The American brachytherapy society survey of brachytherapy practice for carcinoma of the cervix in the United States

Purpose. The purpose of this study was to survey the brachytherapy practice for cervical cancer in the United States. Methods, The Clinical Research Committee of the American Brachytherapy Soci ety (ABS) performed a retrospective survey of individual physicians of the ABS and American Society of Therapeutic Radiologists and Oncologists regard ing the details of the brachytherapy techniques they personally used in the treatment of cervical cancer patients for the year 1995, The replies (some of which may have been an estimate only) were tabulated. The scope of this survey did not allow us to verify the data by chart audits, Results. A total of about 3500 questionnaires were mailed out; 521 response s were received. Of these responders, 206 (40%) did not perform any brachyt herapy for carcinoma of the cervix in 1995, Of the other 315 responders rep orting a total of 4892 patients treated in 1995, 88% used low dose rate (LD R) while 24% used high dose rate (HDR), There was a wide variation in the d oses used. For LDR treatments, the median total external beam radiation the rapy (EBRT) dose was 45 and 50 Gy and the LDR dose was 42 and 45 Gy for ear ly and advanced cancers, respectively. For HDR treatments, the median EBRT dose was 48 and 50 Gy and the median HDR dose was 29 and 30 Gy for early an d advanced cancers, respectively, The median dose per fraction was 6 Gy for a median of five fractions. Interstitial brachytherapy was used as a compo nent of the treatment in 6% of the patients by 21% of responders. Very few responders treated with pulsed or medium dose rates, Conclusion. This retrospective survey showed the current brachytherapy prac tice pattern in the treatment of cervical cancer in the United States and c an serve as a basis for future prospective national brachytherapy data regi stry. There was wide variation in the practice pattern, emphasizing the urg ent need for consensus on these issues, (C) 1999 Academic Press.