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1 results

  • Novel use of a vaginal cylinder purposed dually as obturator and localiser for stereotactic ablative radiotherapy delivery

  • J. Spencer Thompson, Yong Chen, Imad Ali, Christina Henson, Julie Arntzen, Laura Holman, J. Nathan Cantrell, Salahuddin Ahmad
  • Journal:
    Journal of Radiotherapy in Practice / Volume 21 / Issue 4 / December 2022
    Published online by Cambridge University Press:
    09 March 2021, pp. 559-562
    • Article
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  • Background:

    Vaginal cancer is a rare malignancy that poses a challenge to treat and cure, as surgical excision requires life-changing procedures because of the proximity and involvement of rectum, bladder and anus. We report in this case study the successful delivery of stereotactic ablative radiotherapy (SABR) for a patient with vaginal cancer after previous radiotherapy.

    Methods:

    A 71-year-old white female who presented with dyspareunia and irritative urinary symptoms proven by biopsy was our candidate patient. Subsequent PET/CT revealed a hypermetabolic 3 cm lesion at the 12–1 o’clock position in the distal vagina involving the clitoris. The patient was initially treated with volumetric-modulated arc therapy (VMAT) with simultaneous integrated boost technique to the involved nodes, and later upon recurrence treated with SABR using 30 Gy in six fractions.

    Findings:

    To our knowledge, this is the first report of a vaginal cylinder used to physically distance organs at risk from the treatment target and also as a localising device with image guidance for the delivery of SABR using an external beam.