Recommendations of the Spanish brachytherapy group of the Spanish Society of Radiation Oncology and the Spanish Society of Medical Physics for interstitial high-dose-rate brachytherapy for gynaecologic malignancies

Cristina Gutiérrez; Silvia Rodríguez Villalba; Elena Villafranca Iturre; Naiara Fuentemilla Urio; J. Richart Sancho; Sofía Córdoba Largo; Francisco Pino; Ruth Gracia Lucio; Antonio Herreros; Dina Najjari; GEB Grupo Español de Braquiterapia

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Recommendations of the Spanish brachytherapy group of the Spanish Society of Radiation Oncology and the Spanish Society of Medical Physics for interstitial high-dose-rate brachytherapy for gynaecologic malignancies

Cristina Gutiérrez Miguélez ^[1] ; Silvia Rodríguez Villalba ^[6] ; Elena Villafranca Iturre ^[2] ; Naiara Fuentemilla Urio ^[2] ; Jose Richart Sancho ^[6] ; Sofía Córdoba Lago ^[3] ; Francisco Pino Sorroche ^[4] ; Ruth Gracia Lucio ^[4] ; Antonio Herreros Martínez ^[5] ; Dina Najjari-Jamal ^[1] ; GEB Grupo Español de Braquiterapia
1. [1] Universitat de Barcelona
  
  Universitat de Barcelona
  
  Barcelona, España
2. [2] Gobierno de Navarra
  
  Gobierno de Navarra
  
  Pamplona, España
3. [3] Hospital Universitario Puerta de Hierro
  
  Hospital Universitario Puerta de Hierro
  
  Madrid, España
4. [4] Institute Catalá Oncología
  
  Institute Catalá Oncología
  
  Barcelona, España
5. [5] Hospital Clinic Barcelona
  
  Hospital Clinic Barcelona
  
  Barcelona, España
6. [6] Departamento de Oncología Radioterápica, Hospital Clínica Benidorm, Benidorm, España
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Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 4 (April), 2023, págs. 912-932
Idioma: inglés
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Resumen
- The present document includes consensus-based recommendations from the Brachytherapy Group (GEB) of the Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM) for interstitial high-dose-rate (HDR) brachytherapy (BT) for gynaecologic malignancies. A nine-item survey—which included questions on experience with interstitial BT; indications and technique; applicator type; magnetic resonance imaging (MRI)-based planning; dose; fractionation schedule; and treatment planning—was sent to all radiation oncology departments (n = 174) in Spain in 2021. Responses were received from 36 centres (50% of all centres [n = 72] with a BT unit). The consensus-based recommendations presented here are based on a review of the available literature, professional experience among the group of experts, and in-person discussions held during the annual meeting of these two societies. We describe the results of the survey and the following: indications; contraindications; patient selection; description of applicators; role of imaging in planning; contouring; dose prescription; dosimetric reconstruction; optimisation; and dose indications for cancers of the cervix, vagina, and vulva. The various clinical scenarios in which interstitial BT is used in the treatment of gynaecological tumours are described in detail, including cervix intracavitary/interstitial hybrid HDR-BT; cervix perineal templates/freehand implants; primary vaginal malignancies/vaginal recurrences; and vulvar interstitial implants.