Brachytherapy of intraepithelial vaginal cancer (clinical case)

«Radiation and Risk», 2019, vol. 28, No. 4, pp.65-72

DOI: 10.21870/0131-3878-2019-28-4-65-72


Kulieva G.Z. – Researcher. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249035. Tel.: +79533236245; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Sidorin A.V. – Physician
Verbynskaya N.I. – Physician
Rykova E.V. – Physician
Mozerov S.A. – Senior Researcher
Krikunova L.I. – Head of Dep., MD, Prof.

A. Tsyb MRRC, Obninsk.


We present the clinical case of application of high-dose rate 192Ir brachytherapy for intraepithelial vaginal cancer using HDR Gammamed afterloder system. The decision to use HDR brachytherapy for vaginal neoplasia was made by consensus of participants of multidisciplinary meeting following the strong analysis of the history of previous diseases, the presence of human papilloma-virus of high carcinogenic risk, results of current examinations, the patient’s age. The treatment plan was developed using the integral dose-volume histogram in accordance with the recommendations of the European Gynecological GEC-ESTRO Working Group. Treatment planning allowed choosing the most appropriate dose distribution, not exceeding the prescribed dose and the optimal target coverage. Due to dose planning it became possible to develop individually tailored treatment program for each patient and improve patient’s quality of life. Effectiveness of treatment of vaginal cancer depends primarily on the extent of the tumor process.

Key words
vaginal cancer, cervical cancer, radiotherapy, HDR 192Ir brachytherapy, isodose contour, planning, optimization, human papillomavirus, cervical dysplasia, risk organs, contouring.


1. Malignant neoplasms in Russia in 2016 (morbidity and mortality). Eds.: A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow, Р. Hertsen MORI, 2018. 250 p. (In Russian).

2. Siegel R., Ma J., Zou Z., Jemal A. Cancer statistics, 2014. CA Cancer J. Clin., 2014, vol. 64, no. 5, p. 364.

3. Granov A.M., Vinokurov V.L. Luchevaya terapiya v onkoginekologii i onkourologii [Radiation therapy in oncogynecology and oncourology]. St. Petersburg, OOO «Publishing house FOLIANT», 2002. 352 p.

4. Kaprin A.D., Galkin V.N., Ivanov S.A., Solodky V.A., Titova V.A. Brachytherapy in the treatment of vaginal cancer. Biomedical Photonics, 2016, vol. 5, no. 1, pp. 22-26. (In Russian).

5. WHO Classification of Tumors of the Female Reproductive Organs. Vol. 6. WHO Classification of Tumors, 4th edition. Eds.: R.J. Kurman, M.L. Carcangiu, C.S. Harrington, R.H. Young. Geneva, Switzerland, WHO Press, 2014. 307 p.

6. Feng Q., Kiviat N.B. New and surprising insights into pathogenesis of multicentric squamous cancers in the female lower genital tract. J. Nat. Cancer Inst., 2005, vol. 97, no. 24, pp. 1798-1799.

7. Filatova E.I. Primary cancer of the vagina. Diagnostics and treatment tactics. Prakticheskaya onkologiya – Practical Oncology, 2006, vol. 7, no. 4, pp. 228-235. (In Russian).

8. Schockaert S., Poppe W., Arbyn M., Verguts T., Verguts J. Incidence of vaginal intraepithelial neoplasia after hysterectomy for cervical intraepithelial neoplasia: a retrospective study. Am. J. Obstet. Gynecol., 2008, vol. 199, no. 113, pp. 111-115.

9. Gemmel J., Holmes D.M., Duncan I.D. How frequently need vaginal smears be taken after hysterectomy for cervical intraepithelial neoplasia? Br. J. Obstet. Gynaecol., 1990, vol. 97, no. 1, pp. 58-61.

10. Wiener J.J., Sweetnam P.M., Jones J.M. Long term follow-up of women after hysterectomy with a history of preinvasive cancer of the cervix. Br. J. Obstet. Gynaecol., 1992, vol. 99, no. 11, pp. 907-910.

11. Kalogirou D., Antoniou G., Karakitsos P., Botsis D., Papadimitriou A., Giannikos L. Vaginal intraepitheli-al neoplasia in patients treated for carcinoma in situ of the cervix. Eur. J. Gynaecol. Oncol., 1997, vol. 18, no. 3, pp. 188-191.

12. Babarinsa I., Mathew J., Wilson C., Oladipo A. Outcome of vaginal intraepithelial neoplasia following hysterectomy for cervical intraepithelial neoplasia. J. Obstet. Gynaecol., 2006, vol. 26, no 2, pp. 157-158.

13. Turkevich V.G. Luchevoe lechenie pervichnogo i metastaticheskogo raka vlagalishcha [Radiation therapy for primary and metastatic vaginal cancer]. Prakticheskaya onkologiya – Practical Oncology, 2006, vol. 7, no. 4, pp. 236-245.

14. Zolciak-Siwinska A., Gruszczynska E., Jonska-Gmyrek J., Kulik A., Michalski W. Brachytherapy for vag-inal intraepithelial neoplasia. Eur. J. Obstet. Gynecol. Reprod. Biol., 2015, vol. 194, no. 22, pp. 73-77.

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