Abstract
Freehand needles can be used with multichannel vaginal cylinders (MCVC) to cover vaginal
cancer >7 mm thick or with supra-vaginal extension. We report our institutional outcomes
using this novel hybrid technique.
Patients with vaginal malignancies treated with HDR BT using MCVC plus freehand needles
from 2014-2021 at our institution were identified. Clinical characteristics, details
of brachytherapy, initial response, and overall local control (LC) outcomes were recorded.
LC was analyzed via Kaplan-Meier method.
34 patients were identified with median follow-up 1.9 years. 19 patients had primary
endometrial cancer with vaginal recurrence/disease, and remaining had primary vaginal
cancer or other primaries. 7 patients had recurrence after previous RT course. 25
patients received EBRT with median dose 45 Gy in 25 fractions, and rest received BT
alone. Median HR-CTV D90 for patients treated with EBRT plus BT was 77.4 Gy.
30 patients had complete local response to BT on initial examination and/or follow-up
imaging. 1 and 2-year LC rates in patients without prior RT treated with EBRT + BT
were 94.1% and 94.1%, respectively. 1 and 2-year LC rates for those without prior
RT were 88.1% and 76.4%, respectively. 1 and 2-year LC rates for those with prior
RT were 68.6% and 34.3%, respectively. 1 patient had vaginal laceration requiring
surgical repair, and 1 patient developed small bowel obstruction 1 month after BT,
with no additional acute grade 3+ toxicities identified.
Our approach with MCVC plus freehand needles with MRI-based planning was feasible
and safe, with excellent initial local response and low rate of serious toxicities.
Keywords
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Article info
Publication history
Published online: October 17, 2022
Accepted:
September 3,
2022
Received in revised form:
August 26,
2022
Received:
July 26,
2022
Footnotes
✰Disclosures: The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Identification
Copyright
© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
