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The implementation of a PDR 3D-guided gynaecological brachytherapy service in a UK centre

Published online by Cambridge University Press:  19 August 2013

D. Wood ,
L. Lane ,
W. Gillespie ,
S. Baker  and
C. Rowbottom
D. Wood*
Affiliation:
CMPE, The Christie NHS Foundation Trust, Manchester, UK
L. Lane
Affiliation:
CMPE, The Christie NHS Foundation Trust, Manchester, UK
W. Gillespie
Affiliation:
CMPE, The Christie NHS Foundation Trust, Manchester, UK
S. Baker
Affiliation:
CMPE, The Christie NHS Foundation Trust, Manchester, UK
C. Rowbottom
Affiliation:
CMPE, The Christie NHS Foundation Trust, Manchester, UK
*
Correspondence to: David Wood, CMPE, The Christie NHS Foundation Trust, Radiotherapy Theatre, Wilmslow Road, Manchester M20 4BX, UK. Tel: +441614463983. Fax: +441614463520. E-mail: David.wood@christie.nhs.uk
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Abstract

Background

Due to the discontinuation of the widely used low-dose rate (LDR) Caesium afterloader units, many centres in the past 10 years have moved from LDR Selectron treatments to Iridium 192 afterloaders. While the majority of UK centres have opted for high-dose rate (HDR) units, the Christie have invested in two pulsed dose rate (PDR) afterloaders alongside a move to full 3D-planned gynaecological brachytherapy.

Purpose

To share the experience and learning curve involved in the implementation of a 3D-guided PDR brachytherapy service.

Methods

The specific logistical and practical challenges of implementing a PDR service are discussed alongside the more general challenges of implementing 3D-guided magnetic resonance (MR) based brachytherapy. A multidisciplinary approach was undertaken to streamline the patient pathway and give all disciplines a forum to discuss service improvements and resolve problems.

Conclusions

The lessons learned throughout this experience can inform the decisions of departments that may wish to implement a PDR service or indeed a 3D image-guided HDR brachytherapy service in the future. The focus on the utilisation of lean principles to the patient pathway, improved multidisciplinary working and enhancing service efficiency is of interest to all centres.

Keywords

BrachytherapycervixGEC-ESTROgynaeIGBTimage guidedMRIPDRreconstruction
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 3 , September 2014 , pp. 322 - 331
Copyright
Copyright © Cambridge University Press 2013 

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