scholarly journals Impact of High-Dose-Rate Brachytherapy Training via Telehealth in Low- and Middle-Income Countries

2020 ◽  
pp. 1803-1812
Author(s):  
Jeremy B. Hatcher ◽  
Oluwadamilola Oladeru ◽  
Betty Chang ◽  
Sameeksha Malhotra ◽  
Megan Mcleod ◽  
...  
Keyword(s):  
Dose Rate ◽  
Treatment Planning ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Radiation Oncologists ◽  
Medical Physicists ◽  
Low And Middle Income

PURPOSE Our objective was to demonstrate the efficacy of a telehealth training course on high-dose-rate (HDR) brachytherapy for gynecologic cancer treatment for clinicians in low- and middle-income countries (LMICs) METHODS A 12-week course consisting of 16 live video sessions was offered to 10 cancer centers in the Middle East, Africa, and Nepal. A total of 46 participants joined the course, and 22 participants, on average, attended each session. Radiation oncologists and medical physicists from 11 US and international institutions prepared and provided lectures for each topic covered in the course. Confidence surveys of 15 practical competencies were administered to participants before and after the course. Competencies focused on HDR commissioning, shielding, treatment planning, radiobiology, and applicators. Pre- and post-program surveys of provider confidence, measured by 5-point Likert scale, were administered and compared. RESULTS Forty-six participants, including seven chief medical physicists, 16 senior medical physicists, five radiation oncologists, and three dosimetrists, representing nine countries attended education sessions. Reported confidence scores, both aggregate and paired, demonstrated increases in confidence in all 15 competencies. Post-curriculum score improvement was statistically significant ( P < .05) for paired respondents in 11 of 15 domains. Absolute improvements were largest for confidence in applicator commissioning (2.3 to 3.8, P = .009), treatment planning system commissioning (2.2 to 3.9, P = .0055), and commissioning an HDR machine (2.2 to 4.0, P = .0031). Overall confidence in providing HDR brachytherapy services safely and teaching other providers increased from 3.1 to 3.8 and 3.0 to 3.5, respectively. CONCLUSION A 12-week, low-cost telehealth training program on HDR brachytherapy improved confidence in treatment delivery and teaching for clinicians in 10 participating LMICs.

scholarly journals Collaborative Model for International Telehealth: High Dose Rate Brachytherapy Training for Emerging Radiation Oncology Centers in Lower- and Middle-Income Countries

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 51-52
Author(s):  
Jeremy Hatcher ◽  
Adam Shulman ◽  
Claire Dempsey ◽  
Betty Chang ◽  
Sameeksha Malhotra ◽  
...  
Keyword(s):  
Middle East ◽  
Dose Rate ◽  
High Dose Rate ◽  
Cancer Center ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Middle Income ◽  
Cancer Centers ◽  
Global Team ◽  
Middle Income Countries

PURPOSE High dose rate (HDR) brachytherapy is a critical treatment modality—both palliative and curative—for gynecologic malignancies that significantly burden low- and middle-income countries (LMICs). Many of these countries currently have limited capacity to provide necessary brachytherapy treatment. To bridge this gap in LMICs in North Africa and the Middle East, nonprofits Rayos Contra Cancer and Radiating Hope evaluated the efficacy, cost, and feasibility of a pilot HDR brachytherapy continuing medical education curriculum to selected regional cancer centers via videoconferencing. METHODS Rayos Contra Cancer and Radiating Hope recruited a global team of HDR brachytherapy content experts. They developed a 16-week curriculum and recruited 10 regional cancer center partners in LMICs throughout the Middle East, Africa, and Nepal. The curriculum included 17 sessions shared via live Zoom videoconferences. A lead correspondent was assigned for communication at each center. Attendance was taken during each call, and pre- and postsession Likert-scale (1 to 5 points) surveys were collected from participants that assessed their confidence in 15 practical competencies in HDR brachytherapy and overall confidence in their ability to provide services and teach others. RESULTS A total of 326 attendance hours was recorded during the curriculum. Among 46 participants, the average paired confidence scores increased pre- versus postcurriculum in all 15 practical competencies, with an average improvement of 1.2 out of 5 and significant P values in all 15 topics. Absolute improvements were largest for confidence in applicator commissioning (2.3 to 3.8, P = .0015), TPS commissioning (2.2 to 3.7, P = .0010), and commissioning an HDR machine (2.2 to 4.0, P = .00096). Participant confidence significantly increased in ability to provide services (3.5 to 4.2, P = .0023) and teach others (3.4 to 3.9, P = .013). There was no cost to provide this training, and more than 4,300 patients are treated annually with HDR brachytherapy at participating centers. CONCLUSION This novel low-cost telehealth model for HDR brachytherapy training is a promising vehicle for advancing cancer care in LMICs. Postcourse surveys demonstrated increased confidence in both providing care and teaching in HDR brachytherapy, and sessions were well attended. A video-based telehealth teaching platform enabled expert HDR brachytherapy providers and physicists to reach growing cancer centers worldwide.

High–dose rate brachytherapy in the treatment of carcinoma of uterine cervix: twenty-year experience with cobalt after-loading system

2006 ◽  
Vol 16 (3) ◽  
pp. 1101-1105
Author(s):  
A. Mosalaei ◽  
M. Mohammadianpanah ◽  
S. Omidvari ◽  
N. Ahmadloo
Keyword(s):  
Dose Rate ◽  
Treatment Planning ◽  
Uterine Cervix ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Gastrointestinal Complications ◽  
Fractionation Schedule

This retrospective analysis aims to report results of patients with cancer of uterine cervix treated with external-beam radiotherapy (EBR) and high–dose rate (HDR) brachytherapy, using manual treatment planning. From 1975 to 1995, 237 patients with FIGO stages IIB–IVA and mean age of 54.31 years were treated. EBR dose to the whole pelvis was 50 Gy in 25 fractions. Brachytherapy with HDR after-loading cobalt source (Cathetron) was performed following EBR completion with a dose of 30 Gy in three weekly fractions of 10 Gy to point A. Survival, local control, and genitourinary and gastrointestinal complications were assessed. In a median follow-up of 60.2 months, the 10-year overall and disease-free survival rate was 62.4%. Local recurrence was seen in 12.2% of patients. Distant metastases to the lymph nodes, peritoneum, lung, liver, and bone occurred in 25.3% of patients. Less than 6% of patients experienced severe genitourinary and/or gastrointestinal toxicity that were relieved by surgical intervention. No treatment-related mortality was seen. This series suggests that 50 Gy to the whole pelvis together with three fractions of 10 Gy to point A with HDR brachytherapy is an effective fractionation schedule in the treatment of locally advanced cancer of cervix. To decrease the complications, newer devices and treatment planning may be beneficial.

scholarly journals A fast multitarget inverse treatment planning strategy optimizing dosimetric measures for high-dose-rate (HDR) brachytherapy

2017 ◽  
Vol 44 (9) ◽  
pp. 4452-4462 ◽  
Author(s):  
Christian V. Guthier ◽  
Antonio L. Damato ◽  
Akila N. Viswanathan ◽  
Juergen W. Hesser ◽  
Robert A. Cormack
Keyword(s):  
Dose Rate ◽  
Treatment Planning ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Planning Strategy ◽  
Inverse Treatment Planning ◽  
Inverse Treatment

Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

2012 ◽  
Author(s):  
Hardev Singh ◽  
Tania De La Fuente Herman ◽  
Barry Showalter ◽  
Spencer J. Thompson ◽  
Elizabeth J. Syzek ◽  
...  
Keyword(s):  
Dose Rate ◽  
Treatment Planning ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Planning Systems ◽  
Treatment Planning Systems
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