Patterns Of Care For Brachytherapy Research Articles

Patterns of care for brachytherapy in Japan.

This study aimed to assess the current state of brachytherapy (BT) resources, practices and resident education in Japan. A nationwide survey was undertaken encompassing 177 establishments facilitating BT in 2022. Questionnaires were disseminated to each BT center, and feedback through online channels or postal correspondence was obtained. The questionnaire response rate was 90% (159/177), and every prefecture had a response in at least one center. The number of centers in each prefecture ranged from 0.6 to 3.6 (median: 1.3) per million population. The annual number of patients in each center ranged from 0 to 272 (median: 31). While most prefectures provided intracavitary (IC) BT for gynecological cancers and interstitial (IS) BT for prostate cancer, only one-third of the prefectures provided IS BT for cancer sites other than the prostate. The institutional image-guided BT implementation rate was 71%. IC and IS BT was performed for 15.4% of IC BT cases of gynecological cancer. Only 47% of the BT training centers answered that they could provide adequate training in BT for residents. The most common reason for this finding was the insufficient number of patients in each center. The results show that, although BT has achieved uniformity in terms of facility penetration, new technologies are not yet widespread enough. Furthermore, IS BT, which requires advanced skills, is limited to a few BT centers, and considerable number of BT training centers do not have sufficient caseloads to provide the necessary experience for their residents.

Perspectives of brachytherapy: Patterns of care, new technologies, and “new biology”

Brachytherapy has come a long way from its beginnings nearly a century ago. In recent years, brachytherapy has become ever more sophisticated thanks to a multitude of technological developments, including high-dose rate afterloading machines, image-guidance, and advanced planning systems. One of the advantages of brachytherapy, apart from the well-known capability of delivering highly conformal doses directly to the target, is that it is highly adaptable and can be used as a primary, adjunct, or salvage treatment. However, despite the existence of international treatment guidelines, the clinical practice of brachytherapy varies greatly by region, country, and even institution. In the present article, we provide an overview of recent findings from the Patterns of Care for Brachytherapy in Europe (PCBE) Study and we discuss new technologies used in brachytherapy and the emerging concept of “new biology” that supports the use of high-dose brachytherapy. Compared to the 1990s, the use of brachytherapy has increased substantially and it is expected to continue growing in the future as it becomes ever more precise and efficient.

Patterns of care for brachytherapy in Europe: updated results for Spain

The aim of this follow-up pattern of care study was to evaluate current clinical practices, staffing and equipment, and to compare these results to a study performed 5 years previously. This descriptive, pattern of care study was carried out via an online questionnaire. The survey was sent to a total of 95 cancer care centres in Spain. Seventy-three centres (76.8%) responded to the survey. More than half (57.5%) of responding centres offered brachytherapy (BT). A mean of 120 patients/centre were treated by BT in 2007. The most common localisations were the endometrium (29.6% of cases), prostate (29.6%), cervix uteri (14.6%), breast (12.6%), head and neck (3.6%) and vagina (2.5%). Other sites accounted for less than 2% of cases each. Most centres that offered BT (33/40 = 82.5%) were equipped with a dedicated BT operating room. The most commonly reported dosimetric method was CT dosimetry (31 of 40 centres = 77.5%), followed by plain film (30/40 = 75%), ultrasound (26/40 = 65%), MRI (8/40 = 20%), in vivo (7/40 = 17.5%) and PET-CT (5/40 = 12.5%) dosimetry. The three most common treatment sites (gynaecological, breast and prostate) remain unchanged from 2002, with prostate treatments showing large increase. Advanced dosimetric techniques (MRI, PET-CT and CT-dosimetry) continue to gain adherents. Some centres treat small numbers of patients, a finding that deserves more attention in terms of cost and quality of care. Although BT remains strong in Spain, it could be further strengthened by making modern dosimetric techniques and treatments more widely available.

Patterns of care for brachytherapy in Europe: Updated results

Objective This descriptive survey evaluated brachytherapy (BT) practices and resources in the European area. This was a follow-up study to the original patterns of care for brachytherapy in Europe (PCBE). Materials and methods A total of 1121 radiotherapy (RT) centres from 41 countries were asked to complete an online questionnaire on BT practices and resources. Countries with fewer than 50% of centres responding were excluded. Participating countries were divided into three groups based on gross domestic product (GDP); group I contained the countries with the highest GDP. Results The response rate was 56% (633/1121 centres) with 30/41 countries (73%) meeting the inclusion criteria. Sixty percent of reporting centres provided brachytherapy. Responding centres treated an average of 138 (±10, 1 SD) patients with BT; in group I, the mean was 110/centre, an increase of 18% from 2002. CT-dosimetry increased to 61% of centres vs. 33% in 2002. HDR (high-dose rate) BT was the most commonly reported technique (65% of centres). Most BT interventions were for gynaecological tumors (59% of all cases), followed by prostate (17%), breast (9%), lung/bronchus (3%), and esophagus tumors(2%). Conclusion Gynaecological BT remains the most common application, although both prostate and breast BT have increased. CT-based dosimetry has become increasingly common since 2002. The use of HDR and PDR (pulsed-dose rate) techniques has increased markedly, while both LDR and MDR (medium-dose rate) have declined.

150 poster: Patterns of Care for Brachytherapy in the Czech Republic in 2007

150 poster: Patterns of Care for Brachytherapy in the Czech Republic in 2007

Patterns of Care for Brachytherapy in Europe: Facilities and resources in brachytherapy in the European area

Purpose The objective of the survey was to obtain detailed information on the use of brachytherapy through a web-based questionnaire. The present article describes the resources available in 2002. Methods and materials The European area was divided into three groups: Group I included the 15 original member countries of the European Union plus 4 others according to economic wealth; Group II included the 10 most recent members of the European Union; and Group III included 14 other European countries. A national coordinator was designated for each country with a general coordinator to oversee the project to encourage the participation of every radiotherapy center. Results Three hundred forty-eight (47.2%) of the responding centers provided brachytherapy services and, compared to data from 1997, most showed a significant increase in the mean number of brachytherapy patients per center. The average number of radiation oncologists involved in brachytherapy was similar in the three groups. The average workload estimated in hours per week at the cancer centers was, however, higher in Groups II and III. Most centers had at least one treatment planning system, although in Group I 7.7% of the centers had three or more treatment planning systems. Conclusions Notable differences in brachytherapy treatment were observed, especially in the workload of radiation oncologists and physicists in Groups II and III, the two groups with largest number of patients. New surveys can provide a detailed analysis of changes over time, a potentially useful tool to eliminate the differences observed.

Patterns of Care for Brachytherapy in Europe, in Spain and Italy: Comparative Results

The aim of the study was to compare the facilities for brachytherapy in two similar countries, as are Italy and Spain. This survey reports the differences in the use of brachytherapy in these countries. The data regarding brachytherapy was obtained in 2002 by means of a specially designed web site, because Internet allowed the access to the questionnaire in an easy and safe way. In the first edition of the survey, only the countries in which more than 50% of its centers had completed the questionnaire were included. Among these countries there were Italy and Spain. Data was available in 127 centers in Italy and 72 centers in Spain, where 35 and 39, respectively, provided brachytherapy. Although both countries had a similar number of radiotherapy patients and the average number of radiotherapy patients per center was similar in both countries (P = 0.29), there were several differences related to brachytherapy. For instance, the mean number of radiation oncologists regularly performing brachytherapy per center was higher in Spain (P = 0.001). There were also differences in the average number of patients per center in the following tumor sites: breast (P < 0.001) and gynaecological (P < 0.001). In fact, the average number of patients per center who were treated with brachytherapy in these tumor sites was higher in Spain than Italy. Although the estimated workload of the radiation oncologists, physicists and radiation technologists was higher in Spain, no statistically significant differences were found in the average number of patients per center for the following tumor sites: bronchus, head and neck, intracoronary, esophagus, prostate, rectum and skin. Several differences in the use of the brachytherapy procedures applied were also found.

Patterns of Care for Brachytherapy in Europe: Results for 2002 and projects for 2007

Patterns of Care for Brachytherapy in Europe: Results for 2002 and projects for 2007

La curiethérapie en France en 2002 : résultats de l'enquête PCBE de l'ESTRO

The authors report the results of the Patterns of Care for Brachytherapy in Europe (PCBE) throughout France. Responses were obtained for 91% of the Radiation Oncology departments, which have declared using brachytherapy for 67, and gave detailed data for 49 ones. The equipments and treated tumours were recorded. LDR brachytherapy remained the most often used (53.5%), followed by HDR (28%). PDR represented 5.5% and permanent implants 11%. The authors discuss the development of new equipment, with an aggregation of the structures, and an increase of the PDR and prostate implants use.

Patterns of care for brachytherapy in Europe (PC BE) in Spain and Poland: Comparative results

Summary Background Cancer incidence and its mortality depend on a number of factors, including age, socio-economic status and geographic situation, and its incidence is growing around the world [1]. Cancer incidence in Europe is now about 4000 patients per million per year and due to the ageing population a yearly increase of 1–1.5% in cancer cases is estimated in the next two decades [2–4]. Most of the cancer treatments will include external beam radiotherapy or brachytherapy. Brachytherapy has increased its use as a radical or palliative treatment and become more sophisticated with the spread of pulsed dose rate and high dose rate afterloading machines, and the use of new planning systems has additionally improved quality of treatment [5–14] Aim The aim of the present study was to compare two countries (Poland and Spain) and to report the differences in the use of brachytherapy in these countries. For this reason, several characteristics related to brachytherapy were compared. Materials/Methods The data used were collected using a website questionnaire for the year 2002 where every centre that participated in the survey could introduce, change or update the information requested. Hospitals included in the study were those that provided data on brachytherapy, because our objective was to compare the brachytherapy facilities between Poland and Spain. Results Data were available for 22 centres in Poland and 39 centres in Spain that provided brachytherapy in 2002. Spain having more centres that applied brachytherapy (1.0 centre per 1,000,000 inhabitants in Spain vs. 0.6 centre per 1,000,000 inhabitants in Poland), the average number of brachytherapy patients per centre is lower in Spain than in Poland, 137 and 382 respectively. The 5 main tumour sites treated with brachytherapy in Poland were: gynaecological (73.7%), bronchus (13.0%), breast (2.8%), prostate (2.4%) and head and neck (1.6%). In Spain they were: gynaecological (59.7%), breast (15.4%), prostate (12.8%), head and neck (4.2%) and bronchus (1.5%). Statistically significant differences were found in the number of gynaecological, bronchial and breast brachytherapy patients between the countries. Conclusions Although both countries belong to the European Union, there were observed several differences in the use of brachytherapy. We also found some differences in the brachytherapy techniques used in prostate and head and neck cancers.

Overview of brachytherapy resources in Europe: A survey of patterns of care study for brachytherapy in Europe

Background and purpose The Patterns of Care for Brachytherapy in Europe (PCBE) study is aimed at establishing a detailed information system on brachytherapy throughout Europe. Materials and methods The questionnaire was web-based and the analysis used data from each radiotherapy department with brachytherapy. There were three groups: Group I with 19 countries (15 initial European Community (EC) countries plus Iceland, Monaco, Norway and Switzerland -EC+4-), Group II with 10 countries (New European Community countries -NEC-) and Group III with 14 countries (Other European Countries -OEC-). Results In the European area there are 36 of 43 countries (85%) which achieved data collection from at least 50% of centres, and were included in the analysis. The tumour site that had the largest number of treated patients was gynaecological tumours. Several variations have been found in the mean number of patients treated per consultant radiation oncologist and physicist; and in the proportion of brachytherapy patients with gynaecology, prostate and breast tumours, by country and by European area. The provided data showed that the average number of brachytherapy patients per centre increased by 10% between 1997 and 2002. Conclusions A European wide evaluation of brachytherapy practice using a web-based questionnaire is feasible and that there is considerable variation in both patterns of practice and available resources.

Preliminary analysis of the resources in brachytherapy in Europe and its variability of use

The main objective of the program <<Patterns of Care for Brachytherapy in Europe (PCBE)>> is to establish a group with detailed information on brachytherapy throughout Europe. The data was compiled by the general coordinator, the ESTRO, and the <<National Cancer Services Analysis>> through a website. A total of 32 countries reported data from at least 50% of their centres (criteria of inclusion). Countries were grouped in three categories based on the time of incorporation to the European Union. The majority of treatments belonged to gynaecological tumours. A large spread was found regarding workload of specialists depending on centre and group. Collection of information by a website is a feasible methodology. An increase in brachytherapy treatment was observed in all 3 groups by a rate of more than 20% (year 2002 versus year 1997). These results advocate for the continuation of the PCBE study to demonstrate the development in the field, such as an increase or decrease of patient numbers per tumour category.

Patterns of care for brachytherapy in Europe results in Spain

In 2003 ESTRO began a project whose primary objective, was to make a map in the European area of infrastructures in technology and personnel for brachytherapy. A survey and a web site were elaborated. The survey was sent to the 76 Spanish Radiation Oncology departments in May 2003. By the end of 2003, 66 (86.8%) services had responded, 40 (71.4%) of which had brachytherapy. The services with brachytherapy treated 73.5% of the total patients, an average of 1,199 patients. The mean number of patients treated with brachytherapy by department was 135.5 and the number of applications was 265 annually. The average number of specialists was 7, 4 of them trained in brachytherapy. The average weekly work load of the radiation oncologists, physicists, and technicians was 22.6 h, 13.8 h and 21.0 h, respectively. The mean time dedicated to each patient by radiation oncologists, physicists and technicians was 9.2 h; 6.19 h; 7.2 h, respectively. The total number of afterloaders was 43 (22 HDR, 18 LDR, 3 PDR). The tumours most frequently treated with brachytherapy were gynaecological (56.24%), breast (14.2%) and prostate (11.7%). High dose rate was used in 47.46% of the patients and low dose rate in 47.24%. Between 1997 and 2002 there was an increase of 50.53% in patients treated with brachytherapy. The survey shows the brachytherapy resources and activity in Spain up to 2003. Increased use of brachytherapy in prostate tumours, prevalence of gynaecology brachytherapy and similar number of treatments with HDR and LDR are demonstrated in the Patterns of Care of Brachytherapy in Europe (PCBE) study in Spain.

19 Results of the patterns of care for brachytherapy in Europe questionnaire in Hungary

19 Results of the patterns of care for brachytherapy in Europe questionnaire in Hungary

232 oral Patterns of care for brachytherapy in Europe (PCBE): results for Israel

232 oral Patterns of care for brachytherapy in Europe (PCBE): results for Israel

226 Patterns of Care for Brachytherapy in Europe (PCBE)

226 Patterns of Care for Brachytherapy in Europe (PCBE)

1 Patterns of care for brachytherapy in Europe (PCBE)

1 Patterns of care for brachytherapy in Europe (PCBE)

3 oral + poster Patterns of care for brachytherapy in Europe (PCBE): results in Spain

3 oral + poster Patterns of care for brachytherapy in Europe (PCBE): results in Spain