International brachytherapy practice patterns

A survey of the Gynecologic Cancer Intergroup (GCIG)

Akila Viswanathan, Carien L. Creutzberg, Peter Craighead, Mary McCormack, Takafumi Toita, Kailash Narayan, Nicholas Reed, Harry Long, Hak Jae Kim, Christian Marth, Jacob C. Lindegaard, Annmarie Cerrotta, William Small, Edward Trimble

Research output: Contribution to journalReview article

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.

Original languageEnglish (US)
Pages (from-to)250-255
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume82
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Brachytherapy
cancer
standard deviation
dosage
North America
New Zealand
Neoplasms
Japan
Uterine Cervical Neoplasms
fractionation
Radiation Oncology
Korea
Cervix Uteri
Surveys and Questionnaires
standardization
Clinical Trials
seats
radiation

Keywords

  • Brachytherapy
  • Cervical cancer
  • Radiation dose

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

International brachytherapy practice patterns : A survey of the Gynecologic Cancer Intergroup (GCIG). / Viswanathan, Akila; Creutzberg, Carien L.; Craighead, Peter; McCormack, Mary; Toita, Takafumi; Narayan, Kailash; Reed, Nicholas; Long, Harry; Kim, Hak Jae; Marth, Christian; Lindegaard, Jacob C.; Cerrotta, Annmarie; Small, William; Trimble, Edward.

In: International Journal of Radiation Oncology Biology Physics, Vol. 82, No. 1, 01.01.2012, p. 250-255.

Research output: Contribution to journalReview article

Viswanathan, A, Creutzberg, CL, Craighead, P, McCormack, M, Toita, T, Narayan, K, Reed, N, Long, H, Kim, HJ, Marth, C, Lindegaard, JC, Cerrotta, A, Small, W & Trimble, E 2012, 'International brachytherapy practice patterns: A survey of the Gynecologic Cancer Intergroup (GCIG)', International Journal of Radiation Oncology Biology Physics, vol. 82, no. 1, pp. 250-255. https://doi.org/10.1016/j.ijrobp.2010.10.030
Viswanathan, Akila ; Creutzberg, Carien L. ; Craighead, Peter ; McCormack, Mary ; Toita, Takafumi ; Narayan, Kailash ; Reed, Nicholas ; Long, Harry ; Kim, Hak Jae ; Marth, Christian ; Lindegaard, Jacob C. ; Cerrotta, Annmarie ; Small, William ; Trimble, Edward. / International brachytherapy practice patterns : A survey of the Gynecologic Cancer Intergroup (GCIG). In: International Journal of Radiation Oncology Biology Physics. 2012 ; Vol. 82, No. 1. pp. 250-255.
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AU - McCormack, Mary

AU - Toita, Takafumi

AU - Narayan, Kailash

AU - Reed, Nicholas

AU - Long, Harry

AU - Kim, Hak Jae

AU - Marth, Christian

AU - Lindegaard, Jacob C.

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AU - Small, William

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N2 - 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.

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