Stereotactic body radiation therapy in a public oncologic hospital in Brazil: a five years experience

Introduction: The challenge of implementing a new technology in a developing country is huge in many aspects. Personnel training and updating are cornerstones in this process. Brazil has an incidence of about 596,000 new cases of cancer per year. In May 2008, the Instituto do Câncer do Estado de São Paulo (ICESP) Octavio Frias de Oliveira, a public institution linked to University of São Paulo, was established. The radiation oncology department started its' activities in 2010. With 6 linear accelerators, 1 high dose-rate brachytherapy equipment and 1 computed tomography (CT) simulator, about 300 patients are treated per day using different techniques (conventional, 3D-conformal, intensity modulated radiation therapy, volumetric modulated arc therapy – VMAT, conventional and 3D image-guided brachytherapy). In 2011 the first case of stereotatic body radiation therapy (SBRT) was performed. The technique has potential benefits, as improvement of the quality of life of patients (by reducing the numbers of visits to the hospital and promoting better tumor control), and the possibility of treating a larger number of patients in busy departments likes ours (due to the potential more vacancy in the machines). On the other hand, requires high radiotherapy technology and appropriate personnel training. The clinical protocol, for such treatment, includes a CT scan with appropriate immobilization (eg thermoplastic mask, body fix), image fusion when indicated, delineation according to international protocols.