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How would you approach HDR portion of cervical SCC with large area of fistula with sigmoid colon?
Still do Tandem and Ring or opt for interstitial?
Patient will have diverting colostomy. Concern is whether the tandem will be stable enough with large area of fistulization of cervix and lower part of uterus with the bowel.
Answer from: Radiation Oncologist at Academic Institution
Consider using ultrasound every time a tandem is inserted or a Smit sleeve placed under ultrasound guidance (if not already part of routine practice) for tandem guidance, to ensure that a false tract into the fistulous bowel is not produced at the time of tandem placement.
Otherwise, as noted by Dr...
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Answer from: Radiation Oncologist at Community Practice
I usually do either hybrid applicator or template based in interstitial. In either situation, would use tandem also.