1. IAEA/RCA/RAS/6/040 Project Planning Meeting on Improvement in Quality of Radiotherapy for Frequent Cancers in the Region India, Mumbai, 2005-03-03 - 2005-03-09

2. Primary Site 2000 MaleFemaleTotal%Inci. Lip Oral cavity & Pharynx 1452357180916.869.8 Female Breast 1264126411.8013.5 Haematological and Reticulo endothelial system 53149110229.525.5 Oesophagus4015419428.785.1 Cervix Uteri 7527527.018.1 Lung Bronchus and Pleura 5181426606.153.5 Thyroid Gland 994004994.652.70 Ovary, Fallopian tube and Broad Ligament -4794794.465.1 Colon, Rectum, Anus, Anal Canal 1992554544.232.4 Unknown primary sites & others 2441423863.59 2. 1

3. Cancer Site 198519861987199019952000 Lip, oral cavity & pharynx 132326.4%8.4128125.7%7.9118623.2%7.3140323.1%8.3140529.3%7.7180916.8%9.8 Lung1923.8%1.22144.3%1.32224.4%1.43045.0%1.83905.3%2.16606.2%3.5 Female Breast 53110.6%6.956311.4%7.153810.5%6.764010.6%7.987411.9%9.8126411.8%13.5 Cervix Uteri 4749.5%6.14959.9%6.351010.0%6.45479.0%6.65888.0%6.67527.0%8.1 Oesophagus4418.8%2.84759.5%2.94809.4%2.95449.0%3.24909.4%3.89428.78%5.1 Thyroid1432.9%0.91412.8%0.91593.1%0.92253.7%1.32773.8%1.54994.65%2.70

5. Available Radiotherapy Facilities Teletherapy – Co60 Machines Teletherapy – Co60 Machines Six Centers Six Centers Brachytherapy – HDR – One Center Brachytherapy – HDR – One Center MDR - One Center MDR - One Center Radio isotope treatment – Three Centers Radio isotope treatment – Three Centers

6. Available Human Resources Clinical Oncologists (Radio Therapists) Clinical Oncologists (Radio Therapists) - Public Sector – 16 at present - Public Sector – 16 at present - Private Sector – 4 at present - Private Sector – 4 at present Medical Physicists Medical Physicists - Only 4 at present - Only 4 at present Therapy Radiographers Therapy Radiographers - >30 at present - >30 at present Technical assistants Technical assistants - Public Sector – Approx:5 at present - Public Sector – Approx:5 at present - Private Sector – unknown - Private Sector – unknown Maintenance and Engineering Maintenance and Engineering - ? > 6 Approx

7. Available Training Facilities Post Graduate Institute of Medicine Post Graduate Institute of Medicine -Doctor of Medicine course (Radiotherapy) -Doctor of Medicine course (Radiotherapy) Post Graduate Institute of Sciences Post Graduate Institute of Sciences -MSc in Medical Physics -MSc in Medical Physics Dept: of Nuclear Sciences – Colombo Univ: Dept: of Nuclear Sciences – Colombo Univ: -MSc in Medical Physics -MSc in Medical Physics Govt: Training School for Radiographers Govt: Training School for Radiographers -Certificate of Competency -Certificate of Competency

8. Deficiencies & Requirements Equipment - Linear Accelerators Equipment - Linear Accelerators RT Simulators RT Simulators RT Planning Systems RT Planning Systems Brachytherapy – Remote controlled after Brachytherapy – Remote controlled after loading Systems. loading Systems. - Insitu Therapy-implants - Insitu Therapy-implants Quality Assurance Systems Quality Assurance Systems - Immobilization - Immobilization - Verification - Verification - Safety - Safety

9. Deficiencies & Requirements Human Resources Medical Physicists – acute need for more than 20 medical physicists at present for RT Centers alone. Medical Physicists – acute need for more than 20 medical physicists at present for RT Centers alone. Maintenance technicians and Engineers Maintenance technicians and Engineers Medical Physics technical assistants Training Medical Physics technical assistants Training Revision of training modules for therapy radiographers Revision of training modules for therapy radiographers

10. Clinical Quality Assurance Development of Protocol based Therapy Development of Protocol based Therapy Development of routine safety and Quality assessment practice Development of routine safety and Quality assessment practice Clinical audits and surveys Clinical audits and surveys Research and development capabilities Research and development capabilities

11. Development of Training Training of Trainers. Training of Trainers. Expert visits for training (>1 Month Duration). Expert visits for training (>1 Month Duration). Adaptation of Regional Training Modules and Syllabuses (AFRA/RCA 2002). Adaptation of Regional Training Modules and Syllabuses (AFRA/RCA 2002). Accreditation - On completion of training. Accreditation - On completion of training. - Periodically, continued technical - Periodically, continued technical education. education. Involvement of Technical schools and vocational education schools. Involvement of Technical schools and vocational education schools.

12. Radio Therapy Equipment Inventory of equipment and stocks of spare parts. Inventory of equipment and stocks of spare parts. Accessories and other supplies. Accessories and other supplies. Quality of infrastructures. Quality of infrastructures. Time bound replacement schedules. Time bound replacement schedules.

13. Thank You Dr. M.A.Yasantha Ariyaratne M.D. DIRECTOR National Cancer Control Programme Cancer Institute, Maharagama Sri Lanka