Implementation of image-guided brachytherapy for cervix cancer in the UK: progress update

Aims: Image-guided brachytherapy (IGBT) is the new gold standard for cervix cancer brachytherapy. In 2009, the Royal College of Radiologists (RCR) published a guidance document to facilitate the implementation of IGBT for cervix cancer in the UK. This paper reports the progress since the publication of the RCR document.

Materials and methods: Questionnaires were sent to 45 UK centres known to offer brachytherapy for cervix cancer in 2011. Replies were received from 43 (96%) centres. Details collected included brachytherapy machine, imaging technique for brachytherapy planning, applicator design and total dose to point A from external beam radiotherapy and brachytherapy. The results were compared with the 2008 survey reported in the RCR document.

Results: The number of centres offering computed tomography (CT) or magnetic resonance imaging (MRI)-based IGBT for cervix cancer has increased to 32 (71%) in 2011 compared with 12 (26%) in 2008. Although the most common applicator design in 2011 remains the tandem-ovoid applicator (71%), more respondents are using the tandem-ring applicator (29% versus 9% in 2008). Only seven (16%) centres are routinely prescribing < 70Gy(10) to point A in 2011 compared with 10 (22%) in 2008.

Conclusion: Considerable progress with implementing IGBT for cervix cancer has been made in the UK since the publication of the RCR guidance document.