SURVEY OF BRACHYTHERAPY PRACTICE IN THE UNITED-STATES - A REPORT OF THE CLINICAL-RESEARCH-COMMITTEE OF THE AMERICAN-ENDOCURIETHERAPY-SOCIETY

Purpose: To obtain reliable data on the extent of the brachytherapy pr actice in the United States by conducting a comprehensive survey of al l facilities. Methods and Materials: The Clinical Research Committee o f the AES surveyed all 1321 radiation oncology facilities identified i n the Patterns of Care Study (PCS) of the American College of Radiolog y (ACR). Multiple mailings and follow-up were made to obtain a high re sponse rate. Survey responders and nonresponders were compared using c hi-square tests. Summary statistics were reported. Results: Of the 132 1 facilities, 1054 responded (80%). Hospital-based and larger faciliti es had a statistically significant higher rate of response. Brachyther apy was being performed at 819 facilities (the median number of proced ures = 21-50). Two hundred and two facilities did no brachytherapy. Th e common isotopes used were Cs-137 (705 facilities), Ir-192 (585 facil ities),I-125 (236 facilities), and I-131 (194 facilities). The common brachytherapy techniques used were intracavitary (751 facilities), int erstitial (536 facilities), intraluminal (310 facilities), and plaques (148 facilities). Remote afterloaded brachytherapy was used at 205 ce nters as follows: high dose rate (HDR) (164), medium dose rate (MDR) ( 5), and low dose rate (LDR) (36). Computerized dosimetry was most comm only used (790 facilities), followed by Patterson-Parker (104 faciliti es) and Quimby (72 facilities). The common sites treated were cervix ( 701 facilities), endometrium (565 facilities), head and neck (354 faci lities), and lung (344 facilities). Conclusion: Data regarding brachyt herapy practice has been obtained from a large percentage (80%) of all facilities in the United States. The majority (78-81%) of radiation o ncology facilities perform brachytherapy; however, its use is restrict ed to gynecological implants in many of these centers. The results fro m this survey will be used to develop a pattern of care study and data registry in brachytherapy.