What is the role of parametrial and pelvic side wall boosts in the setting of volumetric brachytherapy for locally advanced cervical cancer treated with either 3DCRT or IMRT?
Does using something like a vienna applicator allow you to avoid dose escalation with more external beam? How do you recommend doing a classic parametrial boost? Should this be volume based or based on bony landmarks?
Answer from: Radiation Oncologist at Community Practice
The rationale behind the parametrial/side wall boost could be one or both of below
1. Treating the parametrium
2. Boosting involved pelvic nodes
If it's done for an additional boost dose to the involved nodes, then the nodes should be contoured and dosimetry should be done to ensure cov...
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Answer from: Radiation Oncologist at Community Practice
When treating patients with gross nodal disease, I have been avoiding using the sequential parametrial boost technique by using IMRT dose painting over the gross nodes. This technique must be done very carefully. The cervix GTV target volume is mobile while the nodal targets ar...