Letter from the Editor-in-Chief

Dear Colleagues, Friends, Readers,
this year the fourth issue of our journal is quite special in my opinion. Its opening manuscript is classified as an educational article and is of great importance for some reasons detailed below. These are the Indian Brachytherapy Society Recommendations for radiotherapeutic management of cervical cancer with special emphasis on high dose rate brachytherapy.
As one can find out elsewhere, cervical cancer is the fourth most common cancer among women globally, with an estimated 570,000 new cases and 311,000 deaths worldwide in 2018 [1]. The incidence is higher and about 85% of the locally advanced disease cancers are detected in Low and Middle Income Country/Low Income Country (LMIC/LIC) settings, where sufficient resources, especially radiotherapy facilities, are not available [2]. The situation is compounded further with a high burden in rural areas where access to health care is challenging [3]. With all the international organizations and bodies (WHO/UN/IARC/UICC/IAEA etc.) working on a mission to eliminate (prevention, screening and treatment) cervical cancer, the IBS guidelines for management of cervical cancer in LMICs including India are a major step towards this goal.
Numerous guidelines developed and published are mainly for the western world and are of limited value in LMICs including India, which have a unique ethnic and cultural background, disease patterns, health care systems and access to treatment facilities [4,5].
The highlights of these guidelines are as follows:
1. IBS guidelines have been developed keeping in mind regional differences in cultural and socioeconomic factors, availability of resources and expertise, improvements in knowledge and technology, etc., resulting in highly heterogeneous patterns of care [6,7].
2. The guidelines address various processes especially for HDR brachytherapy (BT) which are practical and not addressed explicitly in most of the recommendations, for e.g., importance of use of clinical drawings for documentation of disease, patient preparation, principles of BT techniques and BT applicator selection criteria, treatment planning details including applicator reconstruction methods, BT procedure related complications and management, etc.
3. These guidelines developed by the experts in management of cervical cancer across various parts of India serve as an important comprehensive QA/QC program for the management of cervical cancers...


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