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

Abstract 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 ablativ...

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Bibliographic Details
Published inJournal of radiotherapy in practice Vol. 21; no. 4; pp. 559 - 562
Main Authors Thompson, J. Spencer, Chen, Yong, Ali, Imad, Henson, Christina, Arntzen, Julie, Holman, Laura, Cantrell, J. Nathan, Ahmad, Salahuddin
Format Journal Article
LanguageEnglish
Published Cambridge, UK Cambridge University Press 01.12.2022
Subjects
Ablation
Anus
Biopsy
Cancer
Cancer therapies
Case Study
Clitoris
Cylinders
General anesthesia
Genital cancers
Lasers
Malignancy
Patients
Pelvis
Planning
Radiation therapy
Rectum
Remission (Medicine)
Vagina
Palo Alto California
United States > US
vaginal cancer
radiotherapy
vaginal cylinder
image guidance
stereotactic ablative
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Summary:Abstract 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.
ISSN:1460-3969
1467-1131
DOI:10.1017/S1460396921000169