This study surveyed radiation oncologists in Morocco to explore current practices and perspectives on brachytherapy for cervix cancer. A 37-question survey was conducted in April 2023 among 165 Moroccan radiation oncologists using Google Forms. Of the 93 respondents, 39% treated over 20 patients in 2022 using 3D image-guided brachytherapy (BT) through the HDR technique; 2D techniques were not reported in the last five years. Intracavitary BT is uniformly applied with a tandem and ovoid applicator. Only 14% utilized interstitial needles for hybrid BT. Iridium-192 was the primary radioactive source (63%), followed by cobalt (37%). Ultrasound-guided 47% of applicator insertions. All used CT scans for planning, but only 6% used MRI fusion due to limited availability. Guidelines for target volume and dose prescription were mostly based on GEC-ESTRO recommendations (74%), followed by Manchester Point A (30.4%) and ABS (11%). Over 90% delineated CTV-HR and CTV-IR; 30% delineated GTV. All marked the bladder and rectum, while 52% marked the sigmoid, 5% the small bowel, and 3% the recto-vaginal point. For dosimetry, 12% used ICRU 89 points, 54% used dose-volume histograms (DVH), and 36% used both. Most reported EQD2cc for OARs for the rectum and bladder, with nine still using ICRU point doses. The most common fractionation schema was 7 Gy in four fractions (60%) and 7 Gy in three fractions (55%). Brachytherapy remains essential for treating cervical cancer in Morocco. Key areas for improvement include MRI fusion-guided brachytherapy, access to advanced applicators, expanding interstitial techniques, and professional training and national referential.

中文翻译：

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摩洛哥宫颈癌近距离放射治疗的实践模式调查

这项研究调查了摩洛哥的放射肿瘤学家，以探讨宫颈癌近距离放射治疗的当前实践和观点。 2023 年 4 月，使用 Google 表单对 165 名摩洛哥放射肿瘤学家进行了一项包含 37 个问题的调查。在 93 名受访者中，39% 的人在 2022 年通过 HDR 技术使用 3D 图像引导近距离放射治疗 (BT) 治疗了 20 多名患者；过去五年没有报道过 2D 技术。腔内 BT 使用串联卵形施药器均匀施药。只有 14% 使用间质针进行混合 BT。铱 192 是主要放射源 (63%)，其次是钴 (37%)。 47% 的施药器插入是通过超声引导的。所有人都使用 CT 扫描进行规划，但由于可用性有限，只有 6% 使用 MRI 融合。目标体积和剂量处方指南主要基于 GEC-ESTRO 推荐（74%），其次是曼彻斯特点 A（30.4%）和 ABS（11%）。 90%以上描绘了CTV-HR和CTV-IR； 30% 划定 GTV。全部标记了膀胱和直肠，52% 标记了乙状结肠，5% 标记了小肠，3% 标记了直肠阴道点。对于剂量测定，12% 使用 ICRU 89 点，54% 使用剂量体积直方图 (DVH)，36% 使用两者。大多数报告了直肠和膀胱 OAR 的 EQD2cc，其中 9 例仍在使用 ICRU 点剂量。最常见的分割方案是 7 Gy 分四次 (60%) 和 7 Gy 分三次 (55%)。在摩洛哥，近距离放射治疗对于治疗宫颈癌仍然至关重要。需要改进的关键领域包括 MRI 融合引导近距离放射治疗、先进施源器的使用、扩大间质技术以及专业培训和国家参考。