Patterns of care study of brachytherapy in New South Wales: XXXX of the uterine corpus.

@entity5 @entity1
PURPOSE: There are limited data at a population level on adjuvant brachytherapy (BT) practice for uterine @entity5 . The aims of the current study were to describe BT practice for this disease in New South Wales (NSW), to assess quality of BT, and to determine if a caseload effect on quality exists. MATERIAL AND METHODS: @entity1 , @entity5 , and treatment related data were collected from all nine NSW radiation oncology departments that treated @entity1 with BT. Included @entity1 had @entity5 of the uterine corpus with treatment including BT. Brachytherapy quality was assessed using published quality benchmarks. Higher gynaecological BT caseload departments were compared with lower caseload departments. RESULTS: One hundred sixty-three NSW residents with gynaecological @entity5 were treated with BT. The four higher gynaecological BT caseload departments treated a median of 25.5 NSW residents (range 22-38), compared to median 10 (range 3-18) in the five lower caseload departments. Seventy-five @entity1 underwent BT for uterine @entity5 . Most @entity1 had early stage endometrioid disease and were treated adjuvantly with intravaginal cylinders using high-dose-rate BT. Doses were in accordance with guideline recommendations in 83% of cases, and BT was appropriately indicated in 76% of cases. Higher caseload departments were more likely to treat with guideline doses (96% vs. 53%, p < 0.001) but there was no difference in compliance rate with treatment indications (p = 0.75). CONCLUSIONS: Brachytherapy @entity1 , techniques, and numbers/unit for uterine @entity5 were similar in NSW compared to the USA but more dispersed than in Western Europe. Doses prescribed may not be optimal in lower gynaecological BT caseload departments - the significance of this represents an area in which more research is needed.
