Australian high‐dose‐rate brachytherapy protocols for gynaecological malignancy

MacLeod, Craig; Cheuk, Robyn; Dally, Mike; Fowler, Allan; Gauden, Stan; Leung, Sam; Milross, Chris; Narayan, Kailash; Stevens, Michael G.; Thornton, Deborah; Carruthers, Scott; Jeal, P. N.

doi:10.1046/j.1440-1673.2001.00872.x

Cited by 4 publications

(4 citation statements)

References 17 publications

(24 reference statements)

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“…HDR protocols for gynaecological malignancy in Australia were previously surveyed in 1999 by Macleod et al The survey was aimed at reviewing fractionation schedules used and the level of consensus throughout the country. Examination of protocols was confined to fractionation and dose 9 . Several international patterns‐of‐care surveys in cervix BT have been published, but this is the first such study comprehensively reflecting Australian and New Zealand practices and protocols.…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy for cancer of the cervix: An Australian and New Zealand survey of current treatment techniques

2008

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Establishing guidelines for the practice of brachytherapy throughout Australia and New Zealand is one of the goals of the Australasian Brachytherapy Group. To better appreciate Australasian resources and conditions, the group conducted a survey in early 2005. The aims were to survey current practices, to emphasize variations in practice and to determine the availability of advanced imaging and treatment methods to assess resources. A survey was sent to all Australian and New Zealand radiotherapy departments. The survey requested details of treatment with respect to external beam radiotherapy, brachytherapy, optimization methods, reporting methods, scheduling brachytherapy and access to imaging and methods of work-up. Thirty-four departments were contacted with 27 (79%) responses returned. Twenty-one departments use brachytherapy. Doses and fractionation schedules varied and use of sectional imaging was minimal. Individualized dosimetry is practised in a limited fashion by 60% of the surveyed departments. There is high compliance with International Commission on Radiation Units 38 dose reporting recommendations. All brachytherapy units identified have access to CT and 85% to MRI within the hospital settings. Brachytherapy for cancer of the cervix is, currently, largely based on the Manchester system. The survey did emphasize considerable variation in dose and fractionation schemes between departments. The Australasian Brachytherapy Group subgroup intends to proceed with the process of formulating recommendations for cervix brachytherapy. It is intended that these will cover the use of image-based planning and treatment, target definition(s), verification of brachytherapy treatments and a uniform dose-reporting mechanism.

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Section: Discussionmentioning

confidence: 99%

Brachytherapy for cancer of the cervix: An Australian and New Zealand survey of current treatment techniques

2008

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“…[27] The dose fractionation of HDR brachytherapy was set at 28.0 Gy/4 fractions against a reference point (Point A). [1314] Point A is the major critical point for the dose specification of HDR brachytherapy in the treatment of gynecological cancer. From the report of Guerrero et al ,[25] the target α/β ratio was 9.90, the target δ was 0.04, the normal organ α/β ratio was 3.25, and the normal organ δ was 0.09 for both proton therapy and HDR brachytherapy.…”

Section: Methodsmentioning

confidence: 99%

“…In general, the dose fractionation for proton beam therapy is 50–70 Gy/20–35 fractions,[12] and the dose fractionation for HDR brachytherapy is 28–30 Gy/4–6 fractions. [1314] When considering biological effects, dose fractionation is as important as RBE. Dose fractionation depends on the total dose and the dose per fraction.…”

Section: Introductionmentioning

confidence: 99%

Establishment of a new three-dimensional dose evaluation method considering variable relative biological effectiveness and dose fractionation in proton therapy combined with high-dose-rate brachytherapy

et al. 2019

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Purpose:The purpose of this study is to evaluate the influence of variable relative biological effectiveness (RBE) of proton beam and dose fractionation has on dose distribution and to establish a new three-dimensional dose evaluation method for proton therapy combined with high-dose-rate (HDR) brachytherapy.Materials and Methods:To evaluate the influence of variable RBE and dose fractionation on dose distribution in proton beam therapy, the depth-dose distribution of proton therapy was compared with clinical dose, RBE-weighted dose, and equivalent dose in 2 Gy fractions using a linear-quadratic-linear model (EQD2LQL). The clinical dose was calculated by multiplying the physical dose by RBE of 1.1. The RBE-weighted dose is a biological dose that takes into account RBE variation calculated by microdosimetric kinetic model implemented in Monte Carlo code. The EQD2LQL is a biological dose that makes the RBE-weighted dose equivalent to 2 Gy using a linear-quadratic-linear (LQL) model. Finally, we evaluated the three-dimensional dose by taking into account RBE variation and LQL model for proton therapy combined with HDR brachytherapy.Results:The RBE-weighted dose increased at the distal of the spread-out Bragg peak (SOBP). With the difference in the dose fractionation taken into account, the EQD2LQL at the distal of the SOBP increased more than the RBE-weighted dose. In proton therapy combined with HDR brachytherapy, a divergence of 103% or more was observed between the conventional dose estimation method and the dose estimation method we propose.Conclusions:Our dose evaluation method can evaluate the EQD2LQL considering RBE changes in the dose distribution.

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“…Despite this, current BT practice for uterine corpus malignancies is not well studied at a population level. There have been no POCS addressing endometrial cancer in Australia, and only one survey of Australian gynaecological BT protocols, which provided limited data on how these patients are being treated with BT [ 7 ]. Similarly, there is very limited international literature detailing patterns of radiotherapy practice for uterine corpus malignancies [ 8 – 11 ].…”

Section: Purposementioning

confidence: 99%

Original paper Patterns of care study of brachytherapy in New South Wales: malignancies of the uterine corpus

Thompson¹,

Delaney²,

Gabriel³

et al. 2015

jcb

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PurposeThere are limited data at a population level on adjuvant brachytherapy (BT) practice for uterine corpus malignancies. The aims of the current study were to describe BT practice for this disease in New South Wales (NSW), to assess quality of BT, and to determine if a caseload effect on quality exists.Material and methodsPatient, tumour, and treatment related data were collected from all nine NSW radiation oncology departments that treated patients with BT. Included patients had malignancy of the uterine corpus with treatment including BT. Brachytherapy quality was assessed using published quality benchmarks. Higher gynaecological BT caseload departments were compared with lower caseload departments.ResultsOne hundred sixty-three NSW residents with gynaecological cancer were treated with BT. The four higher gynaecological BT caseload departments treated a median of 25.5 NSW residents (range 22-38), compared to median 10 (range 3-18) in the five lower caseload departments. Seventy-five patients underwent BT for uterine malignancies. Most patients had early stage endometrioid disease and were treated adjuvantly with intravaginal cylinders using high-dose-rate BT. Doses were in accordance with guideline recommendations in 83% of cases, and BT was appropriately indicated in 76% of cases. Higher caseload departments were more likely to treat with guideline doses (96% vs. 53%, p < 0.001) but there was no difference in compliance rate with treatment indications (p = 0.75).ConclusionsBrachytherapy patients, techniques, and numbers/unit for uterine corpus malignancies were similar in NSW compared to the USA but more dispersed than in Western Europe. Doses prescribed may not be optimal in lower gynaecological BT caseload departments – the significance of this represents an area in which more research is needed.

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Australian high‐dose‐rate brachytherapy protocols for gynaecological malignancy

Cited by 4 publications

References 17 publications

Brachytherapy for cancer of the cervix: An Australian and New Zealand survey of current treatment techniques

Brachytherapy for cancer of the cervix: An Australian and New Zealand survey of current treatment techniques

Establishment of a new three-dimensional dose evaluation method considering variable relative biological effectiveness and dose fractionation in proton therapy combined with high-dose-rate brachytherapy

Original paper Patterns of care study of brachytherapy in New South Wales: malignancies of the uterine corpus

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