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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
INTERNATIONAL ATOMIC ENERGY AGENCY
  • The IAEA will

“-- accelerate and enlarge the contribution of atomic energy to health and prosperity ---”

united nations organisations
United Nations Organisations

The International Atomic Energy Agency

is a Nuclear Technology organisation;

not primarily a cancer organisation

slide3
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

overall cancer problem
Overall Cancer Problem

Ref. M. Parkin IARC Globocan

cancer in developing countries
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

applied radiobiology radiotherapy arbr
Applied Radiobiology & Radiotherapy (ARBR)

Research & Development

through

  • Individual Research Contracts
  • Coordinated (Group) Research
  • Advisory Group Meetings

etc.

research projects
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
development component
DEVELOPMENT COMPONENT

Head & Neck immobilisation

A cost-effective alternative to the current swing to disposable thermoplastic masks

advisory group publications
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
journal publications
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

special interest services
SPECIAL INTEREST SERVICES
  • Directory of Radiotherapy Services

[DIRAC]

  • Dosimetry intercomparison
  • Radiotherapy Cost Evaluator software
technical co operation
TECHNICAL CO-OPERATION

Promotion of nuclear technology in developing countries

by

National Projects

slide13

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

initiate radiation oncology
INITIATE RADIATION ONCOLOGY
  • Uganda
  • Ethiopia
  • Namibia
  • Mongolia
  • GHANA (Accra)

Building

  • Zambia
  • Yemen
  • Borneo

In planning:

Angola, Haiti, Eritrea

upgrading radiotherapy
UPGRADING RADIOTHERAPY

Concentrate on establishing one aspect of radiotherapy at one centre.

~ Teletherapy

~ Brachytherapy

~ Treatment Planning

~ Imaging

~ Immobilisation

About 50 national projects each biennium

agency tools for radiotherapy implementation
AGENCY TOOLSfor radiotherapy implementation
  • Equipment
  • Training
  • Expert visits
equipment
EQUIPMENT

TREATMENT

~ Teletherapy

~ Brachytherapy

CLINICAL QA

~ Treatment Planning

~ Imaging

~ Immobilisation

training
TRAINING
  • Long Term Training for Degree purposes
  • Specialised Training
    • Fellowships 3 to 6 months
  • Training courses 1 to 2 weeks
limitation by personnel

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

slide22

RT Education in Africa

Education for Radiation Oncologists

& Medical Physicists

?

expert visits
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
technical co operation24
TECHNICAL CO-OPERATION

Promotion of nuclear technology in developing countries

by

  • Regional Projects
regional projects
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
africa agreement
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

training courses
TRAINING COURSES
  • Radiation Oncologists
  • Medical Physicists
  • Therapy Radiographers
  • Gynae Nurses
total agency involvement
Total Agency Involvement
  • Clinical
  • Dosimetry
  • Dose Quality Control
  • Radiation protection
  • Radioactive waste management
  • etc. as needed
government commitment

medicalphysicist

radiationoncologist

biologist

radiationtechnologist

Government commitment

Mrs. Patient

Agency

commitment

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