Brachytherapy
Volume 11, Issue 1 , Pages 33-46, January 2012

American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part I: General principles

  • Akila N. Viswanathan

      Affiliations

    • Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, Brigham and Women’s Hospital, 75 Francis Street, ASB 1, L2, Boston, MA 02115. Tel.: +1-703-234-4078; fax: +1-703-435-4390.
    • ,
  • Bruce Thomadsen

      Affiliations

    • University of Wisconsin, Madison, WI
    • ,
  • American Brachytherapy Society Cervical Cancer Recommendations Committee

Received 25 March 2011; received in revised form 3 July 2011; accepted 8 July 2011.

Abstract 

Purpose

To develop brachytherapy recommendations covering aspects of pretreatment evaluation, treatment, and dosimetric issues for locally advanced cervical cancer.

Methods

Members of the American Brachytherapy Society (ABS) with expertise in cervical cancer brachytherapy formulated updated recommendations for locally advanced (Federation of Gynecology and Obstetrics Stages IB2–IVA) cervical cancer based on literature review and clinical experience.

Results

The ABS recommends the use of brachytherapy as a component of the definitive treatment of locally advanced cervical carcinoma. Precise applicator placement is necessary to maximize the probability of achieving local control without major side effects. The ABS recommends a cumulative delivered dose of approximately 80–90Gy for definitive treatment. The dose delivered to point A should be reported for all brachytherapy applications regardless of treatment-planning technique. The ABS also recommends adoption of the Groupe Européen Curiethérapie-European Society of Therapeutic Radiation Oncology (GEC-ESTRO) guidelines for contouring, image-based treatment planning, and dose reporting. Interstitial brachytherapy may be considered for a small proportion of patients whose disease cannot be adequately encompassed by intracavitary application. It should be performed by practitioners with special expertise in these procedures.

Conclusions

Updated ABS recommendations are provided for brachytherapy for locally advanced cervical cancer. Practitioners and cooperative groups are encouraged to use these recommendations to formulate their clinical practices and to adopt dose-reporting policies that are critical for outcome analysis.

Keywords: Cervical cancer, Brachytherapy, Guidelines

 

 In formulating recommendations, it should be noted that variations in approaches to cervical cancer brachytherapy, as with most medical procedures, are commonplace and may readily fall within accepted and appropriate management of such patients. The recommendations presented here are a means to aid practitioners in managing patients, but are not to be viewed as rigid practice requirements by which to establish a legal standard of care.

 The American Brachytherapy Society Cervical Cancer Recommendations Committee for high dose rate includes Sushil Beriwal, MD; Jennifer De Los Santos, MD; D. Jeffrey Demanes, MD; Beth Erickson, MD; David K. Gaffney, MD; Jorgen Hansen, MS; Ellen Jones, MD; Christian Kirisits, ScD; and for low dose rate/pulse dose rate, the Committee includes Indra J. Das, PhD; Patricia Eifel, MD; Susan A. Higgins, MD; Anuja Jhingran, MD; Larissa Lee, MD; William Small Jr, MD; Aaron Wolfson, MD.

PII: S1538-4721(11)00352-7

doi:10.1016/j.brachy.2011.07.003

Brachytherapy
Volume 11, Issue 1 , Pages 33-46, January 2012

Article Tools

* Image Usage & Resolution