Afterloading high dose rate intracavitary vaginal cylinder.

Abstract

To design an afterloading vaginal cylinder application appropriate to treat the vault with high dose rate (HDR) brachytherapy after prior total abdominal hysterectomy. A vaginal cylinder was designed and built using nylon and source loading channels positioned for source movement for HDR vault and vaginal brachytherapy. The channels are positioned to treat a broader isodose surface and to avoid the "end" effects of linear source brachytherapy. The central channel allows an applicator tube to be advanced beyond the end of the cylinder to treat a "tented" vault or a cervical stump (or uterus). Additional peripheral sources can be added to allow vaginal wall plaque therapy. The application allows vault, vault plus proximal vagina, or vault plus entire vagina therapy using HDR. The isodose surface treated is controlled by source positioning and dwell times. The HDR cylinder has wide potential usability for uterus or cervix therapy as both low stage and operable endometrial carcinomas are now usually treated by surgery.