Brachytherapy for cancer of the cervix: An Australian and New Zealand survey of current treatment techniques S van Dyk, 1 D Byram 2 and D Bernshaw 1 1 Radiation Therapy Services, Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, and 2 W.P. Holman Clinic, Launceston, Tasmania, Australia SUMMARY Establishing guidelines for the practice of brachytherapy throughout Australia and New Zealand is one of the goals of the Australasian Brachytherapy Group. To better appreciate Australasian resources and conditions, the group conducted a survey in early 2005. The aims were to survey current practices, to emphasize variations in practice and to determine the availability of advanced imaging and treatment methods to assess resources. A survey was sent to all Australian and New Zealand radiotherapy departments. The survey requested details of treatment with respect to external beam radiotherapy, brachytherapy, optimization methods, reporting methods,scheduling bra- chytherapy and accessto imaging and methods of work-up. Thirty-four departmentswere contacted with 27 (79%) responses returned. Twenty-one departments use brachytherapy. Doses and fractionation schedules varied and use of sectional imaging was minimal. Individualized dosimetry is practised in a limited fashion by 60% of the surveyed departments. There is high compliance with International Commission on Radiation Units 38 dose report- ing recommendations. All brachytherapy units identified have access to CT and 85% to MRI within the hospital set- tings. Brachytherapy for cancer of the cervix is, currently, largely based on the Manchester system. The survey did emphasize considerable variation in dose and fractionation schemes between departments. The Australasian Bra- chytherapy Group subgroup intends to proceed with the process of formulating recommendations for cervix bra- chytherapy.It is intended that these will cover the use of image-based planning and treatment, target definition(s), verification of brachytherapy treatments and a uniform dose-reporting mechanism. Key words: brachytherapy; cervix; conformal; imaging; optimization. INTRODUCTION Advances in imaging and treatment technology in both external beam radiotherapy(EBRT) and brachytherapy(BT) have prompted examination of the practice of gynaecological brachy- therapy within Australia and New Zealand. Clinicians seeking advice on practice changes are looking to the Australasian Bra- chytherapy Group (ABG) for guidance. Members ofthe ABG formed a subgroup to investigate current patterns of care and to provide recommendations and guidelines for practitioners in gynaecological BT. The formulation of guidelines for BT of the cervix willtake into consideration current practices,recently published international guidelines, 1–4 patterns-of-care surveys and future resources. 5 Radiotherapy, particularly BT, is criticalto the successful managementof cervical cancer and has a long history of use. 6 Brachytherapy treatment systems developed early in the S van Dyk Dip App Sci; D Byram MBChB, FRANZCR; D Bernshaw MRACP, FRANZCR. Correspondence: Ms Sylvia van Dyk, Radiation Therapy Services, Peter MacCallum Cancer Centre, St Andrew’s Place, East Melbourne, Vic. 3002, Australia. Email: sylvia.vandyk@petermac.org Conflicts of interest: None. Submitted 11 November 2007; resubmitted 12 March 2008; accepted 18 April 2008. doi: 10.1111/j.1440-1673.2008.02025.x Radiation Oncology Original Article Journal of Medical Imaging and Radiation Oncology (2009) 52, 588–597 ª 2009 The Authors Journal compilation ª 2009 The Royal Australian and New Zealand College of Radiologists