KEY POINTS
- The document translates the joint ABS/GEC-ESTRO objectives for physician brachytherapy training into specific competencies for esophageal and endobronchial applications.
- Competencies cover patient selection, contraindications, endoscopic or bronchoscopic assessment, applicator placement, planning, delivery, radiation safety, quality assurance and follow-up.
- Esophageal brachytherapy is primarily palliative for bleeding or obstruction but may also be used for selected superficial tumours or as a boost to external-beam radiotherapy.
- Endobronchial brachytherapy is mainly used for palliation of airway obstruction or haemoptysis. Contraindications include bronchial fistula, direct invasion of major vessels and inaccessible stenosis.
- Trainees should participate in the entire procedure, including preoperative assessment, sedation, endoscopy or bronchoscopy, applicator placement, planning, delivery, recovery and discharge.
- Three-dimensional image-based planning is preferred when available because applicator curvature or eccentric positioning may substantially alter target and mucosal dose.
- Smaller applicator diameters produce higher mucosal surface doses, while aggressive dwell-time optimization may create proximal and distal hot spots. Standardized reporting of treatment length, prescription depth and small-volume organ doses is recommended.
CLINICAL TAKEAWAY
Competence in endoluminal brachytherapy requires supervised procedural experience, not only treatment-plan review. The framework may improve consistency in training and assessment but explicitly does not serve as a clinical-practice or programme-accreditation guideline.