Implementation of Image-guided Brachytherapy for Cervix Cancer in the UK: Progress Update

Abstract

Aims Image-guided brachytherapy (IGBT) is the new gold standard for cervix cancer brachytherapy. In 2009, the Royal College of Radiologists (RCR) published a guidance document to facilitate the implementation of IGBT for cervix cancer in the UK. This paper reports the progress since the publication of the RCR document. Materials and methods Questionnaires were sent to 45 UK centres known to offer brachytherapy for cervix cancer in 2011. Replies were received from 43 (96%) centres. Details collected included brachytherapy machine, imaging technique for brachytherapy planning, applicator design and total dose to point A from external beam radiotherapy and brachytherapy. The results were compared with the 2008 survey reported in the RCR document. Results The number of centres offering computed tomography (CT) or magnetic resonance imaging (MRI)-based IGBT for cervix cancer has increased to 32 (71%) in 2011 compared with 12 (26%) in 2008. Although the most common applicator design in 2011 remains the tandem-ovoid applicator (71%), more respondents are using the tandem-ring applicator (29% versus 9% in 2008). Only seven (16%) centres are routinely prescribing <70 Gy 10 to point A in 2011 compared with10 (22%) in 2008. Conclusion Considerable progress with implementing IGBT for cervix cancer has been made in the UK since the publication of the RCR guidance document.