Review Article Compendium of fractionation choices for gynecologic HDR brachytherapydAn American Brachytherapy Society Task Group Report Kevin Albuquerque 1, * , Brian A. Hrycushko 1 , Matthew M. Harkenrider 2 , Jyoti Mayadev 3 , Ann Klopp 4 , Sushil Beriwal 5 , Daniel G. Petereit 6 , Daniel J. Scanderbeg 3 , Catherine Yashar 3 1 Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 2 Department of Radiation Oncology, Loyola University, Chicago, IL 3 Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA 4 Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 5 Department of Radiation Oncology, University of Pittsburgh, Pittsburgh, PA 6 Rapid City Regional Hospital, Rapid City, SD ABSTRACT PURPOSE: The purpose of this study was to report a list of accepted fractionation schemes for high-dose-rate (HDR) brachytherapy for gynecological cancers in a definitive, neoadjuvant, or adju- vant setting. METHODS AND MATERIALS: Members of the American Brachytherapy Society (ABS) Task Force with expertise in gynecological brachytherapy reviewed the literature and existing ABS guidelines regarding various dose-fractionation schedules for HDR brachytherapy to create this compendium. Other resources include current guidelines published by medical societies, clinical trials, the published medical literature, and the clinical experience of the ABS Task Force members. The ABS consensus statements for HDR brachytherapy practice were reviewed for these fraction- ation schemes and form the major source for this report. Specific recommendations for therapy and recommendations for further investigations were made when there was agreement. RESULTS: A variety of dose-fractionation schedules for HDR brachytherapy alone or integrating brachytherapy with external-beam radiation exist. The choice of a given fractionation schedule may be appropriate depending on the practice situation for the patient and the resources available. While there is no single optimal dose-fractionation scheme for any disease site or clinical situation, higher doses per fraction with fewer fractions per regimen have been known to increase toxicity. The cor- responding 2-Gray (Gy) per fraction radiobiologic equivalent doses have been provided (normal- ized therapy dose) to compare the various regimens where indicated and can be used to estimate isoeffective schedules. CONCLUSIONS: This compendium of HDR brachytherapy fractionation schedules provides various options to the gynecologic brachytherapist and a ready reference for clinical use in the man- agement of gynecological cancer treatments. Ó 2019 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved. Keywords: Brachytherapy; Fractionation; Gynecological cancer; Consensus Introduction Gynecologic cancers cover a wide spectrum of female organs with tumor types occurring over the lifetime of a woman. Radiation therapy is a critical component of the multidisciplinary management of most of these tumors. Brachytherapy (which involves the application of a radioac- tive source in close proximity to the tumor/tumor bed) is an integral component of radiation treatment for these cancers as well. In tumors of certain organ sites such as advanced cervical and vaginal cancers, tumor control and overall Received 5 October 2018; received in revised form 7 February 2019; accepted 28 February 2019. Financial disclosures: All authors report no financial and personal re- lationships with other people or organizations that could bias their work, except for Dr. Sushil Beriwal (Editorial Board Brachytherapy Journal), Dr. Jyoti Mayadev (GOG foundation advisory board; cochair of the NRG cervix committee), and Dr. Ann Klopp (cochair of the NRG corpus committee). The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. * Corresponding author. Department of Radiation Oncology, UT Southwestern Medical Center, 2280 Inwood Road, Dallas, TX 75390. E-mail address: [email protected] (K. Albuquerque). 1538-4721/$ - see front matter Ó 2019 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.brachy.2019.02.008 Brachytherapy - (2019) -
Compendium of fractionation choices for gynecologic HDR brachytherapydAn American Brachytherapy Society Task Group Report
May 17, 2023
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
