ESTRO 2024 - Abstract Book

S214

Brachytherapy - Gynaecology

ESTRO 2024

Median patient age was 50 (IQR 44-61). All eligible patients received concurrent chemoradiation prior to or during brachytherapy delivery. Curative intent treatment comprised 95% of cases. Interstitial brachytherapy was utilized significantly more post-course, comprising 2.5% (n=4) of 151 cases prior to September 2022 and 16.6% (n=33)of 199 cases thereafter (p<0.01). Figure 1 illustrates interstitial brachytherapy caseload by month. Significantly fewer cases were aborted at first attempt in the post-course setting, with 7.9% (n=12) aborted pre-course and 4.0% (n=8)aborted post-course (p<0.01). Nine patients underwent second attempt (6 pre-course, 3 post-course), all of which were successful. Quality of brachytherapy insertions and planning also improved post training. Figure 2 illustrates improved brachytherapy insertion 2 months post training. Among brachytherapists, the physician who attended the course performed all interstitial cases. Additionally, following the completion of oncologist training, the remaining team members, including physicists, therapists, and nurses, naturally enhanced their skill sets, resulting in a comprehensive and holistic improvement in patient care.

Figure 1.Pre and post training brachytherapy cases performed September 2021-Aug 2023

Figure 2 showing a poor interstitial insertion pretraining, and markedly improved insertion post trapining

Conclusion:

This study underscores the transformative influence of a single, comprehensive brachytherapy training course attended by a radiation oncologist in Botswana. Knowledge and confidence gained during the course significantly increased brachytherapy utilization and paved the way for the successful integration of interstitial brachytherapy into clinical practice. The proportion of aborted procedures also significantly decreased after the course. This educational approach holds substantial promise in bridging the brachytherapy gap in Africa. However, the cost of attendance may be a significant barrier to many physicians in sub-Saharan Africa. Additional research is needed to assess the feasibility of institutions like those in Botswana potentially serving as regional training hubs in order