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Doctors Receive IAEA Training in 3-D Radiotherapy Tools to More Accurately Target Cancer

Doctors receive IAEA training in 3-D radiotherapy tools to more accurately target cancer

With the launch of a series of new IAEA workshops, radiation oncologists are getting financial support and training in 3-D radiation therapy planning. (Photos: D. Calma/IAEA)

Hands-on training with the latest cancer treatment tools helps radiation oncologists — specialized doctors — to deliver precise radiation treatment for managing cancerous or malignant tumours while minimizing harm to healthy tissue caused by unnecessary radiation exposure. This type of training is often out of reach for doctors in low and middle income countries. With the launch of a series of new IAEA workshops, radiation oncologists are getting training in 3-D radiation therapy planning. 

“It is very important to be as accurate as possible when irradiating a tumour,” said Mark Mseti, radiation oncologist from Ocean Road Cancer Institute in Tanzania who participated in the pilot workshop at IAEA headquarters. “The concept of target volume definition and contouring is about making sure that the radiation we use is actually focusing on the disease and not on the healthy tissue. If you can obtain accuracy in drawing, or contouring, the tumour, you will have a higher probability of targeting and obtaining the goals of treatment, while sparing as much of the healthy, normal tissues as you can.”

Cancer is the uncontrolled division of abnormal cells in the body, and radiation can be used to stop that division of cells. Specific doses of radiation can damage cells beyond repair, causing them to stop dividing and to die. This makes radiation very useful for managing and treating cancer, but if the radiation is imprecisely or improperly targeted at the tumour, or delivered at the wrong dose level, the patient’s healthy cells can be unnecessarily damaged or eliminated, or the cancer cells are only partially eliminated, leaving other cancer cells to continue dividing in the person’s body. This could put the patient at risk of health complications in the short or long term. 

Following requests from Member States, the IAEA brought together oncologists from 20 low and middle income countries earlier this month to receive training from experts on target volume definition and contouring for radiotherapy (see box). “Many of these doctors would otherwise be limited to primarily theoretical training due to economic and resource constraints hindering access to often costly hands-on courses,” said Eduardo Rosenblatt, Head of the Applied Radiation Biology and Radiotherapy Section at the IAEA.

We plan to start 3-D radiotherapy by early next year in my country, and this course is quite enriching in terms of knowledge and exposure, and helps us to meet IAEA standards.
Mark Mseti, radiation oncologist, Ocean Road Cancer Institute, Tanzania

“Getting the theoretical knowledge from books is one thing, but practicing with the tools and doing the contouring makes a big difference in terms of accuracy, precision and consistency when planning and delivering treatment,” said Rosenblatt. “Hands-on experience under guidance from experts can help doctors to achieve better treatment results and avoid mistakes.” A training event like this also helps countries to meet the latest safety standards for using radiation in medicine, he added. 

This was the first of a series of workshops that in the future will take place at a regional level, and will aim at enhancing cancer care capacities and further standardizing the safe use of modern cancer treatment tools and techniques. 

As radiotherapy technology quickly progresses, “this type of training is a very good opportunity to be fully up-to-date on the latest guidelines in the different areas for treating the most frequent types of cancers,” said Gaspar Perez Jimenez, a radiation oncologist from the Radiation Oncology Department of the Insituto Oncologico Nacional in Panama who participated in the pilot workshop.

Seeing in 3-D for the first time

For many of the participants, this was their first time working with these advanced tools and 3-D diagnostic scans. 

“In my country, we do contouring in an outdated way using a machine, a paper and a needle to contour in 2-D, and in my three years of training as a radiation oncologist, I have never actually contoured in 3-D; everything has been theories, theories, theories. So I am now getting the training to use the modern and current techniques,” said Mseti. “We plan to start 3-D radiotherapy by early next year in my country, and this course is quite enriching in terms of knowledge and exposure, and helps us to meet IAEA standards.” 

Like Tanzania, many low and middle income countries are only beginning or planning to begin using 3-D cancer treatment tools. Having access to cost-effective workshops makes it easier for these countries to make the transition to 3-D, which, ultimately, means better treatment options, said Rosenblatt. 

“When I get home, I plan to make a presentation to my fellow oncologists to enlighten them about what is happening in the world in terms of precision in controlling tumours and in targeting definition to significantly reduce the radiotoxicity we introduce to our patients, and, ultimately, we can improve cancer care and treatment for our patients,” Mseti said.

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