Image-guided brachytherapy for cervix cancer: an implementation study
Closed for Proposals
Project Type
Coordinated Research ProjectProject Code
E33042
CRP
2199
Approved Date
11/12/2018Project Status
ClosedStart Date
31/10/2019Expected End Date
31/12/2022Completed Date
11/09/2024Participating Countries
Azerbaijan, Bolivia, Plurinational State of, Brazil, Croatia, India, Kyrgyzstan, Morocco, Mongolia, Philippines, Pakistan, Türkiye, United Republic of Tanzania, Ukraine, ZambiaDescription
?Protocols for all steps of the procedures for different modalities of HDRBT
?Treatment planning guidelines
?Guidelines for the transition from basic modalities to modern image guided brachytherapy
?Resources and costs calculations for different scenarios
Objectives
To overcome the barriers to scaling-up IGBT programmes so that it reaches all women with cervical cancer in LMICs.
Specific Objectives
Primary objective:
? To understand the factors that affect the uptake, adaptation and adoption of IGBT in the treatment of cervical cancer [in LMICs]
Secondary objectives:
? To identify implementation problems, and main determinants that hinder access to IGBT for cervical cancer [in LMIC]
? To develop and test practical solutions to these problems that are specific to particular health systems and environments or that address a problem common to a region
? To understand how evidence-based IGBT should be modified to achieve sustained health impacts in real-world settings, including LMICs
? To determine the best way to introduce practical solutions into the healthcare system and facilitating their full-scale implementation, evaluation and modification
? To understand how to scale-up brachytherapy programmes for cervical cancer
? To understand the factors affecting sustainability of scaling-up brachytherapy for cervical cancer
Impact
IGBT adoption improves clinical outcomes, it also increases procedural complexity and treatment duration, potentially straining existing infrastructure and compromising the treatment capacity of radiotherapy centres. By conducting a comprehensive workflow mapping analysis across 14 globally diverse centres, the study identified current brachytherapy workflow efficiencies and processes that need most time. Impact of key variables such as anesthesia type, imaging modality, and treatment planning method were assessed and strategies for optimizing resource utilization while transitioning to IGBT were discussed. Key workflow modifications, such as reduced number of implants and multiple fraction delivery and streamlined planning protocols are explored as viable solutions to prevent increased patient waiting times and maximize treatment capacity.
Relevance
Highly relevant, the study provides actionable insights into how workflow efficiency impacts IGBT feasibility in high-incidence and resource-limited settings. By quantifying treatment time variations and per-machine patient demand, the findings can guide institutional and national-level strategies for transitioning to IGBT. The data presented can support evidence-based policy recommendations for sustainable brachytherapy expansion and inform training programs to optimize workforce capacity and workflow efficiency. Ultimately, these insights can help bridge the gap in global cancer care equity, ensuring that locally advanced cervical cancer patients in resource-limited settings receive timely, high-quality brachytherapy treatments.
CRP Publications
Tata Memorial Hospital/IAEA
Journal Publication
2022
Point-A vs. volume-based brachytherapy for the treatment of cervix cancer: A meta-analysis
Tata Memorial Hospital/IAEA
Journal Publication
2023
Transitioning India to advanced image based adaptive brachytherapy: a national impact analysis of upgrading National Cancer Grid cervix cancer guidelines
IAEA
Abstract
2025
Implementing Image-Guided Brachytherapy (IGBT) For Cervical Cancer in Resource-Limited Settings: An International Multicentre Resource and Workflow Impact Analysis
IAEA
Journal Publication
2024
Brachytherapy Workflow Practices: Analysis of Different Workflow Scenarios in Patients With Cervical Cancer and Impact on Image-Guided Brachytherapy Implementation—An IAEA Study