ESTRO meets Asia 2024 - Abstract Book

S148

Interdisciplinary – Gynaecological

ESTRO meets Asia 2024

Brachytherapy is a key component of treating gynecological cancer. For many years, traditional film-based planning brachytherapy was used to provide the curative dose to the target (at least 85Gy). Lorvidhaya et al. reported a 5-year overall survival rate of 68.2% with traditional brachytherapy. (1) Currently, image-guided brachytherapy (IGBT) using MRI or CT enhances treatment quality. The EMBRACE trial found that MRI-based IGBT had an overall 5-year survival rate of 74%. (2) The IGBT originated in Thailand in the late 2000s. The goal of this study is to determine how frequently IGBT is used to treat gynecological cancer.

Material/Methods:

A web-based survey tool was created specifically for this investigation. Once finished, the questionnaire was given to 14 centers around Thailand, including the northern, central, northeastern, eastern, and southern regions, for participation. In 2019, the key components of a brachytherapy unit, such as imaging, radioisotope consumption, and 2D or 3D capabilities, were documented and reviewed. The IGBT usage rate is the percentage of cancer patients who have received an indication for IGBT at some time during their disease's course. The actual (a-RTU) rate indicates the percentage of patients who receive IGBT.

Results:

Data collection from 14 centres has been completed. In 2019, 2,950 people with gynaecological cancer had radiotherapy treatment. In 2019, the 14 facilities have 32 linear accelerators, 17 CT simulators, one MRI simulator, 11 fluoroscope simulators, and 75 treatment planning systems. For brachytherapy, 11 of 14 facilities feature Iridium-192 HDR units, while three more have Cobalt-60 units. Eight facilities used C-arms for brachytherapy, while one used a CT scanner specifically to this purpose. Fractions for brachytherapy, conventional brachytherapy, and image-guided brachytherapy totalled 7,603, 5,056, and 2,547, respectively. After calculating the a-RTU, 33% of patients had IGBT.

Conclusion:

The a-RTU rate for IGBT in 14 centres was 33%. To close the gap in the future, the economic and health benefits of IGBT will be calculated.

Keywords: Brachytherapy, Image-guided, Utilization, Thailand

References:

1 Lorvidhaya V, Tonusin A, Changwiwit W, Chitapanarux I, Srisomboon J, Wanwilairat S, et al. High-dose-rate afterloading brachytherapy in carcinoma of the cervix: an experience of 1992 patients. Int J Radiat Oncol Biol Phys. 2000;46(5):1185-91. 2 Pötter R, Tanderup K, Schmid MP, Jürgenliemk-Schulz I, Haie-Meder C, Fokdal LU, et al. MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study. Lancet Oncol. 2021;22(4):538-547.

*(from Filling the gap of image-guided brachytherapy for gynecologic cancer – The RCARP-03 project from Thailand)

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Proffered Paper

To assess response & QOL in locally advanced cancer cervix patients treated by NACT followed by CTRT