Report of
FNCA FY2014 Workshop on Radiation Oncology Project

Outline of Workshop

The FNCA 2014 Workshop on Radiation Oncology was held from 4 to 7 November 2014, in Hirosaki City, Aomori Prefecture, Japan.
The workshop was co-organized by the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) and Hirosaki University.
35 participants from 11 FNCA Member Countries, namely Bangladesh, China, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, the Philippines, Thailand and Vietnam and one Regional Cooperation Agreement (RCA) Member State - India as observer from the International Atomic Energy Agency (IAEA) participated in the workshop.
This project carries out some international joint clinical studies in order to establish treatment protocols for Uterine Cervix cancer, Nasopharyngeal cancer and Breast cancer, which affect large number of people in FNCA member countries, and finally to improve the technique of radiation oncology in the Asian region.

Opening Ceremony
Prof. Yoshihiro TAKAI, Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine moderated the session.
Dr. Tsukasa YAMAMURA, Director, Office for Nuclear Non-Proliferation, Science and Technology, Research and Development Bureau, MEXT officially opened the workshop. He emphasized the steady progress of FNCA activities on radiation oncology in the last 22 years in terms of the contribution to improvement in treatment outcomes and the quality of lives of Asian patients. He also mentioned that in this meeting we should discuss steps to promote the activities.

Prof. Ikuo KASHIWAKURA, Executive Director and Vice President of Hirosaki University delivered his welcome remarks. He highlighted the importance of the utilization of nuclear energy in the treatment of cancer.

Dr. Hirohiko TSUJII, Fellow and Former Executive Director of National Institue of Radiological Sciences (NIRS) delivered his remarks. On behalf of the FNCA member countries, he thanked the Hirosaki University School of Medicine for hosting this year’s workshop which was previously scheduled to be held in Vietnam. In order to introduce the aspect of nuclear policy after the Fukushima Nuclear accident, a tour at the Japan Nuclear Fuel Limited in Rokkasho-mura Kamikita-gun, Aomori was included in the Technical Visit.

Dr. Sueo MACHI, FNCA Coordinator of Japan, presented the result of the 14th Ministerial-Level Meeting and 15th Coordinators Meeting, and gave short summaries on the activities of 10 projects of FNCA. He reported that the Radiation Oncology project is one of the most successful projects of FNCA.

Prof. Shigeyuki NAKAJI, Dean of Hirosaki University Graduate School of Medicine and Professor, Department of Social Medicine, gave a special lecture on Increasing Life Expectancy: A new Strategy for Primary Health Care in Aomori Prefecture, a sociomedical trial on lifespan prolongation in Aomori prefecture by the COI (Center of Innovation) STREAM. He spoke about several trials of COI STREAM to prolong the life of residents in Aomori Prefecture where life expectancy is the shortest in Japan, and presented several strategies to increase the life expectancy of people in Aomori.

Phase II Study of Concurrent Chemotherapy and Extended-Field Radiotherapy for Locally Advanced Cervical Cancer (CERVIX-IV)
In this protocol, 95 patients are registered from all the countries (at the point of this workshop) and 91 patients are considered evaluable.(However, the total recent clinical data presented by the representative of each country in this session was 92, which consisted of Bangladesh (28), China (7), Indonesia (6), Japan (20), Korea (7), Malaysia (5), Mongolia (3), Philippines (4) Thailand (4) and Viet Nam (8).

Out of 91 evaluable cases, 51 cases were stage IIB and 40 were stage IIIB. 68 patients (75%) received more than 4 cycles of Cisplatin and grade 3 leukopenia occurred in 28 patients (32%). The 2-year and 5-year local control (LC) were 96% and 91%, respectively, and the 2-year and 5-year PFS were 75% and 55%, respectively. Local control for stage IIB and IIIB were not different. However, the 2-year OS for IIB is 94.9% while IIIB is 82.3% and 5-year OS for stage IIB is 73.8% while IIIB is 55.0%.
An open discussion on the clinical data of Cervix-IV followed. Evaluation of acute and late toxicity should be considered with caution (1 patient from Korea had sigmoid colon perforation 8 months after CCRT). The conclusions about the overall survival, 2-year and 5- year need more follow-up time.

New Protocols for Cervical Cancers (CERVIX-V)
To assess the feasibility of a new protocol for cervical cancer, two candidate protocols were presented and discussed.

First, Japan reviewed "3D Image-Guided Brachytherapy (3D-IGBT)". Each country then reported on the feasibility study of 3D-IGBT implemented in his/her institute.

A lecture by Japan followed. It was on 3D-IGBT based on the IAEA/RCA Regional Training Course on 3D-Image Guided Brachytherapy for Cervical Cancer. The lecture is specific on the concept of target delineation, detail in each target (HRCTV, OAR) and case examples.

Discussion then ensued. Japan asked each country specific issues, for example: CT at the first brachytherapy, CT at every sessions of brachytherapy, MRI at diagnosis and first brachytherapy and ultrasound at every session of brachytherapy. Each country was asked on their capability of conducting IGBT in their centers. Bangladesh, China, Indonesia, Japan, Malaysia, the Philippines and Thailand reported that it is feasible for them to conduct 3D-IGBT in their centers.

The protocol of 3D-IGBT will be developed based on the level of feasibility and will be presented next year.

Secondly, another candidate protocol, "a Phase II study of CCRT for locally advanced adenocarcinoma and adenosquamous carcinoma" was presented by Japan. The presentation summarized the clinical data of adenocarcinoma or adenosquamous carcinoma cases collected by some member countries. An update from large retrospective data of GOG and large randomized trial data from China and a phase II trial with concurrent chemo-radiotherapy with weekly cisplatin and paclitaxel from Japan were presented and discussed. The protocol on adenocarcinoma and adenosquamous carcinoma will be discussed further in the next meeting.

QA/QC of External Beam Therapy
This activity aims to put in place reliable dosimetry in the institutes among the member countries for effective joint clinical studies. The audits in QA/QC of dosimetry measurement and radiation calibration have been conducted, which is for the reliable radiotherapy.
Report on a summary of intercomparison measurements using validated glass dosimeters done on 46 beams in 16 facilities with 4-18 MV at 11 countries were presented by Japan. This fiscal year, measurements were done in Siriraj Hospital, Bangkok, Thailand. Future plan is to do additional audit from host institutions in participating countries.

Next, a report entitled "Consultation for the Commissioning of Radiophotoluminescent Glass Dosimeter (RGD)" was given by Japan. The worldwide activity of IAEA dosimetry laboratory was introduced including Secondary Standard Dosimetry Laboratory (SSDL) network and postal dose audit to radiation therapy hospitals. Recent results of intercomparison between IAEA (TLD) and NIRS (RGD) showed very good agreement.

Lastly, Korea made a presentation on Radiotherapy Protocol, Radiation Treatment Planning, Immobilization, and QA for Breast Cancer Patients in KIRAMS.

Collaboration of FNCA and IAEA/RCA
A country report on the "Status of Radiation Oncology in India" was presented by Prof. Bidhu Kalyan MOHANTI, a representative from India. In Low Middle Income Countries (LMIC) like India, he reported a higher incidence of cancer and made the comparison of cancer radiotherapy in India and Japan, etc. He also reported on the ongoing clinical trials in Fortis Memorial Research Institute.

Phase II Study of Concurrent Chemoradiotherapy (CCRT) for NPC (NPC-III)
A total of 55 patients are registered in this protocol at the point of this workshop (However, the total recent clinical data presented by representatives of each country in this session was 52, which consisted of Bangladesh (1), China (5), Indonesia (10), Japan (0), Kazakhstan (0), Korea (0), Malaysia (9), Mongolia (0), Philippines (7), Thailand (0) and Vietnam (20).).
54 patients(out of 55 patients )of NPC-III were considered evaluable .
Local control rate of NPC-III (Induction) was worse than that of NPC-I (Adjuvant). However, there were no differences on progression free survival (PFS) rate and overall survival (OS) rate between NPC-I and NPC-III. The numbers are small and mature data is awaited.

An open discussion on the clinical data of Phase II study of CCRT for NPC-III followed. The issues of toxicities due to treatment were discussed. Induction chemotherapy was completed in 100% of patients but concurrent chemotherapy compliance was quite low. Only 76% managed to complete 4 cycles or more. Radiotherapy interruption occurred in 28% of patients, mainly due to toxicities. Machine breakdown rate is lower than in previous NPC-I study. Some toxicities reported seemed to be much higher in some centers compared to others. There was concern that the criteria used for grading toxicities may not be uniform among treatment centers. It was proposed to have a lecture on the grading of toxicities and include pictures on the next workshop. Finally, the expected total number of patients for this study is 120. We need to step up our efforts to recruit further 70 patients.

Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (BREAST-I)
A protocol Breast-I was reviewed. The recent clinical data of Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (BREAST-I) was presented by representatives of each participating country. The following numbers were reported: Bangladesh (WBI - 13, PMRT- 37), China ( WBI- 5, PMRT - 2 ), Indonesia (WBI- 1; PMRT -0 ), Japan (WBI-42, PMRT - 0 ), Kazakhstan ( 0 ), Korea (WBI- 2, PMRT -0 ), Malaysia ( 0 ), Mongolia(WBI-0, PMRT-4) Philippines (WBI-0, PMRT=1 ), Thailand (WBI-1, PMRT-0 ) and Vietnam ( 0 ). Total number of patients was WBI (64) and PMRT (44).

Patients treated HF-WBI according to stage was as follows: Stage 0-IIB, 0-6, IA-35, IB-1 and IIA-15 and IIB-8 and HF-PMRT patients according to stage were Stage IIA- 23, IIB-16, IIIA-4 and Unknown-1.

The clinical data of 108 breasts was summarized. 104 patients received radiation therapy with LINAC 6 MV photon and 4 patients with Co-60. As dose homogeneity technique, field in field method in 99, IMRT in 5 and wedge filter in 4 were used. All the patients tolerated the treatment well without any grade 3 or 4 skin, subcutaneous and lung toxicities. Only 15% had grade 2 acute skin dermatitis. No grade 2 or 3 late toxicities were seen on follow up. In HF-WBI arm 64/200 cases and HF-PMRT arm 44/200 cases were enrolled during past 21 months.

An open discussion on the clinical data of Phase II study of Hypofractionated Radiotherapy for Breast Cancer followed. The participants agreed that with regards to short-term results, hypofractionated radiotherapy was noted to be equally safe and effective as conventional methods. Longer follow up and more patients are needed to obtain final conclusions

Open Seminar
The Open Seminar was held at Communication Center of Hirosaki University School of Medicine as part of the workshop. There were 7 lectures on the thems of 1) MEXT Program Supporting HRD for Nuclear Energy and Radiation Utilization in Asian Countries, 2) Applicaion of Radiation and Isotopes in Industry, Agriculture and Environmental Protection, 3) Introduction of FNCA Radiation Oncology Project, 4) 3D Image-Guided Brachytherapy for Cervical Cancer, 5) Current Status of Cervical Cancer in the Philippines, 6) Development of tumor motion prediction-based dMLC control for real time in Radiation Medicine and 7) Current Status of Cytogenetic Biodosemetry in Radiation Medicine.

Technical Visit
The participants conducted a Technical Visit to Hirosaki University School of Medicine and Hospital. They visited the Radiation Oncology Department and then the Advanced Emergency Medical Center. It was followed by another visit to the Japan Nuclear Fuel Limited in Rokkasho Village. A tour was made at the PR Center, Uranium Enrichment Plant, Low-Level Radioactive Waste Disposal Center, Central Control Room of Reprocessing Plant and the High Level (Radioactive Waste) Management Center. It was a very informative technical visit.

Future Plan
It was agreed that the next workshop will be held in Vietnam tentatively on November 30th - December 5th 2015
It was also agreed that the project would continue the discussion on adenocarcinoma and adenosquamous carcinoma of the cervix as the probable next cervix protocol
The participants were strongly encouraged to disseminate information of FNCA activities, achievements and outcomes in local and international meetings.

Closing Session

Minutes of
FNCA FY2014 Workshop on Radiation Oncology

(1) Following the agreement at the 15th Forum for Nuclear Cooperation in Asia (FNCA) Coordinators Meeting, the FNCA FY2014 Workshop on Radiation Oncology was held from November 4th to 7th, 2014, in Hirosaki City, Aomori Prefecture, Japan. The meeting was co-organized by the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) and Hirosaki University. Representatives from 11 FNCA member countries, namely Bangladesh, China, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, the Philippines, Thailand and Vietnam and one Regional Cooperation Agreement (RCA) Member State - India as observer from the International Atomic Energy Agency (IAEA) participated in the meeting.

Opening Ceremony
(2) Prof. Yoshihiro TAKAI, Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine moderated the session.

Dr. Tsukasa YAMAMURA, Director, Office for Nuclear Non-Proliferation, Science and Technology, Research and Development Bureau, MEXT officially opened the workshop. He emphasized the steady progress of FNCA activities on radiation oncology in the last 22 years in terms of the contribution to improvement in treatment outcomes and the quality of lives of Asian patients. He also mentioned that in this meeting we should discuss steps to promote the activities.

Prof. Ikuo KASHIWAKURA, Executive Director and Vice President of Hirosaki University delivered his welcome remarks. He highlighted the importance of the utilization of nuclear energy in the treatment of cancer.

Dr. Hirohiko TSUJII, Fellow and Former Executive Director of National Institute of Radiological Sciences (NIRS) delivered his remarks. On behalf of the FNCA member countries, he thanked the Hirosaki University School of Medicine for hosting this year’s workshop which was previously scheduled to be held in Vietnam. In order to introduce the aspect of nuclear policy after the Fukushima Nuclear accident, a tour at the Japan Nuclear Fuel Limited in Rokkasho-mura Kamikita-gun, Aomori was included in the Technical Visit.

(3) Dr. Sueo MACHI, FNCA Coordinator of Japan, presented the result of the 14th Ministerial-Level Meeting and 15th Coordinators Meeting, and gave short summaries on the activities of 10 projects of FNCA. He reported that the Radiation Oncology project is one of the most successful projects of FNCA.

(4) Prof. Shigeyuki NAKAJI, Dean of Hirosaki University Graduate School of Medicine and Professor, Department of Social Medicine, gave a special lecture on Increasing Life Expectancy: A new Strategy for Primary Health Care in Aomori Prefecture, a sociomedical trial on lifespan prolongation in Aomori prefecture by the COI (Center of Innovation) STREAM. He spoke about several trials of COI STREAM to prolong the life of residents in Aomori Prefecture where life expectancy is the shortest in Japan, and presented several strategies to increase the life expectancy of people in Aomori.

(5) Introduction of individual participants followed.

Session 1: Phase II Study of Concurrent Chemotherapy and Extended-Field Radiotherapy for Locally Advanced Cervical Cancer (CERVIX-IV)

(7) Dr. Masaru Wakatsuki, Chief Medical Doctor of Research Center Hospital for Charged Particle Therapy, NIRS presented the protocol of Cervix IV, a Phase II Study of Concurrent Chemotherapy and Extended-Field Radiotherapy for Locally Advanced Cervical Cancer.

An update on the clinical data of (CERVIX-IV) was presented by representatives of each participating country with the following number of patients: Bangladesh (28), China (7), Indonesia (6), Japan (20), Korea (7), Malaysia (5), Mongolia (3), Philippines (4) Thailand (4) and Viet Nam (8)

Dr. Masaru Wakatsuki then presented the summary of the follow-up data. 95 cases were registered with 91 cases evaluable, 51 were stage IIB and 40 were stage IIIB. 68 patients (75%) received more than 4 cycles of Cisplatin and grade 3 leukopenia occurred in 28 patients (32%). The 2-year and 5-year local control (LC) were 96% and 91%, respectively, and the 2-year and 5-year PFS were 75% and 55%, respectively. Local control for stage IIB and IIIB were not different. However, the 2-year OS for IIB is 94.9% while IIIB is 82.3% and 5-year OS for stage IIB is 73.8% while IIIB is 55.0%.

(8) An open discussion on the clinical data of Cervix-IV followed. Evaluation of acute and late toxicity should be considered with caution (1 patient from Korea had sigmoid colon perforation 8 months after CCRT). The conclusions about the overall survival, 2-year and 5- year need more follow-up time.

Session 2: New Protocols for Cervical Cancers (CERVIX-V)
(9) To assess the feasibility of a new protocol for cervical cancer, two candidate protocols were presented and discussed.

(10) First, Prof. Shingo Kato of the Department of Radiation Oncology, International Medical Center, Saitama Medical University introduced and reviewed "3D Image-Guided Brachytherapy (3D-IGBT)". Each country then reported on the feasibility study of 3D-IGBT implemented in his/her institute.

Dr. Masaru Wakatsuki gave a lecture on 3D-IGBT based on the IAEA/RCA Regional Training Course on 3D-Image Guided Brachytherapy for Cervical Cancer. This lecture is specific on the concept of target delineation, detail in each target (HRCTV, OAR) and case examples.

Discussion then ensued. Prof. Tatsuya Ohno, Professor / Medical Director, Heavy Ion Medical Center, Gunma University asked each country specific issues, for example: CT at the first brachytherapy, CT at every sessions of brachytherapy, MRI at diagnosis and first brachytherapy and ultrasound at every session of brachytherapy. Each country was asked on their capability of conducting IGBT in their centers. Bangladesh, China, Indonesia, Japan, Malaysia, the Philippines and Thailand reported that it is feasible for them to conduct 3D-IGBT in their centers.

The protocol of 3D-IGBT will be developed based on the level of feasibility and will be presented next year.

Secondly, Dr. Masaru Wakatsuki presented another candidate protocol, a Phase II study of CCRT for locally advanced adenocarcinoma and adenosquamous carcinoma. He summarized the clinical data of adenocarcinoma or adenosquamous carcinoma cases collected by some member countries. An update from large retrospective data of GOG and large randomized trial data from China and a phase II trial with concurrent chemo-radiotherapy with weekly cisplatin and paclitaxel from Japan were presented and discussed. The protocol on adenocarcinoma and adenosquamous carcinoma will be discussed further in the next meeting.

(11) An open discussion on the two candidate protocols followed.

Session 3: QA/QC of External Beam Therapy
(12) Report on a summary of intercomparison measurements using validated glass dosimeters done on 46 beams in 16 facilities with 4-18 MV at 11 countries were presented by Dr. Shigekazu Fukuda, Head of Heavy Particle Faculty Section, Dept. of Accelerator and Medical Physics, Research Center for Charged Particle Therapy, NIRS. This fiscal year, measurements were done in Siriraj Hospital, Bangkok, Thailand. Future plan is to do additional audit from host institutions in participating countries.

(13) Dr. Hideyuki MIZUNO, Senior Researcher, Research Center for Charged Particle Therapy, NIRS reported on Consultation for the Commissioning of Radiophotoluminescent Glass Dosimeter (RGD). The worldwide activity of IAEA dosimetry laboratory was introduced including Secondary Standard Dosimetry Laboratory (SSDL) network and postal dose audit to radiation therapy hospitals. Recent results of intercomparison between IAEA (TLD) and NIRS (RGD) showed very good agreement.

(14) Dr. Kum Bae KIM, Senior Researcher, Medical Physicist, Korea Institute of Radiological & Medical Sciences (KIRAMS) and Dr. Wonil JANG, Chief, Department of Radiation Oncology, KIRAMS made a presentation on Radiotherapy Protocol, Radiation Treatment Planning, Immobilization, and QA for Breast Cancer Patients in KIRAMS.

Session4 :Collaboration of FNCA and IAEA/RCA
(15) A country report on the "Status of Radiation Oncology in India" was presented by Prof. Bidhu Kalyan MOHANTI, a representative from India. In Low Middle Income Countries (LMIC) like India, he reported a higher incidence of cancer and made the comparison of cancer radiotherapy in India and Japan, etc. He also reported on the ongoing clinical trials in Fortis Memorial Research Institute.

Session 5: Phase II Study of Concurrent Chemoradiotherapy (CCRT) for NPC (NPC-III)
(16) Prof. Tatsuya Ohno introduced the protocol of NPC-III, Phase II Study of CCRT for NPC. Recent clinical data was presented by representatives of each participating country: Bangladesh (1), China (5), Indonesia (10), Japan (0), Kazakhstan (0), Korea (0), Malaysia (9), Mongolia (0), Philippines (7), Thailand (0) and Vietnam (20). Prof. Tatsuya Ohno presented the summary of the clinical data and the evaluation of the NPC-III study results. 54 patients of NPC-III were analyzed. Local control rate of NPC-III (Induction) was worse than that of NPC-I (Adjuvant). However, there were no differences on progression free survival (PFS) rate and overall survival (OS) rate between NPC-I and NPC-III. The numbers are small and mature data is awaited.

(17) An open discussion on the clinical data of Phase II study of CCRT for NPC-III followed. The issues of toxicities due to treatment were discussed. Induction chemotherapy was completed in 100% of patients but concurrent chemotherapy compliance was quite low. Only 76% managed to complete 4 cycles or more. Radiotherapy interruption occurred in 28% of patients, mainly due to toxicities. Machine breakdown rate is lower than in previous NPC-I study. Some toxicities reported seemed to be much higher in some centers compared to others. There was concern that the criteria used for grading toxicities may not be uniform among treatment centers. It was proposed to have a lecture on the grading of toxicities and include pictures on the next workshop. Finally, the expected total number of patients for this study is 120. We need to step up our efforts to recruit further 70 patients.

Session 6: Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (BREAST-I)
(18) Dr. Kumiko Karasawa, Head of Treatment Team 3, Research Center Hospital for Charged Particle Therapy, NIRS introduced and reviewed the protocol of BREAST-I which was developed in the last workshop. Introduction of Protocol was given by Dr. Kumiko Karasawa. The clinical data of Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (BREAST-I) was presented by representatives of each participating country. The following numbers were reported: Bangladesh (WBI - 13, PMRT- 37), China ( WBI- 5, PMRT - 2 ), Indonesia (WBI- 1; PMRT -0 ), Japan (WBI-42, PMRT - 0 ), Kazakhstan ( 0 ), Korea (WBI- 2, PMRT -0 ), Malaysia ( 0 ), Mongolia(WBI-0, PMRT-4) Philippines (WBI-0, PMRT=1 ), Thailand (WBI-1, PMRT-0 ) and Vietnam ( 0 ). Total number of patients was WBI (64) and PMRT (44).

Patients treated HF-WBI according to stage was as follows: Stage 0-IIB, 0-6, IA-35, IB-1 and IIA-15 and IIB-8 and HF-PMRT patients according to stage were Stage IIA- 23, IIB-16, IIIA-4 and Unknown-1.

(19) Dr. Kumiko Karasawa presented the summary of the clinical data of 108 breasts. 104 patients received radiation therapy with LINAC 6 MV photon and 4 patients with Co-60. As dose homogeneity technique, field in field method in 99, IMRT in 5 and wedge filter in 4 were used. All the patients tolerated the treatment well without any grade 3 or 4 skin, subcutaneous and lung toxicities. Only 15% had grade 2 acute skin dermatitis. No grade 2 or 3 late toxicities were seen on follow up. In HF-WBI arm 64/200 cases and HF-PMRT arm 44/200 cases were enrolled during past 21 months.

(20) An open discussion on the clinical data of Phase II study of Hypofractionated Radiotherapy for Breast Cancer followed. The participants agreed that with regards to short-term results, hypofractionated radiotherapy was noted to be equally safe and effective as conventional methods. Longer follow up and more patients are needed to obtain final conclusions

Session 7: Open Seminar
(21)The Open Seminar was held at Communication Center of Hirosaki University School of Medicine as part of the workshop. During the opening ceremony, Prof. Shigeyuki NAKAJI and Dr. Sueo MACHI gave their remarks. Seven very interesting and innovative topics were presented by distinguished speakers. Prof. Yoshihiro TAKAI and Dr. Dyah Erawati moderated the session.

(22) Dr. Tsukasa YAMAMURA spoke on MEXT Program Supporting HRD for Nuclear Energy and Radiation Utilization in Asian Countries.

(23) Dr. Sueo MACHI gave a lecture on Applicaion of Radiation and Isotopes in Industry, Agriculture and Environmental Protection.

(24) Dr. Kumiko KARASAWA spoke on Introduction of FNCA Radiation Oncology Project.

(25)Prof. Shingo KATO gave a lecture on 3D Image-Guided Brachytherapy for Cervical Cancer

(26) Dr. Rey. H. De Los Reyes gave a lecture on the Current Status of Cervical Cancer in the Philippines

(27) Prof. Noriyasu HOMMA from Tohoku University gave a lecture on Development of tumor motion prediction-based dMLC control for real time in Radiation Medicine.

(28) The last lecture was delivered by Dr. Kentaro ARIYOSHI from Hirosaki University. He gave a lecture on the Current Status of Cytogenetic Biodosemetry in Radiation Medicine.

(29) Dr. Hirohiko TSUJII concluded the Open Seminar with his closing remarks.

Session 8: Technical Visit at Hirosaki University School of Medicine and Hospital.
(30) The participants conducted a Technical Visit to Hirosaki University School of Medicine and Hospital. They visited the Radiation Oncology Department and then the Advanced Emergency Medical Center.

Session 9: Technical Visit at Japan Nuclear Fuel Limited.
(31) A Technical Visit was also conducted at the Japan Nuclear Fuel Limited in Rokkasho Village. A tour was made at the PR Center, Uranium Enrichment Plant, Low-Level Radioactive Waste Disposal Center, Central Control Room of Reprocessing Plant and the High Level (Radioactive Waste) Management Center. It was a very informative technical visit.

Session 10: Future Plan
(32) Regarding Next Workshop and other activities, the following items were discussed and agreed.

1. The participants agreed that the next workshop will be held in Vietnam, tentatively on Nov. 30-Dec. 5, 2015.

2. They also agreed to continue the discussion on adenocarcinoma and adenosquamous carcinoma of the cervix as the probable next cervix protocol

3. The participants were strongly encouraged to disseminate information of FNCA activities, achievements and outcomes in local and international meetings.

Session 11: Drafting the Workshop Minutes
(33) The draft minutes presented by reporters were discussed and amended.
The minutes were unanimously adopted by the workshop participants.

Closing Session
(34) Ms. Moe AOKI, Researcher, International Nuclear and Fusion Energy Affairs Division, Research and Development Bureau, MEXT gave her closing remarks. This was followed by Dr. Hirohiko TSUJII’s closing remarks. The workshop was officially closed.

Day 1 Tue, 4 November 2014
Place : Hirosaki University

8:30-9:00

Registration

9:00-10:20

Opening Ceremony
Moderator: Prof. Yoshihiro Takai (Japan)

9:00-9:05

Opening Address / Dr. Tsukasa Yamamura, Director, Office for Nuclear Non-
  Proliferation, Science and Technology, Research and
  Development Bureau, Ministry of Education, Culture,
  Sports, Science and Technology (Japan)

9:05-9:10

Welcome Remarks/ Prof. Ikuo Kashiwakura,
  Executive Director (Research) and Vice President
  Hirosaki University (Japan)

9:10-9:15

Remark / Dr. Hirohiko Tsujii, Project Leader (Japan)

9:15-9:30

Introduction of FNCA Activity: "FNCA Activity Achievement and FNCA
Ministerial Level Meeting in 2013-2014"/ Dr. Sueo Machi FNCA Coordinator
of Japan (Japan)

9:30-10:00

Special Lecture:A sociomedical trial of lifespan prolongation in Aomori
prefecture by the COI (Center of Innovation) STREAM / Prof. Shigeyuki
Nakaji, Dean of Hirosaki University Graduate School of Medicine (Japan)

10:00-10:10

Introduction of Members

10:10-10:20

Group Photography /Adoption of the Agenda / Confirmation of Session Chairs

10:20-10:40

Break

 

10:40-12:20

Session 1: Phase II Study of Concurrent Chemotherapy and Extended-Field Radiotherapy for Locally Advanced Cervical Cancer (CERVIX-IV)
Co-chairs: Dr. Parvin Akther Banu (Bangladesh) & Dr. To Anh Dung (Vietnam)

1) Introduction of the Protocol

2) Presentation on the clinical data from each country
Bangladesh
China
Indonesia
Japan
Kazakhstan
Korea
Malaysia
Mongolia
The Philippines
Thailand
Viet Nam

3) Summary of the clinical data / Dr. Masaru Wakatsuki (Japan)

4) Discussion

12:20-13:20

Lunch

13:20-15:50

Session 2: New Protocol (CERVIX-V)
Co-chairs: Dr. Kullathorn Thephamongkhol (Thailand)
              Dr. Yaowalak Chansilpa (Thailand)

1) Introduction and Review of Pilot Study "3D image-guided brachytherapy (3D-IGBT)"/ Prof. Shingo Kato(Japan)

2) Country Report " Feasibility Study of 3D –IGBT"
Bangladesh
China
Indonesia
Kazakhstan
Korea
Malaysia
Mongolia
Philippines
Thailand
Vietnam

3) Lecture on 3D-IGBT from Japan / Dr. Masaru Wakatsuki (Japan)

4) Discussion

5) Introduction and Review on "Phase II study of CCRT for locally advanced adenocarcinoma"/ Dr. Masaru Wakatsuki (Japan)

6) Summary of the clinical data / Dr. Masaru Wakatsuki (Japan)

7) Discussion

15:50-16:10

Break

16:10-17:30

Session 3: QA/QC of External Beam Therapy
Co-chairs: Dr. Kum Bae Kim ( Korea ) & Dr. Hideyuki Mizuno (Japan)

1) QA/QC of External Beam Therapy, Report of the Fieldwork / Dr. Shigekazu Fukuda (Japan)

2) Consultation for the Commissioning of Radiophotoluminescent Glass Dosimeter
    Dr. Hideyuki Mizuno (Japan)

3) Breast Cancer Dr. Kum Bae Kim (Korea) & Dr. Wonil JANG (Korea)

4) Discussion

17:30-18:00

Session4: Country Report; Collaboration of FNCA and IAEA/RCA
Co-chairs: Prof. Cao Jianping (China) & Dr. Savkhatova Akmaral (Kazakhstan)

1) Current Status of Radiation Oncology in India and Ongoing Clinical Trials in Fortis Memorial Research Institute / Prof. Bidhu Kalyan MOHANTI (India, IAEA/RCA)

2) Discussion

Day 2 Wed, 5 November 2014
Place : Hirosaki Unviersity

9:00-10:30

Session 5: Phase II Study of Chemoradiotherapy for NPC (NPC-III)
Co-chairs: Dr. Xu Xiaoting (China) & Dr. Lau Fen Nee (Malaysia)

1) Review and introduction of the Protocol / Prof. Tatsuya Ohno (Japan)

2) Presentation on the clinical data from each country
Bangladesh
China
Indonesia
Japan
Kazakhstan
Korea
Malaysia
Mongolia
The Philippines
Thailand
Vietnam

3) Summary of the clinical data / Prof. Tatsuya Ohno (Japan)

4) Discussion

10:30-10:50

Break

10:50-12:30

Session 6: Breast Cancer
Co-chairs: Dr. Parvin A.Banu (Bangladesh) & Dr. Gonchig Odontuya (Mongolia) & Dr. Erdenetuya Yadamsuren (Mongolia)

1) Introduction of the Protocol / Dr. Kumiko Karasawa (Japan)

2) Presentation on the clinical data from each country
Bangladesh
China
Indonesia
Japan
Kazakhstan
Korea
Malaysia
Mongolia
The Philippines
Thailand
Vietnam

3) Summary of the clinical data / Dr. Kumiko Karasawa (Japan)

4) Discussion

12:30-13:40

Lunch and Move to Open Lecture Venue

14:00-17:20

Session 7: Open Seminar
-Open Seminar on Radiation Use for Medical Application-

14:00-14:20: Registration

14:20-14:30: Opening Ceremony
Moderator: Yoshihiro Takai (Japan) & Dyah Erawati (Indonesia)

Opening Remarks / Prof. Shigeyuki Nakaji_ Hirosaki University (Japan)

Remarks / Dr. Sueo Machi FNCA Coordinator _ (Japan)

14:30-14:50: 1) MEXT Programs Supporting HRD for Nuclear Energy and Radiation
    Utilization in Asian Countries / Dr. Tsukasa Yamamura, MEXT (Japan )

14:50-15:10: 2) Application of Radiation and Isotopes in Industry, Agriculture and
    Environmental Protection/ Dr. Sueo Machi (Japan)

15:10-15:30: 3) Introduction of FNCA Radiation Oncology Project / Dr. Kumiko Karasawa (Japan)

15:30-15:50: 4) 3D Image Guided Brachytherapy (3D-IGBT) / Prof.Shing Kato (Japan)

15:50-16:10 Break

16:10-16:30: 5) Current Status of Cervical Cancer in the Philippines / Dr. Rey H.De Los Reyes (The Philippines)

16:30-16:50: 6) Development of tumor motion prediction-based dMLC control
    for real-time conformable radiotherapy / Prof. Noriyasu Homma (Japan)

16:50-17:10: 7) Current Status of Cytogenetic Biodosemetry in Radiation Emergency
    Medicine / Dr. Kentaro Ariyoshi (Japan)

17:10-17:20: Closing Session

Closing Remarks / Dr. Hirohiko Tsujii (Japan)

Day 3 Thu, 6 November 2014
Place : Hirosaki University& Japan Nuclear Fuel Limited

08:20(30)-10:00

Session 8:Technical Visit at Hirosaki University School of Medicine and Hospital

Move to Rokkasho Village by Bus

13:30-15:50

Session 9: Technical Visit at Facilities of Japan Nuclear Fuel Limited

Day 4 Fri, 7 November 2014
Place: Hirosaki University

9:00-09:30

Session 10: Future plan
Co-chairs: Dr. Rey. H. De Los Reyes (Philippines) & Dr. Jaemelyn Marie O. Fernandez(Philippines) & Dr. Navchaa Gombodorj (Mongolia)

9:30-11:45

Session11: Drafting the Workshop Minutes
1) Discussion
2) Adoption of the Minutes

11:45-12:00

Closing Session

Co-chairs: Dr. Rey. H. De Los Reyes (Philippines) & Dr. Jaemelyn Marie O. Fernandez (Philippines) &Dr. Navchaa Gombodorj (Mongolia)

Closing Remark / Ms. Moe Aoki ,MEXT (Japan)

Closing Remark / Dr. Hirohiko Tsujii (Japan)

Participants List
FNCA FY2014 Workshop on Radiation Oncology Project