title: Brachytherapy in Gynecologic Cancers: Why Is It Underused?
abstract: Despite its established efficacy, brachytherapy is underused in the management of cervical and vaginal cancers in some parts of the world. Possible reasons for the underutilization of brachytherapy include the adoption of less invasive techniques, such as intensity-modulated radiotherapy; reimbursement policies favoring these techniques over brachytherapy; poor physician or patient access to brachytherapy; inadequate maintenance of brachytherapy skills among practicing radiation oncologists; transitioning to high-dose-rate (HDR) brachytherapy with increased time requirements; and insufficient training of radiation oncology residents.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA. akila@post.harvard.edu.
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
mesh_terms: D001918:Brachytherapy / Q000639:trends*; D003131:Combined Modality Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D014625:Vaginal Neoplasms / Q000473:pathology / Q000532:radiotherapy*
keywords: Brachytherapy; Cervical cancer; Gynecologic cancer; Intensity-modulated radiotherapy; Utilization; Vaginal cancer