Emily Flower
Crown Princess Mary Cancer Centre Westmead
Senior Radiation Oncology Medical Physicist

Aim: To review a single institution’s pattern of practice, dosimetry results and clinical outcomes for patients with malignancies of the vagina, vulva or urethra using customised vaginal moulds, with or without interstitial needles.

Methods: 18 patients consecutively treated patients were reviewed. Patients were treated using customised vaginal moulds, with or without interstitial needles implanted with a free-hand technique. Technical implementation such as whether or not interstitial needles were added, the type of implant and the imaging used were recorded. D90 and D98 of the CTV, D0.1cc of the urethra and D2cc and D0.1cc of the bladder and rectum were analysed. Any adverse clinical outcomes are reported.

Results: The median D90 and D98 of the CTV was 73.6Gy and 78Gy respectively. The median D2cc and D0.1cc of the bladder was 79.3Gy and 67.5Gy respectively. The median D2cc and D0.1cc of the rectum was 63.5Gy and 66.5Gy respectively. The median D0.1cc of the urethra was 86.2Gy. Two patients developed vaginal ulcers that both resolved. One patient has developed out of field metastatic disease.

Conclusion: A review of patients treated with a customised vaginal mould and interstitial needles showed that the technique allows for acceptable doses to the CTV and organs and risk and acceptable toxicity.


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