In a patient with previous cervix cancer treated with surgery and adjuvant EBRT who presents with recurrent HGSIL, status post vaginectomy, would you consider brachytherapy?
This is a patient in her 70s who previously received 5040 cGy adjuvant EBRT alone to the pelvis.
Answer from: Radiation Oncologist at Community Practice
I would consider advanced imaging such as MRI with vaginal gel to rule out the presence of a supravaginal lesion. Otherwise, I would not treat following excision of the HSIL lesion, even if margins were positive for dysplasia. HPV testing can be done to risk stratify. However, excision/ablation is t...
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