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      Indian Brachytherapy Society Guidelines for radiotherapeutic management of cervical cancer with special emphasis on high-dose-rate brachytherapy

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          Abstract

          Brachytherapy (BT) for locally advanced cervical cancer is vital for optimal outcomes. There is heterogeneity in brachytherapy treatment practice for cervical cancer across India. In an attempt to standardize various processes involved in cervical cancer brachytherapy, the expert members of the Indian Brachytherapy Society (IBS) developed a document related to radiation therapy treatment of cervical cancer with special emphasis on brachytherapy. The guidelines are based on high quality clinical evidence, expert opinion and consensus wherever evidence was lacking. The document provides a guide for external beam radiation and details of all the processes involved in high-dose-rate (HDR) brachytherapy including patient selection, preparation, principles and technique of BT applications, target and normal tissue definition, dose prescriptions, BT planning, reporting parameters, common complications of BT and their management, scope for research, etc. In summary, we present here practical tips and tricks, recording and reporting of cervical cancer brachytherapy, which can be implemented in various clinical environments and forms the basis of this report.

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          Most cited references34

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          The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies

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            American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: high-dose-rate brachytherapy.

            This report presents an update to the American Brachytherapy Society (ABS) high-dose-rate (HDR) brachytherapy guidelines for locally advanced cervical cancer. Members of the ABS with expertise in cervical cancer formulated updated guidelines for HDR brachytherapy using tandem and ring, ovoids, cylinder, or interstitial applicators for locally advanced cervical cancer. These guidelines were written based on medical evidence in the literature and input of clinical experts in gynecologic brachytherapy. The ABS affirms the essential curative role of tandem-based brachytherapy in the management of locally advanced cervical cancer. Proper applicator selection, insertion, and imaging are fundamental aspects of the procedure. Three-dimensional imaging with magnetic resonance or computed tomography or radiographic imaging may be used for treatment planning. Dosimetry must be performed after each insertion before treatment delivery. Applicator placement, dose specification, and dose fractionation must be documented, quality assurance measures must be performed, and followup information must be obtained. A variety of dose/fractionation schedules and methods for integrating brachytherapy with external-beam radiation exist. The recommended tumor dose in 2-Gray (Gy) per fraction radiobiologic equivalence (normalized therapy dose) is 80-90Gy, depending on tumor size at the time of brachytherapy. Dose limits for normal tissues are discussed. These guidelines update those of 2000 and provide a comprehensive description of HDR cervical cancer brachytherapy in 2011. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
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              The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer

              Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer.
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                Author and article information

                Journal
                J Contemp Brachytherapy
                J Contemp Brachytherapy
                JCB
                Journal of Contemporary Brachytherapy
                Termedia Publishing House
                1689-832X
                2081-2841
                29 August 2019
                August 2019
                : 11
                : 4
                : 293-306
                Affiliations
                [1 ]Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
                [2 ]Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
                [3 ]Department of Gynecology Oncology, Cancer Institute (WIA), Chennai, India
                [4 ]Department of Radiation Oncology, M.S. Ramaiah Memorial Hospital, Bangalore, India
                [5 ]Department of Radiation Oncology, Siddhivinayak Cancer Hospital, Miraj, India
                [6 ]Department of Radiation Oncology, R.G. Kar Medical College and Hospital, Kolkata, India
                [7 ]Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
                [8 ]Department of Medical Physics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
                [9 ]Medical Physics Division, Dr. Kamakshi Memorial Hospital, Chennai, India
                [10 ]Department of Radiation Oncology, Jupiter Hospital, Mumbai, India
                Author notes
                Address for correspondence: Prof. Umesh Mahantshetty, Department of Radiation Oncology, 1123, 11th floor, Homi Bhabha Block, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai-400012, Maharashtra, India. phone: +91-22-24177168. e-mail: mahantshettyum@ 123456tmc.gov.in
                Article
                37456
                10.5114/jcb.2019.87406
                6737572
                31523229
                9be25223-aa1b-4318-950b-cc9b1bf20650
                Copyright: © 2019 Termedia Sp. z o. o.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 04 June 2019
                : 30 July 2019
                Categories
                Original Paper

                Oncology & Radiotherapy
                cervical cancer,brachytherapy,indian brachytherapy society,high-dose-rate

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