A national survey of AIRO (Italian Association of Radiation Oncology) brachytherapy (Interventional Radiotherapy) study group

Abstract

PurposeTo review brachytherapy resources and to explore current practice patterns in Italy.Material and methodsIn 2016, on behalf of the Italian Association of Radiation Oncology (AIRO), the Brachytherapy Study Group proposed conducting a survey in order to identify brachytherapy practice patterns. An electronic questionnaire was sent to all radiotherapy centres in Italy, asking for: 1. General information on the Radiation Oncology Centre (affiliation, whether brachytherapy was delivered or not); 2. Brachytherapy equipment and human resources; 3. Brachytherapy procedures; 4. Brachytherapy assessment (number of patients treated annually, treated sites, and different modalities of treatments).ResultsA total of 66 questionnaires were returned (33.5% of all brachytherapy centers in Italy), out of which 48 (74%) from non-academic hospitals, 6 (10%) from academic hospitals, and 12 (16%) from private institutions. Most centers (84%) had only one brachytherapy machine; 44% did not deliver brachytherapy treatments or delivered less than demanded because of the lack of staff or expertise, need of modernization, or other reasons. The majority of treatments were administered to outpatients for gynecological tumors.ConclusionsThis survey illustrates the current status of brachytherapy in Italy and should encourage collaboration to develop, implement, and monitor its use when appropriate.

The role of palliative interventional radiotherapy (brachytherapy) in esophageal cancer: An AIRO (Italian Association of Radiotherapy and Clinical Oncology) systematic review focused on dysphagia-free survival

“…In conclusion, we provided evidence-based support that IRT is an effective and safe treatment option; therefore, its underuse is no longer justified. IRT is not available in all Italian or European RT departments (43,44); hence, a collaboration between radiotherapy centers could be useful to ensure access to all patients who have the indication to the IRT. Further randomized controlled studies should investigate the optimal radiation dose and number of fractions to obtain the highest dysphagia-free survival rates and the lowest risk of severe adverse events.…”

The role of vaginal brachytherapy in stage I endometrial serous cancer: a systematic review

“…Many studies have reported significant toxicity rates in stage IA patients treated with chemotherapy and pelvic EBRT, with a DFS remaining at around 85% [38,39,40]. While some centers have adopted VBT as the local therapy in this setting [23,41,42], many centers continue to use pelvic EBRT as a standard treatment [43,44]. In well selected stage I USC, VBT may be particularly useful in reducing local recurrences and toxicity.…”

“…Despite these positive results, VBT is not always considered as a treatment option in patients with stage I USC. Different Italian survey confirmed that despite this procedure is available, only few centers considered it for the treatment of USC [42,51]. Probably, the lack of experience, expertise, and treatment complexity do not allow the use of VBT in the clinical routine.…”

Can brachytherapy be properly considered in the clinical practice? Trilogy project: The vision of the AIRO (Italian Association of Radiotherapy and Clinical Oncology) Interventional Radiotherapy study group

“…In this first paper, a total of 66 questionnaires were obtained (33.5% of all brachytherapy centers in Italy), out of which 48 (74%) from non-academic hospitals, 6 (10%) from academic hospitals, and 12 (16%) from private institutions. Most centers (84%) had only one brachytherapy machine, and 44% did not deliver brachytherapy treatments or delivered less than demanded due the reasons listed in Figure 2 [6].…”

“…Trilogy strategy of the AIRO Interventional Radiotherapy study groupClinical survey among all the Italian centersEducational survey among all radiation oncology school directorsIn-depth discussion of the results of the two surveys and approval of the strategy with the Interventional Radiotherapy study group, scientific and directive committee of AIRO Lack of personnel (47%) Lack of expertise (11%) The need to update equipment (5%) TIME consuming (7%)Not specified (30%) Reasons for not using available brachytherapy equipment. Modified from reference[6] …”