The course is aimed at teams consisting of radiation oncologists and medical physicists from institutions with concrete plans to implement 3D radiotherapy for cervical cancer, with a special interest in MR/ CT Image Based Brachytherapy. The institutions should have the necessary infrastructure for 3D brachytherapy available (afterloader, access to 3D imaging, CT/MR compatible applicators and a relevant treatment planning system) to facilitate the initiation of implementation of 3D techniques after the course. By participation the participants have the possibility to further develop and refine their 3D approach over time and get feedback on their progress with implementation. Participants should therefore be prepared to invest time in implementation of 3D techniques in between courses and to take part in homework / feedback efforts.
The course aims to:
- Learn about principles of 3D image-based EBRT and brachytherapy including techniques and treatment planning
- Provide understanding of commissioning, quality assurance, principles of planning, plan evaluation and reporting of 2D and 3D brachytherapy in cervical cancer
- Introduce 3D image-based target concepts of GTV, CTV and PTV including both EBRT and brachytherapy in cervical cancer
- Enable practical implementation of 3D techniques in EBRT and brachytherapy in cervical cancer
- Provide an overview on the radiation therapy (external radiation and brachytherapy) in cervical cancer.
By the end of this course participants should be able to:
Understand the rationale of 3D and apply concepts of advanced brachytherapy techniques in clinical practice
Perform contouring and treatment planning for 3D image guided EBRT and brachytherapy in clinical practice
Implement procedures for 3D image guided brachytherapy in cervical cancer in own department
Implement advanced EBRT techniques in cervical cancer in own department.
- Normal and pathologic anatomy of female pelvis.
- Image based anatomy including US, CT, MRI and conventional radiography.
- CTV/ITV/PTV for external irradiation.
- Combination of external irradiation and brachytherapy.
- Different application techniques in brachytherapy.
- ICRU 89 concepts: GTV, CTV, PTV at diagnosis and at time of brachytherapy for 2D and 3D brachytherapy.
- Dose, dose-rate and fractionation and overall treatment time.
- Radiobiological effects from combined external irradiation and brachytherapy, linear quadratic model.
- Prescribing, recording and reporting including ICRU- GEC-ESTRO 89 recommendations.
- Therapeutic outcome: radio-chemotherapy, image based EBRT and brachytherapy.
- Introduction to EMBRACE studies.
- Commissioning and Quality Assurance of various processes involved 3D treatment planning.
- There will be parallel session for Physicist where intricacies of Brachytherapy planning will be discussed.
- There will be two different tracks adapted to different levels of clinical experience among participants: “General track” and “Experienced track” (related to brachytherapy).
Before commencing this course participants should have:
- Basic knowledge of principles and experience with multi-modality management of cervical cancer
- Basic knowledge of and experience with radiological patho-anatomy relevant to cervical cancer
- Experience with existing external beam and brachytherapy workflows and processes in cervical cancer.
- Basic infrastructure in your department which facilitates post-course implementation of 3D image guided brachytherapy (afterloader, access to volumetric imaging, MRI/CT compatible applicators, and treatment planning system).
- Lectures / tutorials: 16 hours
- Practical workshop: 8 hours
- Applicators commissioning and reconstruction: 6 hours – Physicists
- Video presentations: 2 hours – Clinicians
Description:The tutorials include discussions of basics, evidence based treatments, contouring guidelines, variousprocesses involved in advanced EBRT and brachytherapy techniques and quality assurance. The practical hands on demonstration covers a direct learning process involved in approach, brachytherapy techniques, contouring exercises, evaluation and discussions on 3D radiotherapy.
METHODS OF ASSESSMENT
- Contouring (FALCON tool) and dose planning exercises (pre- and post-course homework)
- Interactive feedback through audience voting on specific questions during lectures
- MCQ (interactive session at the end of the course)
- ESTRO teaching course evaluation form.