抄録
Purpose: To standardize the dose prescription for the uterine body and vaginal region for image-guided brachytherapy (IGBT) of cervical cancer, and to understand the current status at each institution in actual clinical practice.
Methods: A web-based questionnaire was sent to all 215 facilities certified by the Japanese Society for Radiation Oncology (JASTRO) to investigate the current status of dose prescribing for the uterine and vaginal region for IGBT. The survey questions included whether IGBT was performed, the imaging modality used for treatment planning, the method of dose prescription in conventional planning, and the method of dose prescription for patients with uterine or vaginal wall invasion.
Results: Sixty-nine of 215 facilities responded to the survey. The results showed that 67.6% of the responding centers performed IGBT, and of those that performed IGBT, 62% used CT only, 0% used MRI only, and 34% used both CT and MRI as imaging modalities for treatment planning. For patients with uterine body involvement, 43% of the centers prescribed doses to the residual body involvement at the start of intracavitary irradiation, and 25% of the centers prescribed doses to the extent of uterine body involvement seen before treatment. Eleven percent of the centers treated with only the point A prescription, with or without uterine invasion, and 15% of the centers administered the dose to the entire uterine body. For patients with vaginal wall infiltration, 45% of the centers prescribed doses to the residual vaginal wall infiltration at the start of intracavitary irradiation, and 36% of the centers prescribed doses to the extent of vaginal infiltration prior to treatment.
Conclusion: IGBT dose prescription for cases of uterine and vaginal wall invasion has not yet been standardized, and it is necessary to reach a certain consensus as IGBT becomes more widely used.
