American Brachytherapy Society: Brachytherapy treatment recommendations for locally advanced cervix cancer for low-income and middle-income countries
American Brachytherapy Society: Brachytherapy treatment recommendations for locally advanced cervix cancer for low-income and middle-income countries
复制标题
DOI：
10.1016/j.brachy.2016.10.007
复制
发表时间：
2017-01-01
期刊：
影响因子：
1.9
通讯作者：
Gaffney, David
中科院分区：
文献类型：
--
作者：
Suneja, Gita;Brown, Derek;Gaffney, David
目的：大多数宫颈癌病例发生在低收入和中等收入国家(LMIC)，即使是早期疾病，结果也不太理想。近距离放射治疗在治疗模式中发挥着核心作用，改善了局部控制和总体存活率。美国近距离放射治疗学会(ABS)旨在为在资源有限的情况下提供近距离放射治疗提供指导。方法和材料：召集了一个由LMIC具有近距离放射治疗管理专业知识的临床医生和物理学家组成的小组。开展了一项调查，以确定作者所在机构的实践模式，并将其扩展到子宫颈癌研究网络的参与者。对科学文献进行综述，以确定关于局部晚期未切除宫颈癌在LMIC中的治疗的共识文献或综述文章。结果：在应邀参与调查的40名参与者中，32人回答(应答率80%)。参与者在14个不同的国家执业，包括高收入国家(中国、新加坡、台湾、英国和美国)和低收入或中等收入国家(孟加拉国、博茨瓦纳、巴西、印度、马来西亚、巴基斯坦、菲律宾、泰国和越南)。专家小组成员审查了修改现有ABS指南的建议，并在本文中重点介绍了这些建议。结论：LMIC中提出了治疗局部晚期、不能切除的宫颈癌的建议。指南对分期、体外放射治疗、同步化疗的使用、总体治疗持续时间、麻醉的使用、敷贴器的选择和放置验证、近距离治疗计划(包括剂量和处方点)、推荐的报告和文献、物理支持和随访进行了评论。(C)2016年美国近距离放射治疗学会。爱思唯尔公司出版，版权所有。
PURPOSE: Most cervix cancer cases occur in low-income and middle-income countries (LMIC), and outcomes are suboptimal, even for early stage disease. Brachytherapy plays a central role in the treatment paradigm, improving both local control and overall survival. The American Brachytherapy Society (ABS) aims to provide guidelines for brachytherapy delivery in resource-limited settings.METHODS AND MATERIALS: A panel of clinicians and physicists with expertise in brachytherapy administration in LMIC was convened. A survey was developed to identify practice patterns at the authors' institutions and was also extended to participants of the Cervix Cancer Research Network. The scientific literature was reviewed to identify consensus papers or review articles with a focus on treatment of locally advanced, unresected cervical cancer in LMIC.RESULTS: Of the 40 participants invited to respond to the survey, 32 responded (response rate 80%). Participants were practicing in 14 different countries including both high-income (China, Singapore, Taiwan, United Kingdom, and United States) and low-income or middle-income countries (Bangladesh, Botswana, Brazil, India, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). Recommendations for modifications to existing ABS guidelines were reviewed by the panel members and are highlighted in this article.CONCLUSIONS: Recommendations for treatment of locally advanced, unresectable cervical cancer in LMIC are presented. The guidelines comment on staging, external beam radiotherapy, use of concurrent chemotherapy, overall treatment duration, use of anesthesia, applicator choice and placement verification, brachytherapy treatment planning including dose and prescription point, recommended reporting and documentation, physics support, and follow-up. (C) 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.