How do you boost patients with IVA cervical cancer who present with a large fistula that worsens during chemoradiation?

After a diversion, would any other factors impact your recommendation (residual disease/response to chemoradiation, performance status)? Although brachytherapy with interstitial implant would be standard, what if unable to get adequate coverage due to residual disease? If EBRT boost (palliative) is recommended, which technique? Dose and fractionation is preferred?

Answer from: Radiation Oncologist at Community Practice

Preferred is interstitial brachy with our dose of 5.5 to 6 Gy x 5 in BID fractionation. Either MRI pre brachy with CT-based planning with applicator or MRI-based planning if can use hybrid applicator.

Comments

Radiation Oncologist at University of Toronto Faculty of Medicine
Would you put needles next on the bladder wall? Wo...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
For fistula, I do as unfortunately, it would not h...

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How do you boost patients with IVA cervical cancer who present with a large fistula that worsens during chemoradiation?

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