Poster — Wed Eve—03: Delivering Brachytherapy for Cervical Cancer: Organizational and Technical Advice to Facilitate Care

Abstract

Many centres in Ontario are currently starting programs in HDR brachytherapy for cervical cancer. To provide guidance for establishing such programs, an Expert Working Group (EWG) was struck in collaboration with Cancer Care Ontario's Program in Evidence Based Care (PEBC) to examine the technical and organizational requirements for high‐quality delivery of HDR to women with cervical cancer. All components of brachytherapy were considered including required facilities, imaging technologies, team composition and qualifications, treatment planning, caseload/volumes, documentation, and quality control. Organizational recommendations for each of these areas were developed based on evidence gathered through an environmental scan and a systematic search of the literature. As such, they represent a synthesis, with adaptation to the environment in Ontario, of the most recent, comprehensive, and relevant existing documents combined with expert consensus opinion of the panel. Although designed for Ontario, these recommendations are generally applicable to other jurisdictions looking to put in place new brachytherapy services, or to improve existing ones. A particular focus of the EWG was the examination of evidence supporting the use of different imaging technologies for guiding and planning HDR brachytherapy of the cervix. Imaging is a key component of this technique and optimizing its use may improve both the quality of brachytherapy and treatment outcomes. We present the first systematic review of imaging for cervical brachytherapy. Although the studies reviewed varied in design and quality, all favoured planning with volumetric 3D imaging over conventional 2D imaging.