TY - JOUR
T1 - Survey on gynecological cancer treatment by Piedmont, Liguria, and Valle d'Aosta group of AIRO (Italian Association of Radiation Oncology)
AU - Cattari, G.
AU - Delmastro, E.
AU - Bresciani, S.
AU - Gribaudo, S.
AU - Melano, A.
AU - Giannelli, F.
AU - Tessa, Mariella
AU - Chiarlone, Renato
AU - Scolaro, Tindaro
AU - Krengli, Marco
AU - Urgesi, Alessandro
AU - Gabriele, P.
N1 - Export Date: 16 March 2017
Correspondence Address: Gabriele, P.; Radiotherapy Department, IRCCS-FPO, Strada Provinciale 42 km 3,95, Italy; email: pietro.gabriele@ircc.it
Funding details: Ministero della Salute
Funding text: The research was supported by 5 x Mille 2008 Ministero della Salute - FPRC Onlus and 5 x Mille 2009 Ministero della Salute - FPRC Onlus.
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An Italian multicenter retrospective study (2014) Gynecol Oncol, 132, pp. 611-617; Katsaros, D., Gribaudo, S., The proper use of multimodality treatment in locally advanced cervical cancer (2011) Gynecol Oncol, 121, pp. 422-423. , author reply 422; Patel, A., Franko, E.R., Jr., Fleshman, J.W., Utilizing the multidisciplinary team for planning and monitoring care and quality improvement (2015) Clin Colon Rectal Surg, 28, pp. 12-20; Rao, K., Manya, K., Azad, A., Uro-oncology multidisciplinary meetings at an Australian tertiary referral centre - Impact on clinical decision-making and implications for patient inclusion (2014) BJU Int, 114, pp. 50-54; Ottevanger, N., Hilbink, M., Weenk, M., Oncologic multidisciplinary team meetings: Evaluation of quality criteria (2013) Eval Clin Pract, 19, pp. 1035-1043; Gabriele, P., Quality standards in multidisciplinary setting ESTRO Course Praha 2013, November 9-12 and Turin 2015, February 1-4; Portelance, L., Chao, K.S., Grigsby, P.W., Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation (2001) Int J Radiat Oncol Biol Phys, 51, pp. 261-266; Fernandez-Ots, A., Crook, J., The role of intensity modulated radiotherapy in gynecological radiotherapy: Present and future (2013) Rep Pract Oncol Radiother, 18, pp. 363-370; Hymel, R., Jones, G.C., Simone, C.B., 2nd, Whole pelvic intensity-modulated radiotherapy for gynecological malignancies: A review of the literature (2015) Crit Rev Oncol Hematol, 94, pp. 371-379; Gill, B.S., Lin, J.F., Krivak, T.C., National Cancer Data Base analysis of radiation therapy consolidation modality for cervical cancer: The impact of new technological advancements (2014) Int J Radiat Oncol Biol Phys, 90, pp. 1083-1090; Townamchai, K., Poorvu, P.D., Damato, A.L., Radiation dose escalation using intensity modulated radiation therapy for gross unresected node-positive endometrial cancer (2014) Pract Radiat Oncol, 4, pp. 90-98; Rijkmans, E.C., Nout, R.A., Rutten, I.H., Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy (2014) Gynecol Oncol, 135, pp. 231-238; Gabriel, G., Barton, M., Delaney, G.P., The effect of travel distance on radiotherapy utilization in NSW and ACT (2015) Radiother Oncol, 117, pp. 386-389
PY - 2016
Y1 - 2016
N2 - Purpose: We focused the attention on radiation therapy practices about the gynecological malignancies in Piedmont, Liguria, and Valle d'Aosta to know the current treatment practice and to improve the quality of care. Material and methods: We proposed a cognitive survey to evaluate the standard practice patterns for gynecological cancer management, adopted from 2012 to 2014 by radiotherapy (RT) centers with a large amount of gynecological cancer cases. There were three topics: 1. Taking care and multidisciplinary approach, 2. Radiotherapy treatment and brachytherapy, 3. Follow-up. Results: Nineteen centers treated gynecological malignancies and 12 of these had a multidisciplinary dedicated team. Radiotherapy option has been used in all clinical setting: definitive, adjuvant, and palliative. In general, 1978 patients were treated. There were 834 brachytherapy (BRT) treatments. The fusion between diagnostic imaging (magnetic resonance imaging - MRI, positron emission tomography - PET) and computed tomography (CT) simulation was used for contouring in all centers. Conformal RT and intensity modulated radiation therapy (IMRT) were the most frequent techniques. The image guided radiation therapy (IGRT) was used in 10/19 centers. There were 8 active BRT centers. Brachytherapy was performed both with radical intent and as boost, mostly by HDR (6/8 centers). The doses for exclusive BRT were between 20 to 30 Gy. The doses for BRT boost were between 10 and 20 Gy. Four centers used CT-MRI compatible applicators but only one used MRI for planning. The BRT plans on vaginal cuff were still performed on traditional radiographies in 2 centers. The plan sum was evaluated in only 1 center. Only 1 center performed in vivo dosimetry. Conclusions: In the last three years, multidisciplinary approach, contouring, treatment techniques, doses, and control systems were similar in Liguria-Piedmont and Valle d'Aosta. However, the technology implementation didn't translate in a real treatment innovation so far. © 2016, Termedia Publishing House Ltd. All rights reserved.
AB - Purpose: We focused the attention on radiation therapy practices about the gynecological malignancies in Piedmont, Liguria, and Valle d'Aosta to know the current treatment practice and to improve the quality of care. Material and methods: We proposed a cognitive survey to evaluate the standard practice patterns for gynecological cancer management, adopted from 2012 to 2014 by radiotherapy (RT) centers with a large amount of gynecological cancer cases. There were three topics: 1. Taking care and multidisciplinary approach, 2. Radiotherapy treatment and brachytherapy, 3. Follow-up. Results: Nineteen centers treated gynecological malignancies and 12 of these had a multidisciplinary dedicated team. Radiotherapy option has been used in all clinical setting: definitive, adjuvant, and palliative. In general, 1978 patients were treated. There were 834 brachytherapy (BRT) treatments. The fusion between diagnostic imaging (magnetic resonance imaging - MRI, positron emission tomography - PET) and computed tomography (CT) simulation was used for contouring in all centers. Conformal RT and intensity modulated radiation therapy (IMRT) were the most frequent techniques. The image guided radiation therapy (IGRT) was used in 10/19 centers. There were 8 active BRT centers. Brachytherapy was performed both with radical intent and as boost, mostly by HDR (6/8 centers). The doses for exclusive BRT were between 20 to 30 Gy. The doses for BRT boost were between 10 and 20 Gy. Four centers used CT-MRI compatible applicators but only one used MRI for planning. The BRT plans on vaginal cuff were still performed on traditional radiographies in 2 centers. The plan sum was evaluated in only 1 center. Only 1 center performed in vivo dosimetry. Conclusions: In the last three years, multidisciplinary approach, contouring, treatment techniques, doses, and control systems were similar in Liguria-Piedmont and Valle d'Aosta. However, the technology implementation didn't translate in a real treatment innovation so far. © 2016, Termedia Publishing House Ltd. All rights reserved.
KW - Brachytherapy
KW - Gynecological cancer
KW - Multidisciplinary
KW - Radiotherapy
KW - Article
KW - brachytherapy
KW - cancer localization
KW - cancer palliative therapy
KW - clinical practice
KW - computer assisted tomography
KW - endometrium cancer
KW - female
KW - female genital tract cancer
KW - follow up
KW - health care quality
KW - health survey
KW - human
KW - image guided radiotherapy
KW - in vivo study
KW - intensity modulated radiation therapy
KW - major clinical study
KW - nuclear magnetic resonance imaging
KW - ovary cancer
KW - positron emission tomography
KW - practice guideline
KW - process optimization
KW - total quality management
KW - uterine cervix cancer
KW - vagina cancer
KW - vulva cancer
U2 - 10.5114/jcb.2016.59286
DO - 10.5114/jcb.2016.59286
M3 - Article
VL - 8
SP - 128
EP - 134
JO - Journal of Contemporary Brachytherapy
JF - Journal of Contemporary Brachytherapy
SN - 1689-832X
IS - 2
ER -