « « Head and Neck Head and Neck » ») )

• Evaluation of the new Machines

Evaluation of the new Machines « « Cyberknife and Tomotherapy Cyberknife and Tomotherapy » » Actual status: Actual status:

• The

The ’ ’standard standard ’ ’ Cobalt machines will be finished in 2010 Cobalt machines will be finished in 2010 – – 2012 2012

• 3

3 « « Gamma knife Gamma knife » » equipments for stereotaxic irradiation equipments for stereotaxic irradiation

3 3 -

• Cobalt

Cobalt-

• 60 in France

60 in France

3 3’ ’

• Cobalt

Cobalt-

• 60 In France

60 In France

179 Departments of Radiotherapy and 402 Machines 179 Departments of Radiotherapy and 402 Machines

4 - Cobalt Machine and the Low Income Countries

• Increasing of the demand for new departments of Radiation Ther

Increasing of the demand for new departments of Radiation Therapy apy and consequently for the equipments: and consequently for the equipments:

• in Africa (Burkina Fasso, Mali, Senegal, Madagascar,

in Africa (Burkina Fasso, Mali, Senegal, Madagascar,… ….., ..,

• In Asia (Vietnam in Mekong delta, Cambodia, Laos,

In Asia (Vietnam in Mekong delta, Cambodia, Laos, Myanmar , Myanmar ,… …

4 ’- The Reality of the most Low Income Countries (Cambodia, Senegal,…)

• Rich patients are treated in developped countries (Singapour,Eur

Rich patients are treated in developped countries (Singapour,Europe,..)

• pe,..)
• Poor patients are not treated

Poor patients are not treated

• No social Security

No social Security

• The patients have to pay the treatments

The patients have to pay the treatments

• A lot of patients with big tumors (Nasopharyngeal, breast , cer

A lot of patients with big tumors (Nasopharyngeal, breast , cervix, vix, lung carcinoma, lung carcinoma,… …..) ..)

• Problems of stability of the electrical power

Problems of stability of the electrical power

• A lot of electrical power cut (3times per day depending on the

A lot of electrical power cut (3times per day depending on the season) season)

• Maintenance technician with a low level of knowledge

Maintenance technician with a low level of knowledge

4 ’’- The response for the Low Income Countries?

• Low cost of the treatment

Low cost of the treatment

• Robust machine

Robust machine

• Very few downtime

Very few downtime

• A machine with easy maintenance

A machine with easy maintenance

• A few spare parts

A few spare parts

• Recommendations

Recommendations

• For the First Machine: a Cobalt unit

For the First Machine: a Cobalt unit

• For the second machine it is depending on

For the second machine it is depending on

• the type of patients to be treated

the type of patients to be treated

• the improvement of the technical environment

the improvement of the technical environment ç çElectrical Electrical power, power,… ….) .)

• The level of knowledge of the staff (Physicist, technician,

The level of knowledge of the staff (Physicist, technician, radiographers, radiographers,… ….) .)

Discussion