Radiation tolerance of the vaginal mucosa

Hintz, Brace L.; Kagan, A. Robert; Chan, Pak Cheung; Gilbert, Harvey A.; Nussbaum, Herman; Rao, Akshay R.; Wollin, Myron

doi:10.1016/0360-3016(79)90525-x

Cited by 9 publications

(13 citation statements)

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“…This sum of physical doses was conducted for a "historical control" and should not be used in practice. 1,2 However, the value is similar to that reported by Au and Grigsby, 1 238 Gy for LDR brachytherapy.…”

Section: Discussionsupporting

confidence: 87%

“…Brachytherapy allows for creating dose escalation which is possible since the tolerance dose of the proximal vagina (vault), uterine-cervix and uterus is high. 1,2 Numerous factors need to be taken into account when planning the treatment, apart from the patient's habitus and tumor configuration. Procedural factors associated with source placement are often important factors affecting outcome.…”

Section: Introductionmentioning

confidence: 99%

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Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Kaidar‐Person

Abdah-Bortnyak

Agarwal

et al. 2014

Reports of Practical Oncology & Radiotherapy

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Kaidar‐Person

Abdah-Bortnyak

Agarwal

et al. 2014

Reports of Practical Oncology & Radiotherapy

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“…VS is a known late effect of radiotherapy for gynecologic malignancies 10–12. Gravity and extension of strictures are different on the basis of the field of radiotherapy and the total dose delivered, being the distal vagina more susceptible to damage, due to a poor blood supply in this area 13. BT has the advantage of affecting a smaller tissue volume than EBRT, thereby restricting the amount of healthy tissue affected and potentially reducing anatomic and functional impairment, but it can still cause VS and necrosis 11, 12.…”

Section: Discussionmentioning

confidence: 99%

Successful topical treatment with mitomycin‐C in a female with post‐brachytherapy vaginal stricture

Betalli

Corti

Minucci

et al. 2008

Pediatric Blood & Cancer

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Vaginal strictures are rare entities in pediatric population, mainly due to congenital genito-urinary tract malformations and sequelae of their surgical treatment, recurrent vaginitis and multisciplinary therapy for malignant tumors. The therapy of choice is not standardized. Conservative treatments are favored and dilators seem to be very effective, but their use in children is difficult due to poor compliance. We report our experience with topical application of mitomycin-C in a female with vaginal stricture secondary to brachytherapy.

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“…This strongly suggests that accurate data regarding complication rates following HDR brachytherapy, like LDR, requires an extended follow‐up period, and preferably, actuarial analysis of complication rates. Hintz et al pointed out that as long as conventional doses (LDR) are kept below 140 Gy for upper vaginal mucosa and 98 Gy for lower vaginal mucosa, ulcerations requiring surgical intervention were not seen (14) .…”

Section: Discussionmentioning

confidence: 99%

High-dose-rate brachytherapy for vaginal cancer: Learning from treatment complications

Tyree

Cárdenes

Randall

et al. 2002

International Journal of Gynecological Cancer

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Historically, early stage vaginal cancer has been treated with low-dose-rate (LDR) brachytherapy with or without external beam radiation therapy (EBRT). Complication rates have been low and treatment efficacious. Although high-dose-rate (HDR) brachytherapy has been used for cervical cancer in many countries for over a decade, only more recently has it been integrated into treatment plans for vaginal cancer. This paper describes three patients treated with HDR brachytherapy who experienced significant late effects. Given the very limited amount of literature regarding the use of HDR brachytherapy in vaginal cancer, this analysis potentially contributes to an understanding of treatment-related risk factors for complications among patients treated with this modality.A focused review of hospital and departmental treatment records was done on three patients treated with HDR brachytherapy. Abstracted information included clinical data, treatment parameters (technique, doses, volume, combinations with other treatments) and outcomes (local control, survival, early and late effects). A review of the available literature was also undertaken. All patients had significant complications. Although statistical correlations between treatment parameters and complications are impossible given the limited number of patients, this descriptive analysis suggests that vaginal length treated with HDR brachytherapy is a risk factor for early and late effects, that the distal vagina has a lower radiation tolerance than the upper vagina with HDR as in LDR, and that combining HDR with LDR as done in our experience carries a high risk of late toxicity. Integration of HDR brachytherapy techniques into treatment plans for early stage vaginal cancers must be done cautiously. The etiology of the significant side effects seen here is likely to be multifactorial. For users of HDR brachytherapy in vaginal cancer, there is a need to further refine and standardize treatment concepts and treatment delivery. Ideally this will be based on continued careful observation and reporting of both favorable and unfavorable outcomes and experiences.

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Radiation tolerance of the vaginal mucosa

Cited by 9 publications

References 0 publications

Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Successful topical treatment with mitomycin‐C in a female with post‐brachytherapy vaginal stricture

High-dose-rate brachytherapy for vaginal cancer: Learning from treatment complications

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