DEVELOPMENT OF CO-OPERATIVE GROUPS OF SPECIALISTS IN ONCOLOGY
F. Guedea, F. Casas, T. Eudaldo, JM. Bachaud.
1. DEVELOPMENT OF CO-OPERATIVE GROUPS OF SPECIALISTS IN ONCOLOGY
In the area of the Medicine in general, and especially in that of Oncology, it is essential the multidisciplinary and multicentral work to be able to compare results and obtain a maximum of good results in cancer patients. There have been developed during these years numerous co-operative groups, which oncologists are from inside Catalunya (Catalano-Balear Oncology Society), oncologists from Catalunya and from the rest of Spain ( AERO-Spanish Association of Radiotherapy and Oncology, SEOM-Spanish Association of Medical Oncology, FESEO-Spanish Federation of Oncology Societies,..), and Catalan oncologists with the rest of European countries (ESTRO-European Society of Radiation Therapy and Oncology, ESMO - European Society of Medical Oncology, ...).
Inside the latter context, and as example of co-operation between two countries of the European Union, there is the GOCO (Cooperative Group Catalan-Occitan). This group, created in 1992, regroups radiotherapy oncologists from Catalunya, Midi-Pyrenées and Languedoc Rousillón. This group connects the co-operation, already historical, in the medical area among these regions and especially promotes the triangle Barcelona-Toulouse-Montpellier.
In this way, this group regroups three types of specialists, radiotherapy oncologists, medical physicists and therapists.
Later we will briefly describe this group, as example of all these co-operative groups in oncology that exist in Catalunya, in the Spanish State and in the whole European Union.
2. HISTORICAL PRECEDENTS OF THE GOCO
On February 8, 1989, a Co-operation Protocol was elaborated in the health area, between the "Generalitat de Catalunya" and "Midi-Pyrénées's Conseil Régional", which allowed the creation of the GOCO. But the scientific Occitanian-Catalan relation, in the field of ionizing radiation, was not a new fact. On the 9th and 10th of June of 1935, met in Barcelona the representatives of " Societé de Radiologie Médicale de France ": "Societé de Radiologie du Litoral Méditerranéen " and " Societé d'electro-radiologie du Sud-Ouest ".
The day was dedicated to radiological diagnosis of the intestinal tuberculosis, at the expenses of Dr. Pinós. Later, the Cancer Pavillion of "Hospital de la Santa Creu i Sant Pau" was visited, which was standing out for its modern facilities of deep radiotherapy. The scientific day continued in the Faculty of Medicine of Barcelona where Dr. Astier of Marseille presented "Radiothérapie de l'Hyperthyroidisme". It was resolved a second meeting for the year 1936, but for reasons known by all, did not manage to celebrate.
3. CURRENT SITUATION OF THE GOCO
From 1936 there existed a period of mutual ignorance, until April 1979 that was celebrated in Carcassonne the "I Interregional Congress of Medicine ".
On September 30, 1989, met in Toulouse representatives of the region and of the "Centre Hôpitalier Regional de Toulouse(CHR)" to debate on technological transference and cooperation with Catalunya. On January 30, 1990, the counselor of health of the "Generalitat de Catalunya", Dr. X. Trias was signing the Protocol of Co-operation, in the field of health between the "Generalitat de Catalunya" and the region Midi-Pyrenées.
The development of these agreements was initiated on March 27, 1990, with a visit to Toulouse's CHR on the part of a Catalan delegation and with the visit to Barcelona on June 15, 1990, of two doctors of Toulouse's CHR. In November the relations in the area of radiotherapy oncology are consolidated with the interchange of two nurses from the Brachitherapy unit of Bellvitge Hospital to the CHR. This center, in the academic year 1990-1991, received a medical physicist in the "Diplomature d'êtudes Approfondis" (DEA) of Radiological Physics, fact that has been repeated since then.
Continuing with this line of collaboration, in the radiophysics field, at the end of January 1991 met in Centre Claudius Regaud: the persons in charge of Radiophysic's DEA, represented by Professor Blanc (Director of the Atomic Physics Centre of Université Paul Sabatier de Toulouse), Dr. J.M. Borràs and the persons in charge of Radiophysic's services of "Hospital de Bellvitge and Hospital de Sant Pau de Barcelona". In this meeting, also took part, the radiophysicists of "Institute Gustave Roussy ", Drs. Chavaudrá and Aubert.
On March 27, 1992, was celebrated in Arties (Vall d'Aran) the first meeting in the field of cancerology, specially contemplating the radiochemotherapy associations and the perspectives of future in the treatment of ORL's tumors.
A little time later appeared, as a memory of radiological physics DEA, "Intercomparison de la dose absorbée dans diferents faisceaux d'irradiation. Projet multicentrique Franco - Catalan ".
On the following year, in March 1994, J.M. Bachaud and P. Francois from CCR, moved to Barcelona with two principal aims: to provide the GOCO with juridical laws and to organize the second meeting of the GOCO, with foundational intentions, to be celebrated on November 4, 1994, in the "Hospital de la Santa Creu i Sant Pau de Barcelona". In 1995 and 1996, the third and fourth congress of the GOCO, were celebrated respectively in Toulouse and Reus, standing out the high degree of participation of doctors, physicists and therapists.
The year 1997, in November, was celebrated the V Congress, with an assistance of 186 members and were established, for the first time, conferences on continued formation for doctors, physicists and therapists. In this way, every group could be present at the conferences on particular topics of interest and take part in its discussion. The VI meeting of the GOCO took place on the 6th and 7th of November, 1998 in Barcelona, congregating about 160 participants and presided by Dr. Valls of "Hospital de l'Esperança de Barcelona". Finally the VII meeting of the GOCO was celebrated in Perpignan on December, 1999 and regrouped 180 persons.
In the area of scientific works, the GOCO has realized up to the moment, a randomized multicentral study to study the usefulness of the hyperfractionation in the cancer of larynx and different joint protocols of treatment. Also joint bases of information have been elaborated in the conservative treatment of the breast cancer. Recently, it has been published in the International Journal of Radiation Oncology Biology and Physics (44:47-52,1999, a retrospective study of uterine sarcomas treated in the last years in the majority of hospitals that belong to GOCO.
Also, different offers have appeared for new studies that include the eyelid brachitherapy and that of penis, a retrospective study of the malignant timomas treated by the centers that belong to GOCO and finally a study on the predictive value of neoadjuvant chemotherapy to irradiation, in the treatment of non small cell lung cancer unoperable.
4. IMPORTANCE OF CO-OPERATIVE GROUPS.
This example of co-operation between two countries of the European Union, in the area of the radiotherapy oncology, demonstrates the importance that the co-operative groups have from a scientifical anb technical point of view, an motivation for the professional level and for the interrelationship among specialists and centres.