ESTRO 2024 - Abstract Book

S213

Brachytherapy - Gynaecology

ESTRO 2024

The implementation of single-insertion, four-session HDR-BT could be performed in 98% of the patients. It yields favorable LC and OS rates, coupled with tolerable toxicity in patients with LACC. Response to initial chemoradiotherapy evaluated on pre-BT MRI is an important prognostic factor and could help to individualized therapeutic strategies.

Keywords: Cervix carcinoma; brachytherapy

274

Proffered Paper

"Bridging the African Gap: Implementing interstitial Brachytherapy for Cervical Cancer in Botswana"

Memory Bvochora-Nsingo 1 , Emily Macduffie 2 , Dawn Balang 1 , Elliphine Gwangwava 1 , Thabiso Emelda Itsabeng 1 , Khan Rana 1 1 Gaborone Private Hospital, Oncology, Gaborone, Botswana. 2 Princess Marina Hospital, Oncology, Gaborone, Botswana

Purpose/Objective:

Brachytherapy is a critical component of curative treatment of cervical cancer (CC), the second most common cancer in sub-Saharan Africa. The scarcity of well-trained professionals and limited resources have impeded the widespread adoption of brachytherapy in the region. In Botswana, where cervical cancer is the most common malignancy and leading cause of cancer-related mortality, a single radiotherapy center was responsible for all treatment of CC cases requiring radiotherapy between 2000 and 2022. Two-dimensional brachytherapy was first introduced in 2012, utilizing conventional techniques prescribing to point A and in 2019 CT-based image-guided brachytherapy was implemented. The acquisition of a Flexitron HDR unit in 2021 offered the opportunity to include interstitial brachytherapy for eligible patients. However, lack of training in both image-guided planning and interstitial placement remained a significant barrier to broad implementation. In September 2022, one radiation oncologist at the center was sponsored to attend a training course in image-guided brachytherapy organized by the European Society of Radiotherapy & Oncology, which included an emphasis on interstitial techniques. Here, we report the utilization of interstitial brachytherapy prior to and after attendance at this single comprehensive brachytherapy training course in order to understand the impact on the practices at one institution.

Material/Methods:

A retrospective review was conducted to document use of brachytherapy for CC patients at a single institution in Botswana. Brachytherapy cases were reviewed between the time of interstitial unit acquisition in September 2021 through August 2023. The date of first fraction and modality were recorded. Chi-squared test was used to compare cases before and after September 2022.

Results:

Between September 2021 and August 2023, 350patients received their first fraction of brachytherapy for CC.