Image-guided cervical brachytherapy: 2014 survey of the American Brachytherapy Society

Publication date: Available online 11 December 2015
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Surbhi Grover, Matthew M. Harkenrider, Linda P. Cho, Beth Erickson, Christina Small, William Small, Akila Viswanathan
IntroductionTreatment planning for gynecologic brachytherapy has evolved from point-based planning to volume-based, image-based planning with the goal of improving tumor control and lessening normal-tissue toxicity. The American Brachytherapy Society (ABS) conducted a survey in 2007, which showed although computed tomography (CT) was often used for treatment planning, most used point A for dose specification. This study is an update of the previous survey to assess treatment patterns and compare them to the 2007 results.MethodsA 45-question electronic survey on cervical-cancer brachytherapy practice patterns was sent to all ABS members and additional radiation oncologists and physicists based in the United States (U.S.) between January and September 2014. Responses from the 2007 survey and the current survey were compared using the chi-squared test.ResultsThere were 370 respondents. Of those, only respondents, not in training, who treat more than one cervical-cancer patient a year and practice in the U.S., were included in the analysis (219). For dose specification to the target, (cervix and tumor) 95% always use CT and 34% always use MRI. However, 46% use point A only for dose specification to the target. There was a lot of variation in parameters used for dose evaluation of target volume and normal tissues. Compared to the 2007 survey, use of MRI has increased from 2% to 34% (p<0.0001) for dose specification to the target. Use of volume-based dose delineation to the target has increased from 14% to 52% (p<0.0001).ConclusionAlthough use of IBBT has increased in the U.S. since the 2007 survey, there is room for further growth, particularly with the use of MRI. This increase may be in part due to educational initiatives. However, there is still significant heterogeneity in brachytherapy practice in the U.S. and future efforts should be geared toward standardizing treatment.

Teaser

The American Brachytherapy Society conducted a survey of image-guided cervical brachytherapy practices in the United States in 2007, which showed that most physicians used CT for planning and used a point-based system only for target-dose prescription. We present the updated results of a 2014 practice pattern survey showing that, compared to 2007, it appears that significantly more physicians are using CT and MRI for planning and more physicians are using a volume-based system for target-dose prescription.


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