Task group on CT contouring in cervix cancer (coordinator Umesh Mahantshetty)
Many centers worldwide do not have access to MR at time of brachytherapy, while CT is a widely available image modality. The GEC ESTRO gyn network is working on guidelines for CT based contouring of targets and OARs based on clinical examination and CT imaging.
Task group on treatment planning recommendations (coordinator Kari Tanderup)
The GEC ESTRO recommendations I and II have provided a joint platform for contouring and reporting in MRI based brachytherapy. These recommendations have not involved guidance on treatment planning, and there is currently a wide variety of treatment approaches in terms of applicators, fractionation, dose rate and dose prescription. However, upcoming experience in image guided adaptive brachytherapy is providing an increasing amount of evidence with regard to outcome and dose effect. Based on this evidence, the GEC ESTRO gyn network is working on recommendations for treatment planning.
Task group on vaginal brachytherapy (coordinator Remi Nout)
The aims of the GEC ESTRO GYN task group on vaginal brachytherapy are to introduce a GEC ESTRO image guided brachytherapy target concept for primary vaginal cancer, vaginal recurrences and endometrial cancer. This task group was initiated during the GEC ESTRO annual meeting in Brussels, December 2013, with the following participants: Henrike Westerveld (AMC), Lars Fokdal (AUH), Max Schmid (MUW), Nicole Nesvacil (MUW), Renaud Mazeron (IGR) and Remi Nout (LEI). Activities started in January 2014 with a focus on primary vaginal cancer. For this purpose current target concepts from 5 participating centers were evaluated both by contouring and dose planning of 5 cases. Through these joint activities a common target concept is under development. Interim results have been presented during GEC ESTRO Gyn network meetings and a publication on these activities is foreseen in the near future. In addition a retrospective multicenter evaluation of outcome in IGABT in primary vaginal cancer was undertaken. So far a total of 87 patients have been included from these 5 centers and results were presented during the World Congress of Brachytherapy 2016.During the next phase the focus will be on the treatment of vaginal recurrences. In parallel the group is planning to start a prospective registration database.
Task group on image registration (coordinators Jamema Swamidas, Christian Kirisits, Kari Tanderup)
The task group on image registration is reviewing the current state of the art of registration methods and strategies for clinical use in image guided brachytherapy. The task group aims to develop guidelines for the use of registration in gyn brachytherapy.