Asia-Pacific Radiation Oncology Special Interest Group (APROSIG)

APROSIG leads International Atomic Energy Agency Virtual Tumour Board Project

We all know how important it is to be able to discuss challenging cases with colleagues, no matter how experienced we are as radiation oncologists. In many Low and Middle Income Countries (LMICs) in our region, our colleagues do not always have such opportunities. Some work in large busy hospitals, where there is limited access to peer review. Others work in small isolated departments that may be the only radiation therapy providers in the country.

In order to improve peer support, APROSIG is leading the International Atomic Energy Agency project RAS6096 to establish Virtual Tumour Boards (VTBs) to discuss difficult cases. AsiaPacific Radiation Oncology Network (ASPRONET) VTBs are held on the first Wednesday of each month using MS Teams. Typically three or four cases are presented over an hour, with an emphasis on radiotherapeutic management.

Twenty to 56 radiation and clinical oncology participants from 13 to 16 countries have joined each VTB.

In the first six VTBs, 21 cases from India, Indonesia, Malaysia, Mongolia, Nepal, Pakistan, the Philippines and Sri Lanka have been discussed. Presenting clinicians were surveyed and all felt that the discussion helped their decision-making; the management of nine cases was changed as a result.

As well as supporting specialist oncologists, trainees from Pakistan and the Philippines have been participating. The educational component will be expanded later this year with the introduction of software to support contouring and plan comparison. It is also envisaged that parallel sessions will commence for medical physicists and for radiation therapists.

Planning for this project commenced in 2017. The COVID-19 pandemic has increased the professional isolation of oncologists in LMICs, so the commencement and roll-out of the VTBs in November 2020 was especially timely.

If you are interested in participating as a subsite expert, please email iain.ward@cdhb.health.nz for more information.