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Title: SU-F-P-09: A Global Medical Physics Collaboration for Implementation of Modern Radiotherapy in Botswana

Abstract

Purpose: The global burden of cancer is considerable, particularly in low and middle-income countries. Massachusetts General Hospital (MGH) and Botswana-Harvard AIDS Institute have partnered with the oncology community and government of Botswana to form BOTSOGO (BOTSwana Oncology Global Outreach) to address the rising burden of cancer in Botswana. Currently, radiation therapy (RT) is only available at a single linear accelerator (LINAC) in Gaborone Private Hospital (GPH). BOTSOGO worked to limit the absence of RT during a LINAC upgrade and ensure a safe transition to modern radiotherapy techniques. Methods: The existing Elekta Precise LINAC was decommissioned in November 2015 and replaced with a new Elekta VERSA-HD with IMRT/VMAT/CBCT capability. Upgraded treatment planning and record-and-verify systems were also installed. Physicists from GPH and MGH collaborated during an intensive on-site visit in Botswana during the commissioning process. Measurements were performed using newly purchased Sun Nuclear equipment. Photon beams were matched with an existing model to minimize the time needed for beam modeling and machine down time. Additional remote peer review was also employed. Independent dosimetry was performed by irradiating OSLDs, which were subsequently analyzed at MGH. Results: Photon beam quality agreed with reference data within 0.2%. Electron beam data agreed with example clinicalmore » data within 3%. Absolute dose calibration was performed using both IAEA and AAPM protocols. Absolute dose measurements with OSLDs agreed within 5%. Quentry cloud-based software was installed to facilitate remote review of treatment plans. Patient treatments resumed in February 2016. The time without RT was reduced, therefore likely resulting in reduced patient morbidity/mortality. Conclusion: A global physics collaboration was utilized to commission a modern LINAC in a resource-constrained setting. This can be a useful model in other areas with limited resources. Further use of technology and on-site exchanges will facilitate the introduction of more advanced techniques in Botswana. We acknowledge funding support from the AAPM International Educational Activities Committee and the NCI Federal Share Proton Beam Program Income Grant.« less

Authors:
; ;  [1];  [2]; ;  [2];  [3];  [4];  [3];  [5];  [6];  [7]
  1. Gaborone Private Hospital, Gaborone (Botswana)
  2. Massachusetts General Hospital, Boston, MA (United States)
  3. (United States)
  4. Harvard Medical School, Boston, MA (United States)
  5. Associates in Medical Physics, Louisville, KY (United States)
  6. Hamad Medical Corporation, Shelbyville, TN (United States)
  7. Forest Hills, NY (United States)
Publication Date:
OSTI Identifier:
22624452
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BOTSWANA; CALIBRATION; COMMISSIONING; COMPUTER CODES; COMPUTERIZED TOMOGRAPHY; ELECTRON BEAMS; HOSPITALS; IAEA; IMPLEMENTATION; LINEAR ACCELERATORS; NEOPLASMS; PATIENTS; PHOTON BEAMS; PROTON BEAMS; RADIATION DOSES; RADIOTHERAPY; REVIEWS

Citation Formats

Makufa, R, Bvochora-Nsingo, M, Karumekayi, T, Schneider, RJ, Efstathiou, JA, Gierga, DP, Harvard Medical School, Boston, MA, Dryden-Peterson, S, Brigham and Women’s Hospital, Boston, MA, Odom, A, Shulman, A, and Pipman, Y. SU-F-P-09: A Global Medical Physics Collaboration for Implementation of Modern Radiotherapy in Botswana. United States: N. p., 2016. Web. doi:10.1118/1.4955716.
Makufa, R, Bvochora-Nsingo, M, Karumekayi, T, Schneider, RJ, Efstathiou, JA, Gierga, DP, Harvard Medical School, Boston, MA, Dryden-Peterson, S, Brigham and Women’s Hospital, Boston, MA, Odom, A, Shulman, A, & Pipman, Y. SU-F-P-09: A Global Medical Physics Collaboration for Implementation of Modern Radiotherapy in Botswana. United States. doi:10.1118/1.4955716.
Makufa, R, Bvochora-Nsingo, M, Karumekayi, T, Schneider, RJ, Efstathiou, JA, Gierga, DP, Harvard Medical School, Boston, MA, Dryden-Peterson, S, Brigham and Women’s Hospital, Boston, MA, Odom, A, Shulman, A, and Pipman, Y. Wed . "SU-F-P-09: A Global Medical Physics Collaboration for Implementation of Modern Radiotherapy in Botswana". United States. doi:10.1118/1.4955716.
@article{osti_22624452,
title = {SU-F-P-09: A Global Medical Physics Collaboration for Implementation of Modern Radiotherapy in Botswana},
author = {Makufa, R and Bvochora-Nsingo, M and Karumekayi, T and Schneider, RJ and Efstathiou, JA and Gierga, DP and Harvard Medical School, Boston, MA and Dryden-Peterson, S and Brigham and Women’s Hospital, Boston, MA and Odom, A and Shulman, A and Pipman, Y},
abstractNote = {Purpose: The global burden of cancer is considerable, particularly in low and middle-income countries. Massachusetts General Hospital (MGH) and Botswana-Harvard AIDS Institute have partnered with the oncology community and government of Botswana to form BOTSOGO (BOTSwana Oncology Global Outreach) to address the rising burden of cancer in Botswana. Currently, radiation therapy (RT) is only available at a single linear accelerator (LINAC) in Gaborone Private Hospital (GPH). BOTSOGO worked to limit the absence of RT during a LINAC upgrade and ensure a safe transition to modern radiotherapy techniques. Methods: The existing Elekta Precise LINAC was decommissioned in November 2015 and replaced with a new Elekta VERSA-HD with IMRT/VMAT/CBCT capability. Upgraded treatment planning and record-and-verify systems were also installed. Physicists from GPH and MGH collaborated during an intensive on-site visit in Botswana during the commissioning process. Measurements were performed using newly purchased Sun Nuclear equipment. Photon beams were matched with an existing model to minimize the time needed for beam modeling and machine down time. Additional remote peer review was also employed. Independent dosimetry was performed by irradiating OSLDs, which were subsequently analyzed at MGH. Results: Photon beam quality agreed with reference data within 0.2%. Electron beam data agreed with example clinical data within 3%. Absolute dose calibration was performed using both IAEA and AAPM protocols. Absolute dose measurements with OSLDs agreed within 5%. Quentry cloud-based software was installed to facilitate remote review of treatment plans. Patient treatments resumed in February 2016. The time without RT was reduced, therefore likely resulting in reduced patient morbidity/mortality. Conclusion: A global physics collaboration was utilized to commission a modern LINAC in a resource-constrained setting. This can be a useful model in other areas with limited resources. Further use of technology and on-site exchanges will facilitate the introduction of more advanced techniques in Botswana. We acknowledge funding support from the AAPM International Educational Activities Committee and the NCI Federal Share Proton Beam Program Income Grant.},
doi = {10.1118/1.4955716},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}