When treating a patient with anal cancer with a vaginal dilator, do you routinely simulate the patient with and without the dilator in place?   

We only simulate with the dilator.The first point is that most of the benefit of the use of a dilator is in the accurate identification of the vulva / introitus avoidance structure during the contouring and planing process. It provides a separation and a place for the penumbra of the beam to go.We h...

We analysed every fraction in 10 patients and the target does not move. The reference is above.

I’ve used vaginal dilators for sbrt of gyne patients who were anesthesia risks for interstitial brachytherapy. I have found that positioning is highly variable. I always wonder about vaginal brachytherapy since we do not do image guidance right before.  So, I would use only for simulatio...