T Phan1, L Mula-Hussain1, S Pavamani2, A Pearce3, D D'Souza4, N G Patil5, L Traptow1, C M Doll1. 1. Department of Oncology, Tom Baker Cancer Centre, Calgary, AB; 2. Department of Radiation Oncology, Christian Medical College, Vellore, South India; 3. Department of Radiation Oncology, Northeast Cancer Centre, Sudbury, ON; 4. Department of Radiation Oncology, London Regional Cancer Program, London, ON; 5. Department of Radiation Oncology, Nova Scotia Cancer Centre, Halifax, NS.
Abstract
BACKGROUND: We documented changes in practice from 2009 to 2012 for cervical cancer brachytherapy in Canada. METHODS: Centres with gynecologic brachytherapy services were sent an e-mail questionnaire querying their 2012 practice. Responses are reported and compared with practice patterns identified in a similar survey for 2009. RESULTS: The response rate was 77% (24 of 31 centres). Almost all use high-dose-rate brachytherapy (92%); low-dose-rate brachytherapy has been completely phased out. Most continue to move patients from the site of applicator insertion to the radiation treatment simulation suite (75%) or to a diagnostic imaging department (29%), or both. In 2012, the imaging modalities used for dose specification were computed tomography [ct (75%)], magnetic resonance imaging [mri (38%)], plain radiography (21%), and cone-beam ct (8%). The number of institutions using mri guidance has markedly increased during the period of interest (9 vs. 1). Most respondents (58% vs. 14%) prescribed using guidelines from the Groupe Européen de Curiethérapie and the European Society for Therapeutic Radiology and Oncology, but they also used point A as a reference. Commonly used high-dose radiation regimens included 30 Gy in 5 fractions and 24 Gy in 3 fractions. CONCLUSIONS: In Canada, image-guided brachytherapy for cervical cancer continues to evolve. Although ct-based imaging remains the most commonly used modality, many centres have adopted mri for at least 1 brachytherapy treatment. More centres are using fewer fractions and a slightly lower biologically effective dose, but are still achieving EQD2 (2-Gy equivalent) doses of 80-90 Gy in combination with external-beam radiation therapy.
BACKGROUND: We documented changes in practice from 2009 to 2012 for cervical cancer brachytherapy in Canada. METHODS: Centres with gynecologic brachytherapy services were sent an e-mail questionnaire querying their 2012 practice. Responses are reported and compared with practice patterns identified in a similar survey for 2009. RESULTS: The response rate was 77% (24 of 31 centres). Almost all use high-dose-rate brachytherapy (92%); low-dose-rate brachytherapy has been completely phased out. Most continue to move patients from the site of applicator insertion to the radiation treatment simulation suite (75%) or to a diagnostic imaging department (29%), or both. In 2012, the imaging modalities used for dose specification were computed tomography [ct (75%)], magnetic resonance imaging [mri (38%)], plain radiography (21%), and cone-beam ct (8%). The number of institutions using mri guidance has markedly increased during the period of interest (9 vs. 1). Most respondents (58% vs. 14%) prescribed using guidelines from the Groupe Européen de Curiethérapie and the European Society for Therapeutic Radiology and Oncology, but they also used point A as a reference. Commonly used high-dose radiation regimens included 30 Gy in 5 fractions and 24 Gy in 3 fractions. CONCLUSIONS: In Canada, image-guided brachytherapy for cervical cancer continues to evolve. Although ct-based imaging remains the most commonly used modality, many centres have adopted mri for at least 1 brachytherapy treatment. More centres are using fewer fractions and a slightly lower biologically effective dose, but are still achieving EQD2 (2-Gy equivalent) doses of 80-90 Gy in combination with external-beam radiation therapy.
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Authors: Astrid A C De Leeuw; Remi A Nout; Ruud G H Van Leeuwen; Anton Mans; Lia G Verhoef; Ina Maria Jürgenliemk-Schulz Journal: Tech Innov Patient Support Radiat Oncol Date: 2018-10-31