Would you offer re-irradiation for recurrent vaginal bleeding?

The patient has stage IV cervix cancer and was previously treated to 30 Gy in 10 fractions one year ago. Embolization for hemostasis was not successful.

If you would re-treat, what dose fractionation scheme would you choose and why?

Answer from: Radiation Oncologist at Community Practice

Based on the previous dose, there is an opportunity for more doses for palliation. Dose and fractionation would be driven by KPS and expected survival. I have done quad shot, 30 in 12 to brachy in these situations based on the above.

Comments

Radiation Oncologist at Fox Chase Cancer Center
Can you talk more about brachy for palliation? Thi...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
Sometimes I have used for patients with better per...

Answer from: Radiation Oncologist at Academic Institution

Short answer, yes, OK to re-RT at 1 year post palliation for palliative intent. Depends on the severity of bleeding to start - requiring hospitalization, packing, and/or transfusions? Likely needs it more significantly. Dosing, for me, depends on the overall clinical picture. If diffusely metastat...

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