Preliminary results of modified interstitial MIAMI brachytherapy applicator for treatment of upper and apical vaginal tumors.
apical tumor
endometrial cancer
multichannel
vaginal brachytherapy
vaginal cuff
Journal
Journal of contemporary brachytherapy
ISSN: 1689-832X
Titre abrégé: J Contemp Brachytherapy
Pays: Poland
ID NLM: 101506276
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
18
05
2020
accepted:
12
08
2020
entrez:
13
1
2021
pubmed:
14
1
2021
medline:
14
1
2021
Statut:
ppublish
Résumé
Intracavitary vaginal brachytherapy (VBT) cylinders are limited in treating upper/apical vaginal disease due to the distance between the target and radiation source positions. Interstitial brachytherapy devices directly expose the vaginal mucosa to radiation sources, increasing morbidity. To target apical disease while limiting excessive treatment to the vaginal mucosa and organs at risk, we modified the commercially available multichannel MIAMI applicator, allowing the direct extension of needles into the apex with the protection of cylinder. The device has one central plastic core with six peripheral channels. The modified device permits titanium needles to surpass the apical surface into vaginal tissue. A retrospective analysis on thirteen patients treated with this device was conducted. Patient demographics, gross tumor volume (GTV)/clinical target volume (CTV), initial diagnosis and management, toxicity data, and EQD There were ten patients with vaginal recurrences and three with primary vaginal/cervical cancers. Mean dosage of VBT treatment was 25.5 Gy in 3-5 fractions. Mean dosage of external beam radiation therapy (EBRT) treatment was 44 Gy. Common acute toxicities included diarrhea, fatigue, cystitis, and nausea. Common chronic toxicities were pelvic pain, vaginal stenosis, and skin telangiectasia. Mean EQD Our data suggests that the custom applicator is associated with robust dosimetric coverage, good loco-regional control, acceptable toxicity, and reduced tissue trauma. This device allows treatment of apically located vaginal tumors without significant damage to the vaginal vault and organs at risk. Additionally, it provides the flexibility to treat multiple patients with variable vaginal diameters and sizes/depths of apical tumors using a single device.
Identifiants
pubmed: 33437304
doi: 10.5114/jcb.2020.101689
pii: 42678
pmc: PMC7787207
doi:
Types de publication
Journal Article
Langues
eng
Pagination
562-571Informations de copyright
Copyright © 2020 Termedia.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
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