Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd Posts in the discussion thread "Comparison of two very common fractionation schedules for HDR Gyn brachytherapy" - 9Gy x2 fr Vs 6.8 Gy x3 fr for HDR Cervix Intracavitory Brachytherapy Fri, 04 Sep 2026 13:35:09 +0000 http://isocentre.wikidot.com/forum/t-310660#post-1152649 Re: Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd#post-1152649 Mon, 16 May 2011 02:42:30 +0000 Nikhilesh Patil 416151 Good conclusion, our brachy dose does not change even if we choose to do SIB for nodes.

]]> http://isocentre.wikidot.com/forum/t-310660#post-1151972 Re: Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd#post-1151972 Sun, 15 May 2011 03:50:11 +0000 Dr Rahul Krishnatry 435674 well the debate for different fractionation in HDR has been since almost 20 years. it was discussed in recent WCI recommendations/ guidelines conference at TMH where different eminent gynecological oncologists from India and abroad were there.
it was felt by the expert panel (Dr Firuza Patel, Dr Pearcy….) and the representatives from various institutes across the globe that
"there is no need of any randomized trials comparing different schedules as long as total duration of treatment is in 6-8 weeks and the total dose to Point A is >80Gy EQD2 and bladder <90Gy EQD2 and rectum < 75GyEQD2 is achieved.
to reach that various fractionation from 5Gy to 9Gy may be used but the goal remains the same."

now the issue which may remain is EBRT to Brachy ratio in the scenerio of EBRT doses ranging from 40-50Gy. the difference of 10 Gy delivered by brachytherapy can make lot of difference in local cervical growth control and also treatment time (5 days to none). this becomes especially important if you have pelvic LN >/=3cm and if you are not using SIB IMRT for addressing the nodes.

]]> http://isocentre.wikidot.com/forum/t-310660#post-1013059 Re: Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd#post-1013059 Sun, 27 Feb 2011 03:07:58 +0000 Nikhilesh Patil 416151 TMH 7Gyx3# is for Stage IIIb but is nonrandomized data.
There was an IAEA multicentric RCT started in 2005/6 comparing 9Gy x 2# vs 7Gyx4# using ring applicators and both arms receive 46Gy/23# EBRT. Dont know if the results are out or still awaited.

]]> http://isocentre.wikidot.com/forum/t-310660#post-1012657 Re: Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd#post-1012657 Sat, 26 Feb 2011 18:43:03 +0000 Indranil Mallick 406941 Dear Nikhilesh
This paper has taken a long time coming. And all things considered validates the 9Gy x 2 fractionation scheme. I am trying to get hold of the full paper, but if my memory serves me right, the 6.8 x 3 fractionation started after EBRT completion in all their patients, thereby introducing a difference in total treatment time in these patients. It would be interesting to see the TMH 7 Gy x 3 results (where the first brachy fr is often in the 5th week of EBRT) somewhere and compare outcomes.
Indranil

]]> http://isocentre.wikidot.com/forum/t-310660#post-1009332 Comparison of two very common fractionation schedules for HDR Gyn brachytherapy http://isocentre.wikidot.com/forum/t-310660/comparison-of-two-very-common-fractionation-schedules-for-hd#post-1009332 Wed, 23 Feb 2011 04:08:50 +0000 Nikhilesh Patil 416151 One of the most recent comparison of two common but different fractionation schedules practiced for intracavitory HDR gynecological brachytherapy.
http://www.ncbi.nlm.nih.gov/pubmed/20685179

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