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The FNCA FY2020 Workshop on Radiation Oncology

Report of
FNCA FY2020 Online Workshop on Radiation Oncology

November 27, 2020


Outline of Workshop

i) Date : November 27th, 2020
ii) Venue : ZOOM
iii) Host Organization : Ministry of Education, Culture, Sports, Science and Technology(MEXT)
iv) Participants :

44 Bangladesh, China, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, Philippines, Thailand, Vietnam.


The FNCA FY2020 Online Workshop on Radiation Oncology was held on November 27th, 2020. The meeting was organized by the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) in cooperation with Nuclear Safety Research Association (NSRA). Representatives from 11 FNCA member countries, namely Bangladesh, China, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, The Philippines, Thailand and Vietnam participated in the workshop (WS).

This project carries out 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.

Group Photo1

Group Photo2

Opening Session
Prof. KATO Shingo, the Project Leader of Radiation Oncology Project opened the workshop with his opening remarks.

Mr. SUZUKI Tetsu, MEXT, Mr. WADA Tomoaki, FNCA Coordinator of Japan and Dr. NAMBA Hideki, FNCA Advisor of Japan gave their remarks respectively.

Prospective Observational Study of 3D-Image guided brachy therapy for Locally Advanced Cervical Cancer (CERVIX-V)
This is a new protocol for cervical cancers following Cervix-IV. The patient enrollment started in 2018.

60 patients were enrolled into Cervix-V in total. The number of patients by county is

Bangladesh (1), China (7), Indonesia (9), Japan (5), Kazakhstan (6), Korea (0), Malaysia (10), Mongolia (2), Philippines (8) Thailand (12) and Vietnam (0).

Out of 60 patients, 54 patients were eligible.
As preliminary analysis of Cervix-V, 42 patients whose follow-up periods exceeded 6 months were analyzed.

All patients were treated with 3D-IGBT.
Compared to the reference doses, almost all cases satisfied those doses.
-39 (93%) patients achieved adequate doses for HR-CTV D90.
-41 (98%) patients achieved the dose constraint for bladder D2cc
-41 (98%) patients achieved the dose constraint for rectum D2cc.
-40 (95%) patients achieved the dose constraint for sigmoid colon D2cc.

-Grade 3 acute hematological toxicity was observed in 5 (12%) patients. These toxicities were manageable.
-Grade 3 or worse acute non-hematological toxicity was observed in 1 (2%) patients so far.
-Grade 3 or worse late toxicity has not been observed so far.
-The 2-year overall survival (OS), local control (LC), and disease free survival (DFS) were 91%, 88%, and 72%, respectively.

Patient enrollment into Cervix-V goes well. Members were encouraged to continue to enroll patients.

Phase II Study of Neoadjuvant Chemotherapy with Concurrent Chemoradiotherapy (CCRT) for Nasopharyngeal Carcinoma (NPC-III)
A total 120 patients have been registered in this protocol.

The number of patients by county is Bangladesh (1), China (9), Indonesia (12), Japan (0), Kazakhstan (0), Korea (0), Malaysia (31), Mongolia (0), Philippines (7) Thailand (0) and Vietnam (60).

Japan presented the summary of analyzed clinical data of NPC-III. The Summary are as follows.
- Patient enrollment was completed in 2019.
- Current Total number of patients enrolled in NPC-III is 120.
- Median follow up period is 38 months.
- Some follow up data with acute toxicities enrolled in 2019 has not been submitted yet.
-The treatment results match with NPC-I (CCRT and adjuvant chemotherapy). However, there are significant differences as well. Locoregional control of NPC-III (Induction chemotherapy and CCRT) is lower than NPC-I while overall survival is better. These results are preliminary results.

The primary endpoint of this clinical trial is 3-year OS. The patients need to be followed up for another 2 years. The 3 year follow up results will be the written preliminary report.

Photo of the Meeting

Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (Postmastectomy Radiation Therapy (PMRT)/BREAST-I)
The total number of registered PMRT patients was 222 (Bangladesh (84), China (13), Indonesia (0), Japan (15), Kazakhstan (20), Korea (0), Malaysia (0), Mongolia (26), Philippines (18), Thailand (0) and Vietnam (46)).

Japan presented the summary of analyzed clinical data of PMRT/BREAST-I. The Summary is as below.

- 222 cases have been enrolled and analyzed while the target accrual number is 200.
- 1 patient's data that has not been analyzed after enrollment was newly added this year.
- 15% of grade 2 and over acute dermatitis and 1% of grade 2 subcutaneous acute toxicity have been observed.
- No grade 3 or over late toxicity has been observed.
- The 3-year locoregional control, progression free survival rates are 96.9%, 88.9%, respectively.
-Co-researchers in this clinical trial should grade toxicity correctly.

Participants agreed to write a report on acute toxicity of this protocol at this point.

The enrolment of patients into this protocol was completed in 2019 and the primary endpoint of the protocol is 5-year local recurrence free survival. Participants were requested to follow up the patients for 4 more years.

Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (Whole Breast Irradiation(WBI)/BREST-I)
The total number of registered WBI patients was 227 (228 breast lesions). The number by country is Bangladesh (31), China (6), Indonesia (16), Japan (134), Kazakhstan (14), Korea (9), Malaysia (0), Mongolia (3), Philippines (0), Thailand (14) and Vietnam (0). Total number of WBI patients was 229. (229 patients / 230 breast lesions).
The summary of the clinical data is as follows.

Japan presented the summary of analyzed clinical data of WBI/BREAST-I. The Summary is as below.

-227 cases were enrolled in HF-WBI protocol from February 2013 until October 2018.
-227 patients with 228 tumors who completed the treatment were analyzed.
-13% of grade 2-3 acute dermatitis had been observed.
-1 locoregional recurrence, 4 distant metastases and 3 breast cancer death have been observed.
-No grade 3 or over late toxicity has been observed.
-The 3 year locoregional control, progression free survival rates are 99.6%, 98.6% respectively.
-Co-researchers in this clinical trial should grade toxicity correctly.

WS Participants agreed to write a report on acute toxicity of this protocol at this point.

Patient enrolment into this protocol was completed in 2018. Participants were requested to follow up the patients for 3 more years to assess the efficacy.

Breast-I clinical trials (PMRT and WBI) have been conducted very well so far.

QA/QC for 3D-IGBT
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.

Dosimetry audit on 3D-IGBT by medical physicists started in 2019 along with CERVIX-V.

Japan reported the results of on-site audit for 3D-IGBT of the 4 hospitals namely the First Affiliated Hospital of Soochow University (China, October 2019) and Philippine General Hospital, St. Luke's Medical Center (Quezon City and Global City) (The Philippines, January 2020). Main points from his report are as follows.

-The dosimetry audits in the 4 hospitals were successfully conducted.
-Measured dose for point A, bladder and rectum were agreed with TPS calculated value within a tolerance level for all.
-Applicator offset value was measured for the centers and 1 hospital showed 2 mm difference between measured and stated value. The hospital staff re-measured the value after the on-site audit and confirmed the consistency with the audit results and modified it. Finally offset data became consistent for all cases.
- Measured source strength and treatment planning system (TPS) registered value agreed within a tolerance level for all hospitals.

The on-site audit is being suspended by the COVID-19 impact. The audit will resume after current difficult situation is improved.

Photo of Documentation

Special Topic -Status of Radiotherapies during the COVID-19 Crisis in FNCA Member Countries-
The purpose of this special session was to know and also share the status of radiotherapies during the COVID-19 in FNCA member countries.

15 hospitals' cases (from each FNCA country) were introduced.

Presenters introduced national data and statistics regarding COVID-19 and explained on their efforts and strategies to perform radiotherapies avoiding infection risk.

Participants learnt there are many ways to reduce the infection risk of patients and medical staffs. As mentioned in presentations, hypo-fractionated radiotherapy should be used more actively and frequently. Safe and effective hypo-fractionation treatment regimen including palliative radiotherapy should be established among FNCA countries.

Photo of Mongolia

Photo of Kazakhstan   Photo of Thailand

Future Plans
1) New Clinical Trials / Palliative Radiation Therapy for Bone Metastasis & Brain Metastasis

In 2019's WS, radiotherapies for bone metastasis and brain metastasis were proposed and discussed as new clinical trials. To draft those protocols, questionnaires were conducted among FNCA members prior to WS.

Dr. MAKISHIMA Hirokazu (Japan)introduced the results of questionnaire on brain metastasis. He also introduced the outline of the clinical trial and draft protocol.

Discussion points of the draft protocol are additional secondary outcomes, sample size, inclusion/exclusion criteria and evaluation method of efficacy. Members can exchange their comments and requests on those points by emails afterwards.

Dr. Kullathorn Thephamongkhol (Thailand) also introduced briefly the results of the questionnaire on radiotherapies for brain metastasis. He summarized the answers regarding "environment of palliative treatment" and "case management" in FNCA members' hospitals.

Based on the questionnaire results, he suggested several potential protocols e.g. single arm study as practice (QoL Study), randomized control trial (RCT) to resolve variation, prospective study for technology transfer, retrospective study to predictive survival benefit /avoidance of unnecessary whole brain radiation therapy (WBRT).

WS participants will exchange emails on the 2 new clinical trials for further discussion after WS.

2) 2021's Workshop
2021's workshop will be held in Mongolia in the beginning of September if the spread of COVID-19 infections has settled down.

 


Minutes of
FNCA 2020 Online Workshop on Radiation Oncology Project

November 27th, 2020


(1) The FNCA FY2020 Online Workshop on Radiation Oncology was held on November 27th, 2020. The meeting was organized by the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT) in cooperation with Nuclear Safety Research Association (NSRA). Representatives from 11 FNCA member countries, namely Bangladesh, China, Indonesia, Japan, Kazakhstan, Korea, Malaysia, Mongolia, The Philippines, Thailand and Vietnam participated in the workshop (WS).

Opening Session
(2) Prof. KATO Shingo, the Project Leader of Radiation Oncology Project opened the workshop with his opening remarks.

(3) Confirmation of agenda was held and the agenda was adopted.

(4) Mr. SUZUKI Tetsu, MEXT, Mr. WADA Tomoaki, FNCA Coordinator of Japan and Dr. NAMBA Hideki, FNCA Advisor of Japan gave their remarks respectively.

Session 1: Prospective Observational Study of 3D-Image Guided Brachytherapy for Locally Advanced Cervical Cancer (CERVIX-V)
(5) Dr. OKONOGI Noriyuki, Chief Physician, Clinical Research Group of Pelvic tumor, Department of Charged Particle Therapy Research, National Institute of Radiological Sciences(NIRS) Quantum Medical Science Directorate National Institutes for Quantum and Radiological Science and Technology(QST) presented the summary of analyzed clinical data of Cervix-V.

(6) 60 patients were enrolled into Cervix-V in total and 54 patients were eligible. As preliminary analysis of Cervix-V, 42 patients whose follow-up periods exceeded 6 months were analyzed.

(7) All patients were treated with 3D-IGBT.

(8) Compared to the reference doses, almost all cases satisfied those doses.
-39 (93%) patients achieved adequate doses for HR-CTV D90.
-41 (98%) patients achieved the dose constraint for bladder D2cc
-41 (98%) patients achieved the dose constraint for rectum D2cc.
-40 (95%) patients achieved the dose constraint for sigmoid colon D2cc.

-Grade 3 acute hematological toxicity was observed in 5 (12%) patients. These toxicities were manageable.
-Grade 3 or worse acute non-hematological toxicity was observed in 1 (2%) patients so far.
- Grade 3 or worse late toxicity has not been observed so far.
-The 2-year overall Survival (OS), local control (LC), and disease free survival (DFS) were 91%, 88%, and 72%, respectively.

(9) Patient enrollment into Cervix-V goes well. Members were encouraged to continue to enroll patients.

Session 2: Phase II Study of Neoadjuvant Chemotherapy with Concurrent Chemoradiotherapy (CCRT) for Nasopharyngeal Carcinoma (NPC-III)
(10) Dr. MAKISHIMA Hirokazu, Chief Physician, Clinical Research Group of Pelvic Tumor, Department of Charged Particle Therapy Research, NIRS, Quantum Medical Science Directorate, QST presented the summary of analyzed clinical data of NPC-III. The Summary are as follows.

- Patients enrollment was completed in 2019.
- Current Total number of patients enrolled in NPC-III is 120
- Median follow up period is 38 months
- Some follow up data with acute toxicities enrolled in 2019 has not been submitted yet.
-The treatment results match with NPC-I (CCRT and adjuvant chemotherapy). However, there are significant differences as well. Locoregional control of NPC-III (Induction chemotherapy and CCRT) is lower than NPC-I while overall survival is better. These results are preliminary results.
(11) The primary endpoint of this clinical trial is 3-year OS. The patients need to be followed up for another 2 years. The 3 year follow up results will be the written preliminary report.

Session 3: Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (Postmastectomy Radiation Therapy (PMRT)/BREAST-I)
(12) Dr. KONO Sawa, Assistant Professor, Department of Radiation Oncology, Tokyo Women's Medical University presented the summary of analyzed clinical data of PMRT/BREAST-I. The Summary are as follows.

- 222 cases have been enrolled and analyzed while the target accrual number is 200.
- 1 patient's data that has not been analyzed after enrollment was newly added this year.
- 15% of grade 2 and over acute dermatitis and 1% of grade 2 subcutaneous acute toxicity have been observed.
- No grade 3 or over late toxicity has been observed.
- The 3-year locoregional control, progression free survival rates are 96.9%, 88.9%, respectively.
-Co-researchers in this clinical trial should grade toxicity correctly.

(13) Participants agreed to write a report on acute toxicity of this protocol at this point.

(14) The enrolment of patients into this protocol was completed in 2019 and the primary endpoint of the protocol is 5-year local recurrence free survival. Participants were requested to follow up the patients for 4 more years.

Session 4: Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (Whole Breast Irradiation (WBI)/ BREAST-I)
(15) Dr. KONO Sawa presented the summary of analyzed clinical data of WBI / BREAST-I. The Summary are as follows.

-227 cases were enrolled in HF-WBI protocol from February 2013 until October 2018.
-227 patients with 228 tumors who completed the treatment were analyzed.
-13% of grade 2-3 acute dermatitis had been observed.
-1 locoregional recurrence, 4 distant metastases and 3 breast cancer death have been observed.
-No grade 3 or over late toxicity has been observed.
-The 3 year locoregional control, progression free survival rates are 99.6%, 98.6% respectively.
-Co-researchers in this clinical trial should grade toxicity correctly.

(16) WS Participants agreed to write a report on acute toxicity of this protocol at this point.

(17) The enrolment of patients into this protocol was completed in 2018. Participants were requested to follow up the patients for 3 more years to assess the efficacy.

(18) Breast-I clinical trials (PMRT and WBI) have been conducted very well so far.

Session 5: QA/QC for 3D-IGBT
(19) Dr. MIZUNO Hideyuki, Principal Researcher, Quality Control Section,
QST hospital of Quantum Medical Science Directorate QST, reported on the results of on-site audit for 3D-IGBT of the 4 hospitals namely the First Affiliated Hospital of Soochow University (China, October 2019) and Philippine General Hospital, St. Luke's Medical Center (Quezon City and Global City) (The Philippines, January 2020). Main points from his report are as follows.

-The dosimetry audits in the 4 hospitals were successfully conducted.
-Measured dose for point A, bladder and rectum were agreed with TPS calculated value within a tolerance level for all.
-Applicator offset value was measured for the centers and 1 hospital showed 2 mm difference between measured and stated value. The hospital staff re-measured the value after the on-site audit and confirmed the consistency with the audit results and modified it. Finally offset data became consistent for all cases.
- Measured source strength and treatment planning system (TPS) registered value agreed within a tolerance level for all hospitals.

(20) The on-site audit is being suspended by the COVID-19 impact. The audit will resume after current difficult situation is improved.

Session 6: Special Topic -Status of Radiotherapies during the COVID-19 Crisis in FNCA Member Countries-
(21) Dr. WAKATSUKI Masaru, Director of Department of Radiation Medicine, QST Hospital, QST explained the overview of this session.

(22) The status of radiotherapies under the COVID-19 was reported by each FNCA country. 15 hospitals' cases were introduced.
Presenters introduced national data and statistics regarding COVID-19 and explained on their efforts and strategies to perform radiotherapies avoiding infection risk.

(23) Prof. KATO Shingo commented on the session.
This session was a very important opportunity to share our knowledge and experiences about how to perform radiotherapies under the very difficult circumstances. We learnt there are many ways to reduce the infection risk of patients and medical staffs. As many presenters mentioned, hypo-fractionated radiotherapy should be used more actively and frequently. Safe and effective hypo-fractionation treatment regimen including palliative radiotherapy should be established among FNCA countries. It is desirable that this type of online meeting will be held again in the near future.

Session 7: Future Plan
1) New Clinical Trials (Radiotherapy for Bone Metastasis and Brain Metastasis)
(24) In 2019's WS, radiotherapies for bone metastasis and brain metastasis were proposed and discussed as new clinical trials. To draft those protocols, questionnaires were conducted among FNCA members prior to WS.

(25) Dr. MAKISHIMA Hirokazu introduced the results of questionnaire on brain metastasis. He also introduced the outline of the clinical trial and draft protocol.
Discussion points of the draft protocol are additional secondary outcomes, sample size, inclusion/exclusion criteria and evaluation method of efficacy. Members can exchange their comments and requests on those points by emails afterwards.

(26) Dr. Kullathorn Thephamongkhol from Thailand also introduced briefly the results of the questionnaire on radiotherapies for brain metastasis. He summarized the answers regarding "environment of palliative treatment " and "case management" in FNCA members' hospitals.

(27) Based on the questionnaire results, he suggested several potential protocols e.g. single arm study as practice (QoL Study), randomized control trial (RCT) to resolve variation, prospective study for technology transfer, retrospective study to predictive survival benefit /avoidance of unnecessary whole brain radiation therapy (WBRT).

(28) WS participants will exchange emails on the 2 new clinical trials for further discussion after WS.

2) 2021's Workshop
(29) 2021's workshop will be held in Mongolia in the beginning of September if the spread of COVID-19 infections has settled down.

 


Program of
FNCA FY2020 Online Workshop on Radiation Oncology Project

27th (Fri) November 2020


Date & Time: 15:00-17:00, 27th November (Fri) ,2020
Place: Web-Meeting
Chair(Facilitator): Prof. KATO Shingo, Japan

(Japan Time)

15:00-15:10
Opening Session (10 min)
Opening remarks
Remarks
Confirmation of agenda
Group Photo by Screenshot
Prof. KATO Shingo (PL, Japan)
MEXT / FNCA Coordinator/ FNCA Advisor
15:10-15:20 Session 1, Prospective Observational Study of 3D-IGBT for Locally Advanced Cervical Cancer (Cervix-V) (10 min)
Summary of Clinical Data Dr. OKONOGI Noriyuki
15:20-15:30 Session 2, Phase II Study of Chemoradiotherapy for NPC (NPC-III) (10 min)
Summary of Clinical Data Dr. MAKISHIMA Hirokazu
15:30-15:40 Session 3, Phase II Study of Hypofractionated Radiotherapy for Breast Cancer (PMRT / BREAST-I) (10 min)
Summary of Clinical Data Prof. KARASAWA Kumiko / Dr. KONO Sawa
15:40-15:50 Session 4,Phase II Study of Hypofractionated Radiotherapy for Breast Cancer(WBI / BREAST-I) (10 min)
Summary of Clinical Data Prof. KARASAWA Kumiko / Dr. KONO Sawa
15:50-16:00 Session 5, QA/QC for 3D-IGBT (10 min)
Report on on-site audit in China and the Philippines
Future Plan of Audit
Dr. MIZUNO Hideyuki
16:00-16:30 Session 6, Special Topic -Status of Radiotherapies during the Covid-19 Crisis in FNCA Member Countries- (30 min)
Introduction / Overview of Session
Country Report (2-3 min x 11 countries)
Q & A / Discussion
Dr. WAKATSUKI Masaru
16:30-17:00 Session 7, Future Plans (30 min)
"Palliative Radiotherapy for Bone Metastasis"
-Results & Analysis of Questionnaire
-Introduction of Protocol (Draft)
Dr. MAKISHIMA Hirokazu
"Palliative Radiotherapy for Brain Metastasis"
-Results & Analysis of Questionnaire
-Introduction of Protocol (Draft)
"2021's Workshop"
Dr. Kullathorn Thephamongkhol


List of Participants
FNCA 2020 Online Workshop on Radiation Oncology Project

Noveber 27th, 2020


Bangladesh

Dr A.F.M. Kamal Uddin (PL)
MBBS, DTCD, MD
Assistant Professor
Radiation Oncology
National Institute of ENT

Dr Parvin Akhter Banu
Chief Consultant Oncologist
Delta Medical College & Hospital Limited

Dr Sharif Ahmed
Associate Consultant
Department of Radiation Oncology
United Hospital Limited

China

Prof Cao Jianping (PL)
Professor / Director
School of Radiation Medicine and Protection,
Soochow University

Dr Xu Xiaoting
Vice-Director of the Department of Radiation Oncology
The First Affiliated Hospital of Soochow University

Indonesia

Dr Henry Kodrat
Medical Staff
Department of Radiation Oncology
Cipto Mangunkusumo Hospital

Dr Dyah Erawati
Head of Radiotherapy Division
Dr. Soetomo General Academic Hospital

Mr Bambang Haris Suhartono
Medical Physicist of Radiotherapy Department
Dr. Soetomo General Academic Hospital

Japan

Mr Wada Tomoaki
FNCA Coordinator of Japan

Dr Namaba Hideki
FNCA Adviso of Japan

Prof Kato Shingo (PL)
Professor
Department of Radiation Oncology
International Medical Center
Saitama Medical University

Dr Nakano Takashi
Managing Director,
Quantum Medical Science Directorate Managing Director,
National Institute of Radiological Sciences(NIRS)
National Institutes for Quantum and Radiological Science and Technology(QST)

Prof Karasawa Kumiko
Professor and Chair
Department of Radiation Oncology, School of Medicine,
Tokyo Women's Medical University

Prof Ohno Tatsuya
Professor and Chairperson
Deparment of Radiation Oncology,
Gunma University Graduate School of Medicine

Prof Wakatsuki Masaru
Director of Department of Radiation Medicine
QST Hospital
National Institutes for Quantum and Radiological Science and Technology (QST)

Dr Mizuno Hideyuki
Principal Researcher
Quality control section, QST hospital,
Quantum Medical Science Directorate,
National Institutes for Quantum and Radiological Science and Technology (QST)

Dr Okonogi Noriyuki
Chief Physician
Clinical Research Group of Pelvic tumor
Department of Charged Particle Therapy Research
National institute of Radiological Sciences(NIRS)
Quantum Medical Science Directorate
National Institutes for Quantum and Radiological Science and Technology(QST)

Dr Makishima Hirokazu
Chief Physician
Clinical Research Group of Pelvic tumor
Department of Charged Particle Therapy Research
National institute of Radiological Sciences(NIRS)
Quantum Medical Science Directorate
National Institutes for Quantum and Radiological Science and Technology(QST)

Dr Kono Sawa
Assistant Professor,
Department of Radiation Oncology
Tokyo Women's Medical University

Dr Fukuda Shigekazu
Section Manager
Radiation Quality Control Section,
QST Hospital,
Quantum Medical Science Directorate
National Institutes for Quantum and Radiological Science and Technology (QST)

Mr Nakaji Taku
Technical Staff
Quality Control Section, QST Hospital, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Science and Technology (QST)

Mr Suzuki Tetsu
Deputy Director
Office for Fusion Energy, Environment and Energy Division and Policy Division,
Research and Development Bureau,
Ministry of Education, Culture, Sports, Science and Technology (MEXT)

Ms Tanaka Fumiyo
Administrative Researcher
International Nuclear and Fusion Energy Affairs Division
Research and Development Bureau
Ministry of Education, Culture, Sports, Science and Technology (MEXT)

Ms Yamada Ai (Secretariat)
Nuclear Safety Research Association (NSRA)

Kazakhstan

Prof. Tasbolat Adylkhanov
Head of Clinical and Radiation Oncology Department
Semey Medical University

Dr. Almagul Zhabagina
Head Teacher/ Doctor of Radiology
Clinical and Radiation Oncology Department
Semey Medical University

Dr Yevgeniya Kossymbayeva
Assistant of Clinical and Radiation Oncology Department
Semey Medical University

Korea

Dr Kum Bae Kim
Senior Researcher (Chief Medical Physicist)
Korea Institute of Radiological & Medical Sciences (KIRAMS)

Dr Wonil Jang
Chief, Department of Radiation Oncology
Korea Institute of Radiological & Medical Sciences (KIRAMS)

Malaysia

Dr Lau Fen Nee (PL)
Senior Consultant / Clinical Oncologist,
National Cancer Institute, Putrajaya, Malaysia

Mr Muzzamer Bin Mohammad Zahid
Medical Physicist,
National Cancer Institute,Putrajaya, Malaysia

Dr Beena Devi
Consultant Clinical Oncologist
Normah Medical Specialist Centre
Kuching, Sarawak

Mongolia

Dr Uranchimeg Tsegmed (PL)
Chair of Radiation Safety Committee/ Radiation Oncologist
National Cancer Centre of Mongolia

Dr Erdenetuya Yadamsuren
Radiation Oncologist of Radiotherapy Department,
National Cancer Center of Mongolia

The Philippines

Dr Miriam Joy Calaguas (PL)
Active Consultant
St.Luke's Medical Center

Dr Rey H. De Los Reyes
Dean, Institute of Medicine
Far Eastern University - Nicanor Reyes Medical Foundation (FEU-NRMF)

Honorary Consultant,
Department of Obstetrics and Gynecology
Jose R. Reyes Memorial Medical Center (JRRMMC)

Dr Jaemelyn Marie O. Fernandez
Visiting Consultant
Jose R. Reyes Memorial Medical Center (RRMMC)

Dr Jerickson Abbie Sapno Flores
Visiting Consultant
Jose R. Reyes Memorial Medical Center (RRMMC)

Thailand

Dr Yaowalak Chansilpa (PL)
Associate Professor,
Department of Radiology, Faculty of Medicine,
Siriraj Hospital, Mahidol University

Dr Kullathorn Thephamongkhol
Lecturer,
Siriraj Hospital, Mahidol University

Mr Pitchayut Nakkrasae
Medical Physicist,
Siriraj Hospital, Mahidol University

Viet Nam

Dr Nguyen Cong Hoang (PL)
Radiation Oncologist
Head of General Radiation Oncology Department
National Cancer Hospital (K Hospital)

Dr To Anh Dung
Head of Breast and Gynecology Radiotherapy Department
National Cancer Hospital (K Hospital)

Dr Nguyen Thi Bich Hien
Radiation Oncologist
Ho Chi Minh City Oncology Hospital




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