International brachytherapy practice patterns: a survey of the Gynecologic Cancer Intergroup (GCIG) Journal Article

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Authors: Viswanathan, A. N.; Creutzberg, C. L.; Craighead, P.; McCormack, M; Toita, T.; Narayan, K; Reed, N.; Long, H.; Kim, H. J.; Marth, C.; Lindegaard, J. C.; Cerrotta, A.; Small, W., Jr; Trimble, E.
Article Title: International brachytherapy practice patterns: a survey of the Gynecologic Cancer Intergroup (GCIG)
Abstract: PURPOSE: To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm). METHODS AND MATERIALS: A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB-IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. RESULTS: A total of 72 responses were analyzed; 61 respondents (85%) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB-IIA patients were 6 Gy for five fractions (18%), 6 Gy for four fractions (15%), and 7 Gy for three fractions (11%); for Stage IIB-IVA patients they were 6 Gy for five fractions (19%), 7 Gy for four fractions (8%), and 7 Gy for three fractions (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB-IIA patients was 78.9 Gy (SD 10.7) and for Stage IIB-IVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002). CONCLUSION: Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials.
Journal Title: International journal of radiation oncology, biology, physics
Volume: 82
Issue: 1
ISSN: 1879-355X; 0360-3016
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2012
Start Page: 250
End Page: 255
Language: eng
DOI/URL:

10.1016/j.ijrobp.2010.10.030
Notes: LR: 20131020; CI: Copyright (c) 2012; GR: K07 CA117979/CA/NCI NIH HHS/United States; JID: 7603616; NIHMS414048; OID: NLM: NIHMS414048; OID: NLM: PMC3489266; 2010/07/03 [received]; 2010/09/03 [revised]; 2010/10/06 [accepted]; 2010/12/22 [aheadofprint]; ppublish