American Brachytherapy Society: Brachytherapy treatment recommendations for locally advanced cervix cancer for low-income and middle-income countries

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• 作者：Gita Suneja¹ ; ^{Gita.suneja@icloud.com} ; Derek Brown² ; Amy Chang³ ; Beth Erickson⁴ ; Elena Fidarova⁵ ; Surbhi Grover⁶ ; ⁷ ; Umesh Mahantshetty⁸ ; Subir Nag⁹ ; Kailash Narayan¹⁰ ; Memory Bvochora-Nsingo¹¹ ; Celia Viegas¹² ; Akila N. Viswanathan¹³ ; Ming Yin Lin¹⁰ ; David Gaffney¹⁴
• 关键词：Cervix cancer ; Brachytherapy ; Global oncology ; Low-resource setting ; Consensus guidelines
• 刊名：Brachytherapy
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：16
• 期：1
• 页码：85-94
• 全文大小：227 K
• 卷排序：16

文摘

Most cervix cancer cases occur in low-income and middle-income countries (LMIC), and outcomes are suboptimal, even for early stage disease. Brachytherapy plays a central role in the treatment paradigm, improving both local control and overall survival. The American Brachytherapy Society (ABS) aims to provide guidelines for brachytherapy delivery in resource-limited settings.Methods and MaterialsA panel of clinicians and physicists with expertise in brachytherapy administration in LMIC was convened. A survey was developed to identify practice patterns at the authors' institutions and was also extended to participants of the Cervix Cancer Research Network. The scientific literature was reviewed to identify consensus papers or review articles with a focus on treatment of locally advanced, unresected cervical cancer in LMIC.ResultsOf the 40 participants invited to respond to the survey, 32 responded (response rate 80%). Participants were practicing in 14 different countries including both high-income (China, Singapore, Taiwan, United Kingdom, and United States) and low-income or middle-income countries (Bangladesh, Botswana, Brazil, India, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). Recommendations for modifications to existing ABS guidelines were reviewed by the panel members and are highlighted in this article.ConclusionsRecommendations for treatment of locally advanced, unresectable cervical cancer in LMIC are presented. The guidelines comment on staging, external beam radiotherapy, use of concurrent chemotherapy, overall treatment duration, use of anesthesia, applicator choice and placement verification, brachytherapy treatment planning including dose and prescription point, recommended reporting and documentation, physics support, and follow-up.