Rapporteurs: Krystyna Kiel Michael Joiner Geoffrey Ibbott - - PowerPoint PPT Presentation

Rapporteurs: Krystyna Kiel Michael Joiner Geoffrey Ibbott

Radiation Oncology Radiation Biology Radiation Physics

Cancer incidence, stage and treatment varies

with region, economic status

• Developing countries:

Cervix, Head & Neck, Lung, Breast More often advanced stage Treatment more often for palliation, although number

• f curative cases is increasing
• Developed countries:

Lung, Breast, Prostate Early detection and awareness/prevention programs Treatment more often for cure

Barriers in Developing Countries

• Need for more RT facilities

Many countries have no RT facilities Machines/population is very low

• Perception that radiation is only for palliation
• People with means go elsewhere for treatment

Economic drive to introduce advanced technologies

• Often a lack of multidisciplinary protocols and tumor

boards, i.e., for pediatric tumors

• MONEY

MONEY

Issues in Developing Countries

• Interest in introducing advanced technologies

without sufficient resources or evidence

• Potential for adopting new technology (e.g., IMRT)

without full appreciation of risks

• Lack of qualified personnel
• Lack of training for advanced technologies

Experience in 3D treatment planning is essential

prior to initiating more-advanced technologies

Certain populations might benefit from adv. tech. Technology separates physician from patient

• Too easy to depend on technology

Many advances in imaging are exciting

• May help better determine target

Reduction in field margins should be

accompanied by image guidance, compensation for motion

• Requires studies to prove we can use this capability

Hyperfractionation and accelerated

fractionation are not as promising as expected

Hypofractionation is useful as a resource-

sparing approach to cancer treatment

• Evidence in lung, brain, prostate, breast cancer

Advanced technologies very demanding of

resources

Technologies are under development, not all

deficiencies are resolved

New techniques (e.g., IMRT) can produce poor

results if QA not adequate

Overwhelming majority of participants

recognize continuing role for Cobalt units.

Potential exists for advanced treatment

methods with Cobalt

IMRT:

• Inadequacy of some planning systems
• Studies show inability of planners to achieve goals
• Studies show planned distribution often not delivered
• Studies required to prove value before widespread use

Small radiation fields

• Appropriate calibration equipment often not available
• Equipment often can’t deliver reference field size

New technologies are advancing faster than

appropriate QA programs can be developed

Global shortage of skilled professionals Will be a long-term demand for trainers and

educators

Training must be adapted to working

environment and available technology

Insufficient recognition of value of training Programs should include broad education Role for networking on national and regional

level to support education

IAEA support for education and training was

recognized and appreciated

The rapporteurs found the conference enlightening and enjoyable We are grateful for the support of the IAEA for

• ur participation