Abstract book - ESTRO meets Asia

S51 ESTRO meets Asia 2018

Abstract text The incidence of cancer is rising rapidly, with a global projection of 24 million cases annually by 2035 1 . Over 70% of these will arise in low and middle-income countries (LMICs). Radiotherapy is a core component of cancer care and despite the need for initial investment, has been shown to be cost-effective in the long term 2 . However, there remains a huge deficit in radiotherapy services in LMICs, with the provision of resources inversely proportional to Gross National Income 3 . By geographic region, the Asia-Pacific has been demonstrated to have the highest absolute deficit in radiotherapy services and in turn, the largest investments required to meet those needs 4 . The Global Task Force in Radiotherapy for Cancer Control (GTFRCC) Lancet Commission 2 demonstrated that in addition to the need for radiotherapy equipment, there is an urgent need for human resources. At present, there is a shortage of in-country training pathways for radiotherapy professionals in many LMICs in the Asia Pacific. One such country facing a shortage of radiotherapy resources is Cambodia, which, until this year, had one linear accelerator for a population of 16 million people. An exciting development has been a recently-built comprehensive cancer centre in Phnom Penh, the National Cancer Centre (NCC), which includes modern radiotherapy services. A major challenge for NCC has been workforce, given the specialized skills required and lack of formal training programs within Cambodia. Motivated local staff, regional and global partnerships and the help of international organisations have been important factors in ensuring training of staff. The Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) of the Royal Australian and New Zealand College of Radiologists (RANZCR) has been one initiative which has partnered with NCC, primarily in aiding with education and training of radiation oncology staff. APROSIG is a volunteer group which aims to support the safe and effective delivery of radiotherapy in neighbouring LMICs with respect to equipment availability, staffing levels and training, standards of treatment delivery, and levels of quality assurance. A major initiative led by APROSIG has been the organization of in-country Australian radiation therapist trainers as part of the Australian Volunteers Program (AVP) funded by the Australian Government for periods of 6-15 months. These volunteer assignments facilitate the education of Cambodian radiation therapists in CT simulation and treatment setup as well as educating the Cambodian physicists in treatment planning techniques. In partnership with the Asia Pacific Special Interest Group (APSIG) from the Australasian College of Physical Scientists and Engineers in Medicine, there have also been Australian medical physicist volunteers based in Cambodia for 2-12 month postings, for supervision of equipment commissioning, development of 3DCRT, electron and brachytherapy treatment techniques and for training of the local physicists. Another APROSIG initiative has been, in collaboration with the Office for Global Health at the University of Sydney, the arrangement of 1-month observerships for Cambodian cancer professionals (including diagnostics and cancer registry) in Australia through the support of Australian government’s Australia Awards Fellowship program. In addition to the NCC collaboration, APROSIG has partnered with other Asia-Pacific radiation oncology departments, including Ho Chi Minh City Oncology Hospital, Vietnam. APROSIG aims to ensure that its activities result in locally sustainable services and that technology use is stratified to the needs and expertise on a local level. APROSIG also values collaboration with other local, regional and international initiatives as well as the International Atomic Energy Agency (IAEA) and other organisations.

and age upon transposed ovarian endocrinic function was evaluated. Results Ovarian transposition was performed on one ovary in 9 cases and on both ovaries in 89 cases. Ovarian endocrinic function of 10 patients who received IMRT with no dose constrain on radiation dose to ovaries was absent. 37 cases in 88 patients (43.02%) who underwent IMRT with limited radiation dose to ovaries preserved their normal ovarian endocrinic function. The percentage of patients with normal normal ovarian endocrinic function was 34.1% and 48.9% respectively in unilateral and bilateral ovaries limitation (P<0.05). The comparatively lower side ovarian maximum dose less than 9.985Gy prevented the disruption of ovarian function better(94.6% vs 5.4%, P=0.002). The comparatively lower side ovarian mean dose less than 5.32Gy prevented the disruption of ovarian function better (81.1% vs 18.9%, P=0.003). The average age of normal and abnormalovarian endocrinic function was 35.57 years and 39.92 years respectively (P<0.001). Conclusion In young cervical cancer patients who underwent radical hysterectomy and ovarian transposition with receiving adjuvant radiotherapy, ovarian endocrinic function was significantly affected. Using IMRT, preservation of ovarian function was more possible with the limited dose of the ovaries, meanwhile bilateral ovaries limitation should be better than unilateral limitation. The comparatively lower side ovarian maximum dose less than 9.985Gy, and mean dose less than 5.32Gy could better prevented the ovarian endocrinic function, which should be suggested as the new optimal dose limit in IMRT to preserve ovarian endocrinic function. Ovarian endocrine function was better preserved in younger patients. Sunday 9 December Round table/Debate: Setting the scene: advocacy and education SP-128 APROSIG : Knowledge exchange between Australasian and Asia-Pacific radiotherapy professionals M.L. Yap 1,2,3 , A. Oar 4 , E. Esguerra 5 , S. Corde Tehei 6 , S. Downes 6 , G. Grogan 7 , S. Heng 6 , G. Newman 8 , C. Opie 9 , K. Rogl 10 , N. Shelton 11 , I. Ward 12 1 Liverpool Cancer Therapy Centre, Ingham Institute for Applied Medical Research- UNSW Sy dney, Liverpool, Australia 2 Macarthur Cancer Therapy Centre, Western Sydney University, Campbelltown, Australia 3 Sydney University, School of Public Health, Camperdown, Australia 4 Radiation Oncology Centres, Gold Coast University Hospital, Gold Coast, Australia 5 Sydney University, Office for Global Health, Camperdown, Australia 6 Prince of Wales Hospital, Radiation Oncology Department, Randwick, Australia 7 Sir Charles Gardiner Hospital, Radiation Oncology Department, Nedlands, Australia 8 Townsville Cancer Centre, Radiation Oncology Department, Townsville, Australia 9 Royal North Shore Hospital, Northern Sydney Cancer Centre, St Leonards, Australia 10 Radiation Oncology Centres, Cairns Hospital, Cairns, Australia 11 Austin Hospital, Olivia Newton John Cancer Wellness and Research Centre , Heidelberg, Australia 12 Christchurch Hospital, Canterbury Regional Cancer and Haematology Service, Christchurch, New Zealand