title: American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: high-dose-rate brachytherapy.
abstract: OBJECTIVE
  This report presents an update to the American Brachytherapy Society (ABS) high-dose-rate (HDR) brachytherapy guidelines for locally advanced cervical cancer.
  
  
  METHODS
  Members of the ABS with expertise in cervical cancer formulated updated guidelines for HDR brachytherapy using tandem and ring, ovoids, cylinder, or interstitial applicators for locally advanced cervical cancer. These guidelines were written based on medical evidence in the literature and input of clinical experts in gynecologic brachytherapy.
  
  
  RESULTS
  The ABS affirms the essential curative role of tandem-based brachytherapy in the management of locally advanced cervical cancer. Proper applicator selection, insertion, and imaging are fundamental aspects of the procedure. Three-dimensional imaging with magnetic resonance or computed tomography or radiographic imaging may be used for treatment planning. Dosimetry must be performed after each insertion before treatment delivery. Applicator placement, dose specification, and dose fractionation must be documented, quality assurance measures must be performed, and followup information must be obtained. A variety of dose/fractionation schedules and methods for integrating brachytherapy with external-beam radiation exist. The recommended tumor dose in 2-Gray (Gy) per fraction radiobiologic equivalence (normalized therapy dose) is 80-90Gy, depending on tumor size at the time of brachytherapy. Dose limits for normal tissues are discussed.
  
  
  CONCLUSIONS
  These guidelines update those of 2000 and provide a comprehensive description of HDR cervical cancer brachytherapy in 2011.
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA. abs@americanbrachytherapy.org.
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: De Los Santos
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Demanes
authors.forename: David
authors.initials: D
authors.lastname: Gaffney
authors.forename: Jorgen
authors.initials: J
authors.lastname: Hansen
authors.forename: Ellen
authors.initials: E
authors.lastname: Jones
authors.forename: Christian
authors.initials: C
authors.lastname: Kirisits
authors.forename: Bruce
authors.initials: B
authors.lastname: Thomadsen
authors.forename: Beth
authors.initials: B
authors.lastname: Erickson
mesh_terms: D001918:Brachytherapy / Q000592:standards*; D005260:Female; D006801:Humans; D011879:Radiotherapy Dosage / Q000592:standards*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*