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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

  • The IAEA will

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


United nations organisations l.jpg
United Nations Organisations

The International Atomic Energy Agency

is a Nuclear Technology organisation;

not primarily a cancer organisation


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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


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Overall Cancer Problem

Ref. M. Parkin IARC Globocan


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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


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Applied Radiobiology & Radiotherapy (ARBR)

Research & Development

through

  • Individual Research Contracts

  • Coordinated (Group) Research

  • Advisory Group Meetings

    etc.


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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


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DEVELOPMENT COMPONENT

Head & Neck immobilisation

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


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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


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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


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SPECIAL INTEREST SERVICES

  • Directory of Radiotherapy Services

    [DIRAC]

  • Dosimetry intercomparison

  • Radiotherapy Cost Evaluator software


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TECHNICAL CO-OPERATION

Promotion of nuclear technology in developing countries

by

National Projects


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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


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INITIATE RADIATION ONCOLOGY

  • Uganda

  • Ethiopia

  • Namibia

  • Mongolia

  • GHANA (Accra)

    Building

  • Zambia

  • Yemen

  • Borneo

In planning:

Angola, Haiti, Eritrea


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UPGRADING RADIOTHERAPY

Concentrate on establishing one aspect of radiotherapy at one centre.

~ Teletherapy

~ Brachytherapy

~ Treatment Planning

~ Imaging

~ Immobilisation

About 50 national projects each biennium


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AGENCY TOOLSfor radiotherapy implementation

  • Equipment

  • Training

  • Expert visits



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EQUIPMENT

TREATMENT

~ Teletherapy

~ Brachytherapy

CLINICAL QA

~ Treatment Planning

~ Imaging

~ Immobilisation


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TRAINING

  • Long Term Training for Degree purposes

  • Specialised Training

    • Fellowships 3 to 6 months

  • Training courses 1 to 2 weeks


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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



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RT Education in Africa

Education for Radiation Oncologists

& Medical Physicists

?


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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


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TECHNICAL CO-OPERATION

Promotion of nuclear technology in developing countries

by

  • Regional Projects


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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


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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


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TRAINING COURSES

  • Radiation Oncologists

  • Medical Physicists

  • Therapy Radiographers

  • Gynae Nurses


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Total Agency Involvement

  • Clinical

  • Dosimetry

  • Dose Quality Control

  • Radiation protection

  • Radioactive waste management

  • etc. as needed


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medicalphysicist

radiationoncologist

biologist

radiationtechnologist

Government commitment

Mrs. Patient

Agency

commitment


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THE INTERNATIONAL ATOMIC ENERGY AGENCY

ARBR

A PARTNER IN HEALTH