Matthew M Harkenrider1, Surbhi Grover2, Beth A Erickson3, Akila N Viswanathan4, Christina Small5, Stephanie Kliethermes5, William Small6. 1. Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL. Electronic address: mharkenrider@lumc.edu. 2. Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 3. Department of Radiation Oncology, Froedtert Hospital & Medical College of Wisconsin, Milwaukee, WI. 4. Department of Radiation Oncology, Brigham & Women's Hospital/Dana-Farber Cancer Institute, Boston, MA. 5. Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL. 6. Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL.
Abstract
PURPOSE: Report current practice patterns for postoperative endometrial cancer emphasizing vaginal brachytherapy (VBT). METHODS AND MATERIALS: A 38-item survey was e-mailed to 1,598 American Brachytherapy Society (ABS) members and 4,329 US radiation oncologists in 2014 totaling 5,710 recipients. Responses of practitioners who had delivered VBT in the previous 12 months were included in the analysis. Responses were tabulated to determine relative frequency distributions. χ(2) analysis was used to compare current results with those from the 2003 ABS survey. RESULTS: A total of 331 respondents initiated the VBT survey, of whom 289 (87.3%) administered VBT in the prior 12 months. Lymph node dissection and number of nodes removed influenced treatment decisions for 90.5% and 69.8%, respectively. High-dose-rate was used by 96.2%. The most common vaginal length treated was 4 cm (31.0%). Three-dimensional planning was used by 83.2% with 73.4% of those for the first fraction only. Doses to normal tissues were reported by 79.8%. About half optimized to the location of dose specification and/or normal tissues. As monotherapy, the most common prescriptions were 7 Gy for three fractions to 0.5-cm depth and 6 Gy for five fractions to the surface. As a boost, the most common prescriptions were 5 Gy for three fractions to 0.5-cm depth and 6 Gy for three fractions to the vaginal surface. Optimization points were placed at the apex and lateral vagina by 73.1%. Secondary quality assurance checks were performed by 98.9%. CONCLUSIONS: VBT is a common adjuvant therapy for endometrial cancer patients, most commonly with HDR. Fractionation and planning processes are variable but generally align with ABS recommendations.
PURPOSE: Report current practice patterns for postoperative endometrial cancer emphasizing vaginal brachytherapy (VBT). METHODS AND MATERIALS: A 38-item survey was e-mailed to 1,598 American Brachytherapy Society (ABS) members and 4,329 US radiation oncologists in 2014 totaling 5,710 recipients. Responses of practitioners who had delivered VBT in the previous 12 months were included in the analysis. Responses were tabulated to determine relative frequency distributions. χ(2) analysis was used to compare current results with those from the 2003 ABS survey. RESULTS: A total of 331 respondents initiated the VBT survey, of whom 289 (87.3%) administered VBT in the prior 12 months. Lymph node dissection and number of nodes removed influenced treatment decisions for 90.5% and 69.8%, respectively. High-dose-rate was used by 96.2%. The most common vaginal length treated was 4 cm (31.0%). Three-dimensional planning was used by 83.2% with 73.4% of those for the first fraction only. Doses to normal tissues were reported by 79.8%. About half optimized to the location of dose specification and/or normal tissues. As monotherapy, the most common prescriptions were 7 Gy for three fractions to 0.5-cm depth and 6 Gy for five fractions to the surface. As a boost, the most common prescriptions were 5 Gy for three fractions to 0.5-cm depth and 6 Gy for three fractions to the vaginal surface. Optimization points were placed at the apex and lateral vagina by 73.1%. Secondary quality assurance checks were performed by 98.9%. CONCLUSIONS:VBT is a common adjuvant therapy for endometrial cancerpatients, most commonly with HDR. Fractionation and planning processes are variable but generally align with ABS recommendations.
Authors: Matthew M Harkenrider; Alec M Block; Kaled M Alektiar; David K Gaffney; Ellen Jones; Ann Klopp; Akila N Viswanathan; William Small Journal: Brachytherapy Date: 2016-05-31 Impact factor: 2.362
Authors: John M Stahl; Jack M Qian; Christopher J Tien; David J Carlson; Zhe Chen; Elena S Ratner; Henry S Park; Shari Damast Journal: Support Care Cancer Date: 2018-09-05 Impact factor: 3.603
Authors: Garrett L Jensen; Parul N Barry; Harriet Eldredge-Hindy; Scott R Silva; Sarah L Todd; Kendall P Hammonds; Walker R Zimmerman; Daniel S Metzinger; Moataz N El-Ghamry Journal: J Contemp Brachytherapy Date: 2021-05-07
Authors: Raymond B Mailhot Vega; David Barbee; Wesley Talcott; Tamara Duckworth; Bhartesh A Shah; Omar F Ishaq; Christina Small; Anamaria R Yeung; Carmen A Perez; Peter B Schiff; Ophira Ginsburg; William Small; May Abdel-Wahab; Gustavo Sarria Bardales; Matthew Harkenrider Journal: J Contemp Brachytherapy Date: 2018-12-28