Patterns of care for brachytherapy in Europe: Updated results

Objective: This descriptive survey evaluated brachytherapy (BT) practices and resources in the European area. This was a follow-up study to the original patterns of care for brachytherapy in Europe (PCBE). Materials and methods: A total of 1121 radiotherapy (RT) centres from 41 countries were asked to complete an online questionnaire on BT practices and resources. Countries with fewer than 50% of centres responding were excluded. Participating countries were divided into three groups based on gross domestic product (GDP); group I contained the countries with the highest GDP. Results: The response rate was 56% (633/1121 centres) with 30/41 countries (73%) meeting the inclusion criteria. Sixty percent of reporting centres provided brachytherapy. Responding centres treated an average of 138 (±10, 1 SD) patients with BT; in group I, the mean was 110/centre, an increase of 18% from 2002. CT-dosimetry increased to 61% of centres vs. 33% in 2002. HDR (high-dose rate) BT was the most commonly reported technique (65% of centres). Most BT interventions were for gynaecological tumors (59% of all cases), followed by prostate (17%), breast (9%), lung/bronchus (3%), and esophagus tumors(2%). Conclusion: Gynaecological BT remains the most common application, although both prostate and breast BT have increased. CT-based dosimetry has become increasingly common since 2002. The use of HDR and PDR (pulsed-dose rate) techniques has increased markedly, while both LDR and MDR (medium-dose rate) have declined.