Applied Radiobiology and Radiotherapy Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
Section of Dosimetry and Medical Radiation Physics, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
JCO Glob Oncol. 2024 Feb;10:e2300336. doi: 10.1200/GO.23.00336.
The workflow of brachytherapy (BT) is an essential aspect of treatment to consider in image-guided brachytherapy (IGBT). It has an overarching effect influencing patient throughput and the number of cancer treatments that can be performed as it occupies equipment, space, and personnel. There is limited research addressing this issue. Under the International Atomic Energy Agency's Coordinated Research Activity titled IGBT for cervix cancer: An implementation study, our study analyzes various scenarios in the clinical workflow of BT delivery for cervical cancer. It aims to determine the extent to which these scenarios allow the routine implementation of IGBT. With this information, current barriers and individualized adaptations to efficient workflows can be identified to enhance the global application of IGBT, leading to better cervical cancer treatment.
A web-based poll of questions regarding practices in BT workflow was presented to 62 participants from low-, lower middle-, upper middle-, and high-income countries (19 countries).
This study highlighted diversity in BT practices across countries, income levels, and regions. It identified variations in workflow, patient throughput, and resource availability, which can have implications for the efficiency and quality of BT treatments. Scenario A, utilizing multiple locations for the steps of the BT procedure, was the most commonly used. The availability of resources, such as imaging devices and trained personnel, varied among the participating centers and remained challenging for IGBT implementation and sustainability.
The design of the BT facility plays a vital role in improving efficiency, with a dedicated BT suite contributing to an efficient workflow but limiting patient throughput, especially for high-volume centers. Although IGBT is effective, its implementation requires consideration of various logistical challenges and should be individualized.
近距离放射治疗（Brachytherapy，BT）的工作流程是影像引导近距离放射治疗（Image-Guided Brachytherapy，IGBT）中需要考虑的一个重要治疗环节。它对设备、空间和人员的占用，对患者吞吐量和可进行的癌症治疗数量有着全面的影响。目前针对这一问题的研究还很有限。在国际原子能机构题为“宫颈癌的 IGBT：实施研究”的协调研究活动下，我们的研究分析了宫颈癌 BT 治疗中临床工作流程的各种方案，旨在确定这些方案在多大程度上允许常规实施 IGBT。有了这些信息，就可以确定当前的障碍，并对高效工作流程进行个性化调整，以加强全球范围内对 IGBT 的应用，从而改善宫颈癌的治疗效果。
我们向来自低收入、中低收入、中上收入和高收入国家（19 个国家）的 62 名参与者在线发布了关于 BT 工作流程实践的问卷调查。
本研究强调了各国、不同收入水平和地区之间 BT 实践的多样性。它确定了工作流程、患者吞吐量和资源可用性方面的差异，这可能对 BT 治疗的效率和质量产生影响。方案 A 利用多个地点进行 BT 操作步骤，是最常用的方案。参与中心的资源可用性，如成像设备和经过培训的人员，存在差异，这对 IGBT 的实施和可持续性仍然构成挑战。
BT 设施的设计对于提高效率至关重要，专用的 BT 套房有助于实现高效的工作流程，但会限制患者吞吐量，特别是对于高容量中心。尽管 IGBT 是有效的，但它的实施需要考虑到各种后勤方面的挑战，应根据具体情况进行调整。
