What is the optimal adjuvant vaginal brachytherapy schedule when a patient is getting concurrent chemotherapy?

I treat in the two weeks between cycles once adequately healed from surgery. Often this is between cycles 1-2 but occasionally between 2-3. I don’t modify my prescription.

I offer 7 Gy x 3 weekly, but prefer 6 Gy x 5 to surface regardless of when chemotherapy is given.

We have some currently unpublished, but upcoming institutional research submitted to ABS 2025 that showed increased risks of vaginal stenosis with 21 Gy in 3 fx to depth compared to a more gentle fracti...

We use the same 7 Gy x 3 prescribed at 5 mm.

Kiess et al., PMID 22850412