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Radiation Oncology • Gynecologic Cancers
What is your approach to adjuvant vaginal cuff radiation in patients with prior definitive pelvic radiation therapy?
If a patient had a remote history of pelvic radiation for another cancer and now has uterine cancer, what factors (grade, stage, KPS, LVSI, etc) would you use to determine if the patient should receive vaginal cuff brachytherapy? Does the use of chemotherapy influence your decision?
Answer from: Radiation Oncologist at Community Practice
I do take the previous dose into account.
Sometimes use a multichannel cylinder and try to control the rectum and bladder dose.
Also, prescribe lower end of acceptable dose schedule like 6 Gy x 5 to surface or 4 Gy x 6 to surface.
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Answer from: Radiation Oncologist at Academic Institution
If a woman has a remote history of pelvic radiation (45-50 Gy) for a prior malignancy, I typically use the same criteria to evaluate them for vaginal brachytherapy as I would if they had not had prior radiation.