American Brachytherapy Society consensus guidelines for adjuvant vaginal cuff brachytherapy after hysterectomy
American Brachytherapy Society consensus guidelines for adjuvant vaginal cuff brachytherapy after hysterectomy
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DOI：
10.1016/j.brachy.2011.08.005
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发表时间：
2012-01-01
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：
Small, William, Jr.;Beriwal, Sushil;Gaffney, David
目得：制定子宫切除术后辅助阴道断端近距离放射治疗的使用建议，并更新以前的美国近距离放射治疗协会（ABS）guidelines.METHODS AND MATERIALS：ABS的一组成员进行了文献回顾，补充了他们的临床经验，并制定了辅助阴道断端近距离放射治疗的建议。ABS认可国家综合癌症网络关于子宫内膜癌和宫颈癌患者放射治疗适应症的指南以及美国协会的质量保证指南关于《医学物理学家》ABS对施源器选择、插入技术、靶体积定义、剂量分割和术后辅助阴道断端治疗的规范提出了具体建议。ABS建议应根据患者解剖结构、靶体积几何结构和医生判断选择施源器。应明确规定剂量处方点。制表列出了单独近距离放射治疗和联合外照射放射治疗（如适用）的建议剂量。应选择合适的近距离放射治疗施源器，该施源器应符合阴道尖并实现粘膜接触，同时具有最佳肿瘤和正常组织剂量。剂量处方点可以单独选择，但剂量应报告在阴道表面和0.5厘米deep.Conclusions：建议辅助阴道断端近距离放射治疗。鼓励从业人员和合作团体使用这些建议来制定他们的治疗和剂量报告政策。这些建议将允许从不同机构的报告进行有意义的比较，并导致更好和更适当地使用阴道近距离放射治疗。(C)2012年美国近距离放射治疗协会。爱思唯尔公司出版All rights reserved.
PURPOSE: To develop recommendations for the use of adjuvant vaginal cuff brachytherapy after hysterectomy and update previous American Brachytherapy Society (ABS) guidelines.METHODS AND MATERIALS: A panel of members of the ABS performed a literature review, supplemented their clinical experience, and formulated recommendations for adjuvant vaginal cuff brachytherapy.RESULTS: The ABS endorses the National Comprehensive Cancer Network guidelines for indications for radiation therapy for patients with endometrial cancer and cervical cancer and the guidelines on quality assurance of the American Association on Physicists in Medicine. The ABS made specific recommendations for applicator selection, insertion techniques, target volume definition, dose fractionation, and specifications for postoperative adjuvant vaginal cuff therapy. The ABS recommends that applicator selection should be based on patient anatomy, target volume geometry, and physician judgment. The dose prescription point should be clearly specified. Suggested doses were tabulated for treatment with brachytherapy alone, and in combination with external beam radiation therapy, when applicable. A properly fitted brachytherapy applicator should be selected that conforms to the vaginal apex and achieves mucosal contact with optimal tumor and normal tissue dosimetry. Dose prescription points may be individually selected but doses should be reported at the vaginal surface and at 0.5-cm depth.CONCLUSIONS: Recommendations are made for adjuvant vaginal cuff brachytherapy. Practitioners and cooperative groups are encouraged to use these recommendations to formulate their treatment and dose reporting policies. These recommendations will permit meaningful comparisons of reports from different institutions and lead to better and more appropriate use of vaginal brachytherapy. (C) 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.