title: American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part III: low-dose-rate and pulsed-dose-rate brachytherapy.
abstract: OBJECTIVE
  To develop a guideline for quality practice of low-dose-rate (LDR) and pulsed-dose-rate (PDR) brachytherapy for locally advanced cervical cancer.
  
  
  METHODS
  Members of the American Brachytherapy Society (ABS) with expertise in cervical cancer brachytherapy formulated updated guidelines for LDR and PDR brachytherapy for locally advanced (International Federation of Gynecology and Obstetrics [FIGO] Stages IB2-IVA) cervical cancer based on literature review and clinical experience.
  
  
  RESULTS
  The ABS strongly recommends the use of brachytherapy as a component of the definitive treatment of locally advanced cervical carcinoma. Precise applicator placement is necessary to maximize the probability of achieving local control without major side effects. The ABS recommends a cumulative delivered dose of approximately 80-90Gy for definitive treatment. Dosimetry must be performed after each insertion before treatment delivery. The dose delivered to point A should be reported for all intracavitary brachytherapy applications regardless of treatment planning technique. The ABS also recommends adoption of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology guidelines for contouring, image-based treatment planning and dose reporting. Interstitial brachytherapy may be considered for a small proportion of patients whose disease cannot be adequately encompassed by intracavitary application and should be performed by practitioners with special expertise in these procedures. Quality management measures must be performed, and follow-up information should also be obtained.
  
  
  CONCLUSIONS
  Updated ABS guidelines are provided for LDR and PDR brachytherapy for locally advanced cervical cancer. Practitioners and cooperative groups are encouraged to use these guidelines to formulate their clinical practices and to adopt dose-reporting policies that are critical for outcome analysis.
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA 02115, USA.
authors.forename: Larissa J
authors.initials: LJ
authors.lastname: Lee
authors.forename: Indra J
authors.initials: IJ
authors.lastname: Das
authors.forename: Susan A
authors.initials: SA
authors.lastname: Higgins
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.forename: Bruce
authors.initials: B
authors.lastname: Thomadsen
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
authors.forename: Aaron
authors.initials: A
authors.lastname: Wolfson
authors.forename: Patricia
authors.initials: P
authors.lastname: Eifel
mesh_terms: D001918:Brachytherapy / Q000592:standards*; D005260:Female; D006801:Humans; D011879:Radiotherapy Dosage / Q000592:standards*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*