CONSENSUS GUIDELINES FOR HIGH-DOSE-RATE REMOTE BRACHYTHERAPY IN CERVICAL, ENDOMETRIAL, AND ENDOBRONCHIAL TUMORS

Purpose: A large number of medical centers have recently instituted th e use of High Dose-Rate Afterloading Brachytherapy (HDRAB). There is w ide variation in treatment regimens, techniques, and dosimetry being u sed and there are no national standard protocols or guidelines for opt imal therapy. Methods and Materials: The Clinical Research Committee ( CRC) of the American Endocurietherapy Society (AES) met to formulate c onsensus guidelines for HDRAB in cervical, endometrial, and endobronch ial tumors. Conclusion: Each center is encouraged to follow a consiste nt treatment policy in a controlled fashion with complete documentatio n of treatment parameters and outcome including efficacy and morbidity . Until further clinical data becomes available, the linear quadratic model can be used as a guideline to formulate a new HDR regimen exerci sing caution when changing from a Low Dose Rate (LDR) to a HDRAB regim en. The treatments should be fractionated as much as practical to mini mize long term morbidity. As more clinical data becomes available, the guidelines will mature and be updated by the Clinical Research Commit tee of the AES.