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If an anatomical defect forms due to rapid disease response from pelvic radiation for large gynecological tumors, is it safe to proceed with a further radiotherapy boost
For instance, a fistula is formed in the vagina either with respect to bladder/rectum, while treating the cervix, and there is no gross residual disease appreciated would you proceed with a boost (brachytherapy, SBRT or VMAT boost)?
Answer from: Radiation Oncologist at Community Practice
I would proceed with brachytherapy as planned. For a fistula, if symptomatic, would consider diversion - bilateral nephrostomy or diversion colostomy as needed. Brachytherapy would treat the involved bladder or rectal wall to a therapeutic dose without any needles in the tissue, thereby avoiding any...
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