PURPOSE: Most cervix cancer cases occur in low-income and middle-income countries (LMIC), and outcomes are suboptimal, even for early stage disease. Brachytherapy plays a central role in the treatment paradigm, improving both local control and overall survival. The American Brachytherapy Society (ABS) aims to provide guidelines for brachytherapy delivery in resource-limited settings.
METHODS AND MATERIALS: A panel of clinicians and physicists with expertise in brachytherapy administration in LMIC was convened. A survey was developed to identify practice patterns at the authors' institutions and was also extended to participants of the Cervix Cancer Research Network. The scientific literature was reviewed to identify consensus papers or review articles with a focus on treatment of locally advanced, unresected cervical cancer in LMIC.
RESULTS: Of the 40 participants invited to respond to the survey, 32 responded (response rate 80%). Participants were practicing in 14 different countries including both high-income (China, Singapore, Taiwan, United Kingdom, and United States) and low-income or middle-income countries (Bangladesh, Botswana, Brazil, India, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). Recommendations for modifications to existing ABS guidelines were reviewed by the panel members and are highlighted in this article.
CONCLUSIONS: Recommendations for treatment of locally advanced, unresectable cervical cancer in LMIC are presented. The guidelines comment on staging, external beam radiotherapy, use of concurrent chemotherapy, overall treatment duration, use of anesthesia, applicator choice and placement verification, brachytherapy treatment planning including dose and prescription point, recommended reporting and documentation, physics support, and follow-up.
Accumulation of polycyclic aromatic hydrocarbons (PAH) poses significant dangers to the environment and human health. The advancement of technology for cleaning up PAH-contaminated environments is receiving more attention. Adsorption is the preferred and most favorable approach for cleaning up sediments polluted with PAH. Due to their affordability and environmental friendliness, carbonaceous adsorbents (CAs) have been regarded as promising for adsorbing PAH. However, adsorbent qualities, environmental features, and factors may all significantly impact how well CAs remove PAH. According to growing data, CAs, most of which come from laboratory tests, may be utilized to decontaminate PAH in aquatic setups. However, their full potential has not yet been established, especially concerning field applications. This review aims to concisely summarize recent developments in CA, PAH stabilization processes, and essential field application-controlling variables. This review analysis emphasizes activated carbon, biochar, Graphene, carbon nanotubes, and carbon-nanomaterials composite since these CAs are most often utilized as adsorbents for PAH in aquatic systems.