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Radiation Oncology • Gynecologic Cancers
How do you boost a positive parametrial margin in endometrial cancer after TAH BSO?
Do you use brachytherapy or external beam? What prescription / dose / regimen do you typically use? What if there is small bowel hanging into the field near the cuff?
Answer from: Radiation Oncologist at Academic Institution
For a patient with a positive margin, we would first want to image post-operatively to make sure there isn't any gross disease. MRI is most helpful for this. The goal for the dose would be to treat this region to about 60 Gy. We would initially treat the pelvis to 45 Gy with an integrated boost at t...
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Answer from: Radiation Oncologist at Academic Institution
Agree with the above explanation. If the patient is receiving VBT, this will not contribute an appreciable dose to the pelvic sidewall/parametria.
As a teaching point, we consider the brachytherapy dose in combination with EBRT dose for definitive treatment of cervical cancer with parametrial...