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Differences among healthcare systems have always existed in Asia, ranging from ultra-sophisticated Hong Kong to countries that are just beginning to purchase advanced equipment. Several Asian countries have multiple modern radiotherapy sites and others are beginning to bring this new technology to underserved areas.     For example, in Cebu, Philippines, the Tan Kim Ching Cancer Center will soon open a center with advanced equipment. And in Nepal, the B.P Kairala Memorial Cancer Hospital in Bharatpur, Chitwan will soon inaugurate a new system to help counter a steady increase in cancer rates. Chan King Ho's doctors used Helios Inverse Planning software to minimize the dose to her parotid glands, brainstem, upper spinal cord, and optic nerve. Helios works in conjunction with Varian's MLC-120 collimator to achieve unrivaled precision in cancer treatment.

Cancer demographers have identified the Pearl River in Southern China near Canton as a central occurrence site of nasopharyngeal cancer (NPC). There, the median age of patients with this difficult-to-treat cancer is ten years younger than patients throughout most of the world. In Hong Kong, the nasopharyngeal cancer incidence is approximately 24 per 100,000, ranking NPC fifth after lung, liver, colon, and breast cancers.     "Physicians in Hong Kong treat about 1000 new patients with nasopharyngeal cancer each year," says Dr. Peter Choi of the Prince of Wales Hospital in Hong Kong. "Our standard treatment has been radiotherapy, but we have to be very careful not to cause damage to the brainstem, upper spine, optic nerve, or parotid gland. This is particularly important with the parotid gland, where high doses with conventional radiotherapy could cause dry mouth or permanent loss of saliva-unfortunate side effects that greatly diminish a patient's quality of life." "We have found the initial clinical results in the first few NPC patients treated with the technique to be very encouraging." Dr. K.Y. Cheung, Senior Physicist, Head of medical Physics, Prince of Wales Hospital, Hong Kong Mrs. Chan King Ho, left, and Dr. Peter Choi     Recently, Dr. Choi started Treating patients at Prince of Wales Hospital with a newly installed SmartBeam IMRT system that concentrates higher doses of radiation to the tumor while avoiding surrounding healthy tissue.     According to Dr. K.Y. Cheung, Senior Physicist and Head of Medical Physics in the Department of Clinical Oncology at Prince of Wales Hospital, the Varian IMRT system is practical and user-friendly. "Planning IMRT treatments using the Helios inverse planning module is relatively easy and fast compared to three-dimensional conformal radiotherapy planning," says Dr. Cheung. "We can achieve much better dose distributions in IMRT treatments, and we have found the initial clinical results in the first few NPC patients treated with the technique to be very encouraging."     One of these initial patients was Mrs. Chan King Ho, a 43-year-old wife and mother of four children. Mrs. Chan feels very fortunate to be one of the first of Dr. Choi's patients to receive this new type of radiation therapy. A six-and-a-half week treatment course of IMRT directed at the undifferentiated nasopharyngeal cancer achieved complete local and regional remission for Mrs. Chan.     "She came through the treatment like a champion and remains very pleased with the results of therapy," notes Dr. Choi. "I have great hopes and expectations for IMRT in these types of cancers, in view of its dosimetric advantage to highly irregular tumors that wrap around vital organs in the head and neck area."