Download Division of Radiation Oncology, Department of Radiology,

23 October 2009
Reference : RCA Project RAS/6/048
Application of 3D Conformal Radiotherapy for Predominant Cancers in the
RCA Region
The National work plan of the RAS/6/048 started after the National project
coordinator meeting in Singagapore on 7-11 May, 2007
In Thailand, the radiation therapy facilitied are mainly in the medical school,
National Cancer center and in privatehospital. There are 6 cancer centers in 6
major cities belong to the Ministry of Public Health, and during the
construction in 4 cities. In medical school, the staffs have chance to further
their training supported by the Ministry of Education but not for the staffs of the
Ministry of Public Health. The objective of this project in Thailand is to
improve the capacity of the local cancer centers to treat the patients with 3D
CRT technique.
After the Project Planning Meeting, three local cancers are selected to be the
model of this project. These three cancer center have the RTP system,
diagnostic CT and the linear accelerator. The staffs of these three centers were
assigned to participate to all Regional Training Course
1. Regional Training Course (RTC) on 3D-CRT and QA (Imaging and
treatment planning for radiation oncologist. (Osaka, Japan)
2. Regional Training Course on 3D-CRT and QA (Clinical Implementation
on the most common cancers, part I) for radiation oncologist (Bangkok,
Thailand)
3. RTC on 3D-CRT and QA for Medical Physicist (Singapore)
4. Regional Training Course on 3D-CRT and QA (Clinical Implementation
on the most common cancers, part II) for radiation oncologist (Mumbai,
India)
Thailand was the host for the 2nd RTC in April 2008 on Head & Neck cancer,
lung cancer and breast cancer. IAEA gave the financial support and 2 experts
from Singapore : Prof.Fong and Dr.Wee.
During the early phase of the project, there was some problem on the process
of nomination of the participants. The Office of Energy for Peace (OEP) in
Thailand which usually takes responsibility for the announcement of the RTC,
didn’t allow the project coordination to control this process. The staffs of the
selected cancer centers missed the first RTC.
About the local training. the radiation oncologists, medical physicists and
radiation therapists in the medical school have the duty to be the consultant and
trainer for the other radiotherapy centers, and also the other medical school who
start the new technique. The training courses held in Siriraj Hospital were
- Commissioning and quality assurance in computerized treatment planning
system for radiotherapy
- Upgrading radiation therapy technique capability for RTT
- Workshop on Radiation beam data acquisition and verification for TPS in
external beam therapy
There are also the workshops and lectures held by the Thai Radiation
Oncology Society
- Workshop on target delineation of Head and Neck cancer and Prostate
cancer
- Image-based Radiation therapy workshop
- Advanced in Radiation therapy treatment planning
- Oncologic imaging course, held by the division of diagnostic radiology
Additional on-site training are also done, for example
- Medical Oncologists were trained the workflow of 3D-CRT and IMRT,
process of image acquisition from positioning, immobilization and CT
simulation, image fusion, target and critical structure delineation, concept of
GTV, CTV and PTV regarding to ICRU 50, treatment planning with
evaluation of the treatment plan, the process of treatment delivery and
treatment verification with port film, EPID and OBI
- Medical physicists were trained about image acquisition, image fusion,
treatment planning and evaluation, the QA process of the treatment plan
- RTT were trained about the CT simulation, the process of treatment
delivery and treatment verification with port film, EPID and OBI
At the end of this project, two of the three selected cancer centers succeed
their 3D work. They treated 60-80 patients with 3D-CRT per year. The
other center has the problem with their diagnostic CT and going to install
the new CT machine soon.
Even the project is finished. The process of training the radiation therapy
personnel in Thailand will continue in order to upgrade the radiation
therapy technique capability of all radiotherapy centers. The support from
IAEA in term of the expert and financial support and the most important is
the institutes where the radiotherapy personnel can be trained for period of
time are appreciated.
Yaowalak Chansilpa
Division of Radiation Oncology
Department of Radiology,
Faculty of Medicine Siriraj Hospital
Mahidol University