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Abstract
The purpose of this study is to survey the current patterns of practice, and barriers to implementation, of 3D image-guided brachytherapy (3D-IGBT) for cervical cancer in Japan. A 30-item questionnaire was sent to 171 Japanese facilities where high-dose-rate brachytherapy devices were available in 2012. In total, 135 responses were returned for analysis. Fifty-one facilities had acquired some sort of 3D imaging modality with applicator insertion, and computed tomography (CT) and magnetic resonance imaging (MRI) were used in 51 and 3 of the facilities, respectively. For actual treatment planning, X-ray films, CT and MRI were used in 113, 20 and 2 facilities, respectively. Among 43 facilities where X-ray films and CT or MRI were acquired with an applicator, 29 still used X-ray films for actual treatment planning, mainly because of limited time and/or staffing. In a follow-up survey 2.5 years later, respondents included 38 facilities that originally used X-ray films alone but had indicated plans to adopt 3D-IGBT. Of these, 21 had indeed adopted CT imaging with applicator insertion. In conclusion, 3D-IGBT (mainly CT) was implemented in 22 facilities (16%) and will be installed in 72 (53%) facilities in the future. Limited time and staffing were major impediments.
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Details
1 Gunma University Heavy Ion Medical Center, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371–8511, Japan
2 Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903–0215, Japan
3 Department of Radiation Oncology, Hyogo Cancer Center, 13–70 Kitaoji-cho, Akashi, Hyogo, 673–8558, Japan
4 Department of Radiation Oncology, Tottori University Hospital, Nishi-cho, Yonago, Tottori, 683–8504, Japan
5 Tokyo Bay Advanced Imaging and Radiation Oncology Clinic MAKUHARI, 1–17 Toyosuna, Mihama-ku, Chiba, 261–0024, Japan
6 Division of Radiation Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka, 411–8777, Japan
7 Department of Radiology, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, Koshigaya, Saitama 343–8577, Japan