PO09

Abstract

According to our experience, intracavitary brachytherapy of metastasis into vagina is not effective, especially in the case of volumetric tumor. As a rule we use intratissue brachytherapy with an intracavitary applicator of maximal diameter. Patient and Methods In 2020 Ca of transverse colon was diagnosed in a patient 58 years old, female. Ultrasonography, CT, MRI investigations and biopsy confirmed mts in both ovarian, pathological retroperitoneal, mesenteric and intracranial lymph nodes, left lobe of liver. First line of treatment included surgery, chemotherapy and hormone therapy. Operations: median laparotomy, right-sided hemicolectomy, atypical resection of the left lobe of liver. Chemotherapy (14 courses) - 8 courses with oxaliplatin and capecitabine and 6 courses with irinotecan. Mts into vagina were revealed a month after completing the treatment. 39,6 Gy (2.2 Gy*18 fractions) to pelvis with concomitant intracavitary brachytherapy 7Gy*4, total dose 28 Gy with normalization 5 mm from mucosa was delivered. In three months volumetric lesion in vagina right wall was confirmed at CT scans and visually. Intratissue brachytherapy with rigid needles was decided to use. Dose distribution and needle location is shown at the Figure. Needle insertion was done by freehand under anesthesia. Doses amounted to 30 Gy (1 time per week, 10 Gy fraction). Treatment was carried out at Microselectron 30 channels on the base of CT scans. Radiation reactions (burning and profuse discharge) lasted one month approximately. Results In 3 months CT with contrast did not show the presence of pathological foci in the body. And visually vagina had no signs of a tumor. Conclusion It was shown that intratissue brachytherapy is effective in the treatment of tumors affecting vagina. According to our experience, intracavitary brachytherapy of metastasis into vagina is not effective, especially in the case of volumetric tumor. As a rule we use intratissue brachytherapy with an intracavitary applicator of maximal diameter. In 2020 Ca of transverse colon was diagnosed in a patient 58 years old, female. Ultrasonography, CT, MRI investigations and biopsy confirmed mts in both ovarian, pathological retroperitoneal, mesenteric and intracranial lymph nodes, left lobe of liver. First line of treatment included surgery, chemotherapy and hormone therapy. Operations: median laparotomy, right-sided hemicolectomy, atypical resection of the left lobe of liver. Chemotherapy (14 courses) - 8 courses with oxaliplatin and capecitabine and 6 courses with irinotecan. Mts into vagina were revealed a month after completing the treatment. 39,6 Gy (2.2 Gy*18 fractions) to pelvis with concomitant intracavitary brachytherapy 7Gy*4, total dose 28 Gy with normalization 5 mm from mucosa was delivered. In three months volumetric lesion in vagina right wall was confirmed at CT scans and visually. Intratissue brachytherapy with rigid needles was decided to use. Dose distribution and needle location is shown at the Figure. Needle insertion was done by freehand under anesthesia. Doses amounted to 30 Gy (1 time per week, 10 Gy fraction). Treatment was carried out at Microselectron 30 channels on the base of CT scans. Radiation reactions (burning and profuse discharge) lasted one month approximately. In 3 months CT with contrast did not show the presence of pathological foci in the body. And visually vagina had no signs of a tumor. It was shown that intratissue brachytherapy is effective in the treatment of tumors affecting vagina.