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With vaginal cuff brachytherapy, do you treat to active or treatment length?

When you prescribe your dose at 0.5 cm depth of the vagina? For instance, if you measure a vaginal length to be 8 cm, would you prescribe to treat 4 cm active length or 4 cm treatment length? Or you would do something differently? There seems to be a variability in clinical practice in regards to the prescription length. If local control is equivalent between two different approaches (active vs treatment length), why not use a definition with a shorter prescription length which may potentially yield better toxicity outcomes?
2 Answers
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

There is no consensus what length to treat. The data for 2 to 5 cm appears to have similar outcomes. We treat 3 cm length so we have 7 dwell positions but as the rectovaginal septum thins out in the mid and lower vagina, the depth of prescription of 5 mm is usually in upper 2 cm or so only. Beyond t...

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

Usually not with patient who needs brachy alone. If patient needs EBRT, then in these patients, I treat entire length with EBRT.

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