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

Abstract

Purpose: Brachytherapy (BT, interventional radiotherapy-IRT) is a kind of radiation therapy, in which the radioactive source is placed nearby or even inside the cancer itself. Even though this kind of radiation therapy appears effective and valuable, BT has been facing a slow but progressive decline over the past decades in Europe, particularly in Italy. Aims of this study were to identify the practical and theoretical reasons why BT is facing a slow decline in Italy, and to define a vision of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) and a strategy about this emerged issues. Material and methods: A programmatic path divided into three steps like a trilogy was launched by AIRO Interventional Radiotherapy study group. The study group performed an initial data collection to highlight both the clinical and the educational topics and problems through specific surveys. After having analyzed the results of the surveys and shared a vision about the emerged issues, a specific strategy was adopted. Results: Four relevant domains were identified and for each ones, a strategy has been discussed and defined. This manuscript shows in detail the individual actions defined (accomplished or in progress). Conclusions: The AIRO vision implies that specific strategic interventions must be carried out in the field of national guidelines, education, research, and communication with patients and colleagues of other specialties in an interdisciplinary setting.

Intracavitary/Interstitial Applicator Plus Distal Parametrial Free Needle Interstitial Brachytherapy in Locally Advanced Cervical Cancer: A Dosimetric Study

“…And the development of brachytherapy technology is relatively backward compared with external beam radiotherapy. It is necessary to strengthen the clinical practice, education, research and communication ( 25 ). Practical education should be given special attention due to the higher technical requirements for the operator, especially the technology mentioned in our research.…”

Interventional radiotherapy as exclusive treatment for primary nasal vestibule cancer: single-institution experience

“…Moreover, it could assist in identification of patients who could benefit from this kind of treatment. According to this, we recommend a multidisciplinary approach, developing large multicentric database, and introducing this approach at an educational level [ 25 ].…”

INTERACTS (INTErventional Radiotherapy ACtive Teaching School) consensus conference on sarcoma interventional radiotherapy (brachytherapy) endorsed by AIRO (Italian Association of Radiotherapy and Clinical Oncology)

“…Moreover, the integration of a well-standardized data collection systems (large databases) could help to better analyze the outcomes in homogenous and also in non-homogenous series using several treatments, resulting useful in the comparison between different therapies [ 46 , 47 , 48 , 49 , 50 ]. The implementation of educational programs in this field could be useful to improve the therapeutic possibilities [ 34 , 36 , 51 , 52 ]. Due to lack of published data, consensus meetings as the one presented here, constitute an excellent opportunity to establish experts’ opinion with the aim to provide the best diagnostic and therapeutic approaches in patients with STS [ 16 ].…”