Varanasi, India

AROI ESTRO 3D Radiotherapy with a Special Emphasis on Implementation of MRI/CT Based Brachytherapy in Cervical Cancer

The course is aimed at teams consisting of radiation oncologists and medical physicists from institutions with concrete plans to implement 3D radiotherapy for cervical cancer, with a special interest in MR/ CT Image Based Brachytherapy. The Institutions which participated in previous editions of Gynaecology AROI ESTRO teaching course are encouraged to register and will be selected on priority for the course. Also, Institutions who have the necessary infrastructure for 3D brachytherapy (afterloader, access to 3D (US/ CT/ MR) imaging, CT/MR compatible applicators and a relevant treatment planning system) to facilitate the initiation of implementation of 3D techniques after the course can apply. The course is conducted on regular basis every year and this will be 7th Edition which will focus on feedback, hurdles, progress and further development of a network to systematically work on research and implementation issues specific to India and other developing countries. The workshop involving both the advanced track and freshers should be prepared to invest time in implementation of 3D techniques in between courses and to take part in homework / feedback efforts. A finite number of teams from various set-ups and geographical locations in India will be invited by AROI. Participants from neighboring countries and other Asia Pacific (APAC) Region (max 5-10) may also apply to participate.

The course aims to:

  • Learn about principles of 3D image-based EBRT and brachytherapy including techniques and treatment planning
  • Provide understanding of commissioning, quality assurance, principles of planning, plan evaluation and reporting of 2D and 3D brachytherapy in cervical cancer
  • Introduce 3D image-based target concepts of GTV, CTV and PTV including both EBRT and brachytherapy in cervical cancer
  • Enable practical implementation of 3D techniques in EBRT and brachytherapy in cervical cancer
  • Provide an overview on the radiation therapy (external radiation and brachytherapy) in cervical cancer.
  • Enhance the practical implementation and logistics in the existing environment.
  • Further roadmap and steps of intervention to improve the existing standards.
  • Provide a platform to implement and develop an Indian network for future research and development in cervical cancer radiotherapy


By the end of this course participants should be able to: 

Learning outcomes

By the end of this course participants should be able to: 

• Understand the rationale of 3D and apply concepts of advanced brachytherapy techniques in clinical practice

• Understand and apply ICRU 89 concepts: GTV, CTV, PTV at diagnosis and at time of brachytherapy for 2D and 3D brachytherapy

Perform contouring and treatment planning for 3D image guided EBRT and brachytherapy in clinical practice

• Implement procedures for 3D image guided brachytherapy in cervical cancer in own department

• Implement advanced EBRT techniques in cervical cancer in own department.





  • Normal and pathologic anatomy of female pelvis
  • Image based anatomy including US, CT, MRI and conventional radiography at diagnosis and at BT
  • CTV/ITV/PTV for external irradiation
  • IMRT/VMAT, IGRT and treatment planning for external irradiation
  • Combination of external irradiation and brachytherapy
  • Dose, dose-rate and fractionation and overall treatment time
  • Radiobiological effects from combined external irradiation and brachytherapy, linear quadratic model
  • Prescribing, recording and reporting including ICRU- GEC-ESTRO 89 recommendations 
  • Therapeutic outcome: radio-chemotherapy, image based EBRT and brachytherapy
  • Introduction to EMBRACE studies
  • Commissioning and Quality Assurance of various processes involved 3D brachytherapy treatment planning.
  • Feedback and review of hurdles in implementation
  • Workshops with hands-on contouring and treatment planning




Before commencing this course participants should have: 

  • Basic knowledge of principles and experience with multi-modality management of cervical cancer
  • Basic knowledge of and experience with radiological patho-anatomy relevant to cervical cancer
  • Experience with existing external beam and brachytherapy workflows and processes in cervical cancer.
  • Basic infrastructure in your department which facilitates post-course implementation of 3D image guided brachytherapy (afterloader, access to volumetric imaging, MRI/CT compatible applicators, and treatment planning system).




  • Lectures / tutorials: 16 hours
  • Practical workshop: 8 hours
  • Applicators commissioning and reconstruction: 6 hours – Physicists
  • Video presentations: 2 hours - Clinicians


Description: The tutorials include discussions of basics, evidence-based treatments, contouring guidelines, various processes involved in advanced EBRT and brachytherapy techniques and quality assurance. The practical hands on demonstration covers a direct learning process involved in approach, brachytherapy techniques, contouring exercises, evaluation and discussions on 3D radiotherapy. 




Contouring (FALCON tool) and dose planning exercises (pre- and post-course homework) 

  • Interactive feedback through audience voting on specific questions during lectures
  • MCQ (interactive session at the end of the course)
  • ESTRO teaching course evaluation form.
  • Exclusive feedback sessions for “Experienced track” participants




Available here.


To be provided if available


Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS). EACCME credits are recognised by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.

AROI Course directors

  • Supriya Chopra, Radiation Oncologist, Tata Memorial Centre, Navi Mumbai (IN)

ESTRO Course directors

  • Kari Tanderup, Medical Physicist, University Hospital, Aarhus (DK) 
  • Remi Nout, Radiation Oncologist, Erasmus University Medical Centre, Rotterdam (NL)


To follow