Patterns of practice survey for brachytherapy for cervix cancer in Australia and New Zealand

Abstract

Brachytherapy remains an integral component of definitive treatment for cervix cancer in Australia and New Zealand. There was increased use of soft tissue imaging modalities with emphasis on verification; high rates of volumetric planning, and adherence to a defined overall treatment period. Brachytherapy was not substituted with other EBRT modalities. Despite this, there remain barriers to implementation of image-guided brachytherapy.

High‐risk CTV delineation for cervix brachytherapy: Application of GEC‐ESTRO guidelines in Australia and New Zealand

“…Radiation oncologists currently using image‐based brachytherapy were identified from a patterns‐of ‐care survey conducted in 2014, and invited to participate in a target volume delineation study. Of the 38 centres performing brachytherapy throughout Australia, New Zealand and Singapore, 21 used MRI at some point in brachytherapy planning.…”

“…The main imaging modality has been CT with only one department using MRI in 2005 increasing to three in 2009. The number of patients with cervical cancer treated in many departments can be low with 29% of centres treating 10 or less cervical brachytherapy patients per year in 2014 …”

“…The number of patients with cervical cancer treated in many departments can be low with 29% of centres treating 10 or less cervical brachytherapy patients per year in 2014. 9 The practice of cervical brachytherapy is usually limited to one or two radiation oncologists in a department with limited opportunities for quality assurance on delineated volumes. The aims of this study were to evaluate translation of GEC-ESTRO guidelines into the Australian and New Zealand setting by measuring variability in HR-CTV delineation and assessing the dosimetric consequences of this.…”

Ultrasound-guided Brachytherapy for Cervix Cancer

“…The most common use of ultrasound during brachytherapy for cervix cancer is to guide placement of the applicator into the uterine canal to avoid perforation of the uterus. Such use has been reported since the mid-1970s and has continued to evolve and expand since then [7,8]. Uterine perforation can cause fever, pain, peritonitis and sepsis, which may delay treatment.…”

Implementation of state-of-the-art (chemo)radiation for advanced cervix cancer in the Netherlands: A quality improvement program

“…The fast developments of image-guided adaptive treatment of LACC induces changing 'Patterns of care' [14][15][16][17][18]. The importance of training, audits, and continuous education is widely recognized, and sharing experiences (joys and pitfalls) for chosen approaches can boost clinical implementation.…”