How do you plan urgent radiation therapy for vaginal bleeding caused by locally advanced cervical cancer?

Agree with @Dr. First Last, we do the same and start at 1.8. Vaginal packing (you can treat with the packing in), transfuse if needed given bleeding. 4-field to start and can turn around a box within a couple hours, and then switch to IMRT as soon as approved. We also try to start the chemo quickly....

Generally, my approach has been vaginal packing, support and start chemo plus pelvic RT with 1.8 Gy per fraction as an in-patient to expedite treatment if based on imaging that the patient has non metastatic disease. This approach does help most of the time in slowing down bleeding. Sometimes if it ...