Planning National Radiotherapy Services

Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education p

Capturing naive validity in the Cut-free approach

Rejecting the Cut rule has been proposed as a strategy to avoid both the usual semantic paradoxes and the so-called v-Curry paradox. In this paper we consider if a Cut-free theory is capable of accurately representing its own notion of validity. We claim that the standard rules governing the validity predicate are too weak for this purpose and we show that although it is possible to strengthen these rules, the most obvious way of doing so brings with it a serious problem: an internalized version of Cut can be proved for a Curry-like sentence. We also evaluate a number of possible ways of escaping this difficulty.Fil: Barrio, Eduardo Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Rosenblatt, Lucas Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Tajer, Diego. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentin

Neoadjuvantna radioterapija i kemoterapija u bolesnika s lokalno uznapredovalim rektalnim karcinomom: randomizirana studija faze III KBC “Sestre milosrdnice” u suradnji s IAEA-om i ESTRO-m

At the Department of Oncology and Nuclear Medicine UHC “Sestre milosrdnice” patients who had advanced rectal cancer were treated with preoperative radiotherapy and chemotherapy, in cooperation with the IAEA and ESTRO. Fifteen patients who met the criteria and signed informed consent were included. Patients were randomized into two groups: Group 1: standard group, neoadjuvant approach (chemotherapy 5-FU / leucovorin concomitantly with radiotherapy (45-50 Gy in 25 fractions); Group 2: short course group, chemotherapy 5-FU / leucovorin with radiotherapy (25 Gy in 5 fractions). The main objectives were to determine the rate of resectability after completion of neoadjuvant therapy and to determine the percentage of local control and overall survival.U Klinici za onkologiju i nuklearnu medicine KBC “Sestre milosrdnice” u suradnji sa IAEA i ESTRO-m proveli smo ispitivanje o primjeni preoperativne radioterapije i kemoterapije u bolesnika s uznapredovalim karcinomom rektuma. U ispitivanje smo uključili petnaest bolesnika koji su zadovoljili uključne kriterije i potpisali informirani pristanak. Bolesnici su randomizirani u dvije skupine: skupina 1: standardni neoadjuvantni pristup (kemoterapija 5-FU / leucovorin konkomitantno uz radioterapiju (45-50 Gy u 25 frakcija); skupina 2: kemoterapija 5-FU / leukovorin uz radioterapiju (25 Gy u 5x). Glavni cilj bio je utvrditi stopu resektabilnosti nakon provedene neoadjuvantne terapije te odrediti postotak lokalne kontrole i ukupnog preživljenja

Africa Radiation Oncology Network (AFRONET): an IAEA Telemedicine Pilot Project

In developing countries, many centres work in relative isolation with limited access to up-to-date published literature, international meetings, and expert opinion. Methods: The International Atomic Energy Agency established the AFrica Radiation Oncology NETwork (AFRONET) as a pilot project for African countries. Through videoconferencing, cancer professionals discussed and reviewed challenging cancer cases. Monthly virtual meetings took place among radiotherapy centres in Africa. During these meetings, individual cases were presented and discussed, and a consensus recommendation for treatment was reached. The platform was also used for regularly scheduled webinars. Results: 64 monthly meetings were held and 154 cases have been discussed. The average number of participating centres was 9 per session. Central nervous system tumours were the most common and 5.2% of patients were HIV positive. The profile of diseases and comorbidities represents a window into the typical patient population of radiotherapy centres in Africa. Videoconferencing discussions strengthened clinical decision making for oncology patients. Both the case discussions and the webinars contributed to resident education in participating centres. Conclusions: This pilot experience has shown that it is feasible to use available telemedicine tools to establish a network for case discussions and education in radiation oncology in African countries. &nbsp

Fundamentos, Experiencias e Investigacion

Los días 20, 21 y 22 de agosto de 2009, se realizó el II Congreso Latinoamericano de Arte Terapia y III del Mercosur en Santiago de Chile. Fundación Telefónica

Foundations, Experiences and Research

The II Latin American Congress on Art Therapy and III of Mercosur in Santiago, Chile was held on the 20, 21 and 22 August 2009 and was supported by the Foundation Telefónica

Expanding global access to radiotherapy

Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries,$62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to$184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income,$33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of$96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and$239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even greater total benefit of $365·4 billion ($12·8 billion in low-income countries, $67·7 billion in lower-middle-income countries, and$284·7 billion in upper-middle-income countries). The returns, by the human-capital approach, are projected to be less with the nominal cost model, amounting to $16·9 billion in 2015-35 (-$14·9 billion in low-income countries; -$18·7 billion in lower-middle-income countries, and$50·5 billion in upper-middle-income countries). The returns with the efficiency model were projected to be greater, however, amounting to $104·2 billion (-$2·4 billion in low-income countries, $10·7 billion in lower-middle-income countries, and$95·9 billion in upper-middle-income countries). Our results provide compelling evidence that investment in radiotherapy not only enables treatment of large numbers of cancer cases to save lives, but also brings positive economic benefits

International Conference on Advances in Radiation Oncology (ICARO): Outcomes of an IAEA Meeting

The IAEA held the International Conference on Advances in Radiation Oncology (ICARO) in Vienna on 27-29 April 2009. The Conference dealt with the issues and requirements posed by the transition from conventional radiotherapy to advanced modern technologies, including staffing, training, treatment planning and delivery, quality assurance (QA) and the optimal use of available resources. The current role of advanced technologies (defined as 3-dimensional and/or image guided treatment with photons or particles) in current clinical practice and future scenarios were discussed