Vaginal Sparing Radiotherapy Using IMPT and Daily Dilator Placement for Women with Anal Cancer.

IF 2.1 Q3 ONCOLOGY International Journal of Particle Therapy Pub Date : 2022-04-26 eCollection Date: 2022-01-01 DOI:10.14338/IJPT-21-00025
Scott C Lester, Laura A McGrath, Rachael M Guenzel, Jenae C Quinn, Carolyn J Schultz, T Baron Bradley, Bret D Kazemba, Shima Ito, Christopher L Hallemeier
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Abstract

Sexual dysfunction is a common toxicity and detrimental for the quality of life of women treated with chemoradiotherapy for anal cancer. Sexual dysfunction occurs because the vagina is closely approximated to the anal canal and typically receives substantial doses of radiation. Strategies for mitigation have largely been focused on posttreatment therapy and symptom management. The use of daily vaginal dilator placement during radiotherapy to mitigate dose to the vagina has been previously explored with modest gains, while proton therapy is under active investigation for the treatment of anal cancer. Use of proton therapy for anal cancer reduces dose to some organs at risk but may inadvertently increase vaginal toxicity if the proton beam terminates in the vaginal tissue. Herein, we present the case histories of 2 women treated for squamous cell carcinoma of the anal canal with the novel combination of intensity-modulated proton therapy and daily vaginal dilator placement to maximally reduce dose to the vagina and protect it from areas of increased energy deposition at the end of the proton range.

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阴道保留放疗使用IMPT和每日扩张器放置肛门癌妇女。
性功能障碍是肛门癌患者接受放化疗后常见的毒性,对患者的生活质量不利。性功能障碍的发生是因为阴道与肛管非常接近,通常会受到大剂量的辐射。缓解策略主要侧重于治疗后治疗和症状管理。在放疗期间每日放置阴道扩张器以减轻对阴道的剂量,先前已进行了探索,并取得了一定的进展,而质子治疗正在积极研究中,用于治疗肛门癌。使用质子治疗肛门癌可以减少对某些危险器官的剂量,但如果质子束终止于阴道组织,则可能无意中增加阴道毒性。在此,我们报告了2名女性肛管鳞状细胞癌患者的病例史,她们采用了强度调节质子治疗和每日阴道扩张器放置的新组合,以最大限度地减少阴道剂量,并保护阴道免受质子范围结束时能量沉积增加的区域的影响。
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来源期刊
International Journal of Particle Therapy
International Journal of Particle Therapy Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.70
自引率
5.90%
发文量
23
审稿时长
20 weeks
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