If an anatomical defect forms due to rapid disease response from pelvic radiation for large gynecological tumors, is it safe to proceed with the generally required further radiotherapy boost (brachytherapy, SBRT or VMAT 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.

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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If an anatomical defect forms due to rapid disease response from pelvic radiation for large gynecological tumors, is it safe to proceed with the generally required further radiotherapy boost (brachytherapy, SBRT or VMAT boost)?

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