Image-based multichannel vaginal cylinder brachytherapy for XXXX .

@entity5 @entity1 @entity137 @entity1168
PURPOSE: To investigate the clinical feasibility and treatment outcomes of image-based @entity1168 ( @entity1168 ) brachytherapy using an intracavitary multichannel vaginal cylinder for the definitive treatment of @entity5 . METHODS AND MATERIALS: A total of 41 @entity1 with @entity5 (24% primary vaginal and 76% recurrence from other gynecologic primaries) treated with definitive radiotherapy    chemotherapy including image-based @entity1168 brachytherapy with a multichannel vaginal cylinder were included in the study. Image-based brachytherapy was completed using either CT- (41%) or MR-based planning (59%) with each fraction. The high-risk clinical target volume was defined based on the pre- and postexternal beam radiotherapy gross @entity5 volume. Doses were converted to equivalent dose of 2Gy per fraction. Endpoints examined were dose-volume parameters and early clinical outcomes. RESULTS: The median high-risk clinical target volume was 24.2cc (interquartile range [IQR], 12.6), with a median dose to 90% (D90) of 77.1Gy (IQR, 3.4). The median dose to 2cc (D2 cc) for the bladder, rectum, and sigmoid were 59.4Gy (IQR, 5.6), 58.2Gy (IQR, 4.1), and 52.3Gy (IQR, 5.5), respectively. After a median followup of 16 months (range, 3-35), complete clinical response was documented in 98% of the @entity1 . The 2-year local, regional, and distant control; and disease-free and overall survival were 93%, 100%, 81%, 78%, and 88%, respectively. The 2-year actuarial rate of late Grade 3 or higher @entity137 was 4% overall with 0%, 0%, 0%, and 4% for vaginal, bladder, urethral, and gastrointestinal, respectively. CONCLUSIONS: Image-based @entity1168 brachytherapy using an intracavitary multichannel cylinder seems feasible in @entity5 treatment. The described clinical implementation shows promising early clinical outcomes with high rates of local control and @entity137 , which should be validated with extended followup.
