Impact of suboptimal tandem implantation on local control and complications in intracavitary brachytherapy for cervix cancer

Kissel, M.; Silva, Marlon; Lequesne, Justine; Grellard, Jean‐Michel; Loiseau, C.; Barraux, V.; Lerouge, D.; Lecornu, M.; Lesaunier, F.; Haie-Méder, Christine; Chargari, Cyrus; Thariat, Juliette

doi:10.1016/j.brachy.2019.08.004

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…However, this requires additional skills and training of professionals. In addition, the availability of in-room imaging like a fluoroscopic c-arm or ultrasound (US) may be required for correct tandem placement (8,9).…”

Section: Training Of Professionalsmentioning

confidence: 99%

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Addressing the burden of cervical cancer through IAEA global brachytherapy initiatives

et al. 2020

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PURPOSE: Brachytherapy (BT) is an essential component of definitive therapy for locally advanced cervical cancer. Despite the advantages of the dose distribution with BT in cervical cancer, there is paucity of specific skills required for good-quality BT applications. Furthermore, replacing BT with other modern external beam techniques as a boost can lead to suboptimal results in cervix cancer. METHODS AND MATERIALS: Review of available IAEA resources, research and cooperation programs available from the IAEA was completed. These opportunities can be used to address challenges in Brachytherapy.The International Atomic Energy Agency (IAEA) provides support for BT through various means that includes education and training, both long term, short term and continuing medical education of professionals, providing expert visits to support implementation, development of curricula for professionals, e-learning through the human health campus, contouring workshops, 2D to 3D BT training, and virtual tumor boards. In addition, the IAEA provides support for implementing quality assurance in radiotherapy to its member states and provides guidelines for comprehensive audits in radiation therapy (QUATRO), and produces safety standards and training in radiation safety. In addition, mapping BT resources, making the case for investment and support for setting up BT services and radiotherapy centers are also available. The IAEA Dosimetry Laboratory provides calibration services to Secondary Standards Dosimetry Laboratories for well chambers used to confirm the reference air kerma rate of Co60 and Ir192 high-dose-rate BT sources, as well as for Cs137 low-dose-rate sources.Furthermore, the IAEA supports research and development in radiotherapy (and BT) through coordinated research activities that include controlled randomized clinical trials, Patterns of Care studies among others. Partnerships with professional organizations and funding bodies, as well as through the United Nations Joint Global Programme on Cervical Cancer Prevention and Control support radiotherapy activities, including BT in countries worldwide. CONCLUSION: The IAEA supports brachytherapy implementation, training and research and provides resources to professionals in the area.

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Section: Training Of Professionalsmentioning

confidence: 99%

“…For example, a review of clinical trials showed clinical failure rates significantly higher after inadequate vs. adequate radiotherapy (16). This is especially important for BT for cervix cancer (8,9). The need for a QMS (formally established) is clear, to create and maintain a high standard for patient treatment.…”

Section: Quality Assurance In Brachytherapymentioning

confidence: 99%

Addressing the burden of cervical cancer through IAEA global brachytherapy initiatives

et al. 2020

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“…Investigators from premier institutions have documented that suboptimal implantation was frequent, and failure to perform a brachytherapy boost correlates with increased local failure risk in patients with cervical cancer, whereas tandem malposition does not (Kissel et al). 1 Fortunately, brachytherapy is most often iterative where we deliver more than a single fraction. Just as in other settings, we have much to learn from our deviations (Kalapurakal et al).…”

Section: Introductionmentioning

confidence: 99%

Brachytherapy: common pitfalls

Huang

Gaffney

2022

Int J Gynecol Cancer

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Gynecologic radiation oncology is a demanding area of oncology requiring expertise in external beam and brachytherapy. Both physicians and physicists are called on to use their full complement of skills to employ state-of-the-art treatments to benefit patients. A wide variety of unusual presentations are frequent in gynecology, and hence, it is necessary to have a number of techniques available to offer the optimal treatments. The heterogeneity of treatments and the rarity of certain gynecological presentations lead to complexity and potential error. We reviewed previous gynecological high dose rate brachytherapy treatment images and plans for patients from the past decade and identified examples of common problems to share with the community. The strategies to prevent or recover from these pitfalls are also presented. With increasing number of applicator choices, it is critical for clinics to follow rigorous commissioning steps to ensure treatment process safety as described. The clinics should consider implementing a thorough on-boarding program and regular hands-on practice as a continuous quality improvement measure. The use of checklists can be invaluable and result in fewer human errors. Gynecological chart rounds that focus on brachytherapy are also encouraged. Lastly, an incident learning system to document small deviations that occur in the process, and a rigorous root cause analysis process could help prevent potential future incidents.

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Complications of intracavitary brachytherapy for gynecologic cancers and their management: A comprehensive review

Glaser¹,

Mohindra²,

Mahantshetty³

et al. 2021

Brachytherapy

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Impact of suboptimal tandem implantation on local control and complications in intracavitary brachytherapy for cervix cancer

Cited by 5 publications

References 40 publications

Addressing the burden of cervical cancer through IAEA global brachytherapy initiatives

Addressing the burden of cervical cancer through IAEA global brachytherapy initiatives

Brachytherapy: common pitfalls

Complications of intracavitary brachytherapy for gynecologic cancers and their management: A comprehensive review

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