Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

M. Foote



Author of

  • +

    P1.08 - Poster Session 1 - Radiotherapy (ID 195)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Radiation Oncology + Radiotherapy
    • Presentations: 1
    • +

      P1.08-003 - I Love a Sunburnt Country ... Tripartite Collaborative Approaches to Bringing Stereotactic Ablative Body Radiotherapy (SABR) Lung to the People of Regional Australia (ID 259)

      09:30 - 09:30  |  Author(s): M. Foote

      • Abstract

      Background
      Australia is one of the most urbanized countries in the world. Patients with cancer in regional Australia have poorer access to oncology services, resulting in lower survival rates for lung cancer[1]. Implementation of SABR lung is focused in metropolitan centres, limiting access for regional patients. The development of new regional radiotherapy centres could improve this, but these centres require support to implement this complex technology. A tripartite collaboration consisting of radiation oncologists, physicists and radiation therapists was formed to enable implementation of SABR.

      Methods
      The collaboration includes the following 11 radiation oncology departments: Regional hospitals: North Coast Cancer Institute ( Lismore, Port Macquarie and Coff’s Harbour), Newcastle Calvary Mater Hospital, Central Coast Cancer Care Centre ( Gosford) Sydney Metropolitan Hospitals: Westmead and Nepean Hospitals, St George Hospital, Royal North Shore Hospital, Royal Prince Alfred Hospital, Prince of Wales Hospital. The goal was to support centres starting an SABR programme, and facilitate ongoing assessment of outcomes. Multidisciplinary working groups consisting of radiation oncologists, radiation therapists and physicists were formed to cover: Clinical protocol development: existing protocols, including the Dutch (ROSEL), Leeds, RTOG and TROG Chisel protocols were reviewed. Ethically approved SABR protocols for Stage I NSCLC, pulmonary and vertebral metastases were developed with assistance from international and local experts. Planning protocols: development of prescription pages and IMRT checklists for treatment. Physics quality assurance: specification documents for equipment, quality assurance and image verification procedures are being developed. Data collection: a database to archive clinical data and all radiotherapy planning and diagnostic imaging was developed. Ongoing support for regional centres includes: email servers for rapid response to questions, video-conferenced clinical and technical audits of SABR cases. Data collection will facilitate quality assurance and future research.

      Results
      The tripartite approach has led to the uniform adoption of clinical and technical protocols, and facilitated large-scale data pooling of SABR patient information across NSW. Key drivers of success were: the recognition of the need to data pool, identification of key team members to lead the process who had expertise in trial coordination, database development and implementation of radiotherapy technology, and administrative support from involved departments.

      Conclusion
      By increasing collaboration between metropolitan and regional radiotherapy centres we have successfully facilitated the safe implementation of SABR lung, increasing accessibility for patients in regional Australia. This model could be used as the basis for a national collaboration, and the development of accreditation and credentialing procedures for Australian departments. 1. Vinod, S. K. et al. . Cancer 116, 686–694 (2010).

  • +

    P3.08 - Poster Session 3 - Radiotherapy (ID 199)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Radiation Oncology + Radiotherapy
    • Presentations: 1
    • +

      P3.08-005 - IAEA RCA 6065: Improving access to stereotactic ablative body radiotherapy (SABR) for lung cancer patients in Asia. (ID 988)

      09:30 - 09:30  |  Author(s): M. Foote

      • Abstract

      Background
      The IAEA/RCA Project “Strengthening the Application of Stereotactic Body Radiotherapy” aims to increase the capacity to deliver SABR in Asia. Lung cancer is one of the most common cancers in Asia. Most patients present with locally advanced or metastatic disease, but increased access to diagnostic scanning will result in earlier detection of lung cancers suitable for SABR. The shorter treatment time is beneficial in reducing the burden of treatment and economic costs of radiotherapy treatment. The clinical efficacy and socio-economic benefits of SABR have led to rapid implementation in the US[1], Europe[2] and parts of Asia[3]. SABR lung demands specialised expertise, physical infrastructure, and a long-term commitment to rigorous quality assurance. There is significant heterogeneity in the resources and expertise between the RCA Member States. This project aims to identify and ameliorate obstacles to the safe and effective implementation of SABR within Asia. Figure 1

      Methods
      Each country developed a work-plan specific to their capacities and needs. Key strategies for implementation of the project are: Development of treatment protocols Regional training courses Advocacy with Government bodies responsible for policy-making and funding, and education of the wider medical community and public about the benefits of SABR Expert missions with on-site training Publications including educational materials and the results of implementation( utilisation rates, local control and clinical outcomes) Formation of regional training hubs Specific goals identified for Australia were the need to standardise protocols, advocacy for access to funding through Medicare for advanced radiotherapy technologies, and the safe implementation of SABR in regional centres. The Tripartite Collaboration being developed at a national level between RANZCR, AIR and ACPSEM and the NSW SABR Collaboration will address these concerns.

      Results
      Australia has already contributed physics expertise to facilitate the success of the first regional training course, held in Singapore in December 2012. Sydney will host the final regional training course in 2015 on SABR for lung and spine. We continue to contribute our technical and clinical expertise in developing training materials and resources for the project.

      Conclusion
      Collaboration between well-resourced and developing countries in Asia is helping to sustainably develop resources and expertise to improve access to SABR for lung cancer patients. This networking provides future opportunities for large scale clinical trials and research in diseases with a high prevalence in the region. 1. Pan H et al. Cancer 2011 117(19):4566 2. Palma D et al. J Clin Oncol. 2010;28(35):5153 3. Teshima T al. J Radiati. Res 53.5 (2012): 710