S36
Brachytherapy - General brachytherapy
ESTRO 2026
Material/Methods: Between August and October 2025, a prospective observational audit was conducted at the National Institute of Cancer Research & Hospital (NICRH), Dhaka.Thirty consecutive women with histologically confirmed cervical carcinoma completing curative EBRT (45–50.4 Gy in 25–28 fractions ± weekly cisplatin 40 mg/m ² ) were scheduled for high-dose-rate (HDR) intracavitary BT (3–4 fractions × 7 Gy).Data were prospectively recorded using an ESTRO-aligned audit dataset capturing EBRT completion, BT initiation, OTT, and delay causes (> 14 days).At mid-study, a digital coordination model was introduced comprising:(1) scheduled SMS and reminder phone calls to patients; and(2) a shared Excel-based coordination sheet updated in real-time by oncologists, physicists, technologists, and nurses to manage BT-slot allocation.Primary endpoint: EBRT–BT interval.Secondary endpoints: OTT ≤ 56 days and distribution of delay causes. Results: Median age = 51 years (range 36–70); 83 % FIGO IIB– IIIB; 73 % received concurrent cisplatin.All patients completed EBRT; 27 (90 %) received planned BT.Median EBRT–BT interval = 17 days (IQR 15–21); 46 % initiated BT ≤ 14 days; 32 % completed full RT ≤ 56 days.Primary delay factors: limited applicator slots (37 %), machine downtime (27 %), and logistic / social barriers (36 %).After implementation of the digital model, median waiting time decreased to 12 days (IQR 10–15), and completion ≤ 56 days improved to 53 % (p = 0.04).No grade ≥ 3 toxicities occurred; data completeness = 100 %. Conclusion: This audit identified significant access delays in cervical-cancer brachytherapy within a high-volume LMIC centre.A simple, data-driven digital scheduling model integrating multidisciplinary coordination and patient reminders substantially improved treatment timeliness and completion without additional infrastructure.This scalable, resource-neutral workflow innovation exemplifies how quality-improvement principles can be embedded into existing systems to advance ESTRO’s global mission of equitable, high- quality radiotherapy delivery. Keywords: Low cost Digital innovation, LMIC, Brachytherapy References: 1. Datta NR et al. Clin Oncol (R Coll Radiol). 2020; 32:e67–e75.2. Kumar L et al. J Contemp Brachytherapy. 2023; 15:1–7.3. Chopra S et al. Int J Radiat Oncol Biol Phys. 2018; 100:1181–1190.
angiosarcoma (n=1), and meibomian carcinoma (n=1).The median total prescribed dose was 40 Gy (range: 32–55 Gy), delivered in a median of 10 fractions (range: 8–12). Acute toxicity occurred in 81.1% of treatments (n=30): grade 1 in 17 cases, grade 2 in 8, and grade 3 in 5. Late toxicity was observed in 18.9% (n=7), including fibrosis (n=3), telangiectasia (n=3), and hyperpigmentation (n=1).A complete response was achieved in 89.2% of treatments (n=33), and partial response in 10.8% (n=4). Only two local recurrences were observed. The 5-year disease-free survival rate was 88%. Conclusion: HDR plesiotherapy proved to be an effective and well- tolerated treatment for both NMSC and cutaneous breast cancer recurrences, achieving high local control and acceptable toxicity rates. It represents a valuable therapeutic option for selected superficial lesions. Keywords: Plesiotherapy, Skin Cancer, Breast Cancer References: 1- Sawada Y, Nakamura M. Daily lifestyle and cutaneous malignancies. Int J Mol Sci. 2021;22(10):5227. https://doi.org/10.3390/ijms22105227.2- Rubió J, Hernandez AM, Ferreira MC, et al. Trends in incidence and survival analysis innon-melanoma skin cancer from 1994 to 2012 in Girona, Spain: a population- based study. Cancer Epidemiol. 2016;45:6–10. https://doi.org/10.1016/j.canep.2016.09.001.3- Guinot JL, Rembielak A, Perez-Calatayud J, et al. GEC ESTRO. GEC-ESTRO ACROP recommendations in skin brachytherapy. Radiother Oncol. 2018 Mar;126(3):377- 385. doi: 10.1016/j.radonc.2018.01.013. Epub 2018 Feb 16. PMID: 29455924. Digital Poster 1706 Enhancing access to cervical cancer brachytherapy through a low-cost digital scheduling model: a prospective audit from Bangladesh Mahbuba Akhter Tania Radiation Oncology, National Institute of Cancer Research & Hospital, Mohakhali, Dhaka, Dhaka, Bangladesh
Purpose/Objective: Brachytherapy (BT) following external-beam
radiotherapy (EBRT) is essential for curative treatment of cervical cancer.In low- and middle-income countries (LMICs), limited equipment and workflow inefficiencies often delay BT initiation, prolonging overall treatment time (OTT) and affecting local control.This prospective audit aimed to measure BT waiting intervals and evaluate the impact of a low-cost digital scheduling model designed to improve treatment timeliness and completion in a national cancer centre in Bangladesh.
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