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Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer
  1. A. Katz1,
  2. E. Njuguna1,
  3. E. Rakowsky1,
  4. A. Sulkes1,
  5. J. Sulkes2 and
  6. E. Fenig1
  1. 1Institute of Oncology and
  2. 2Epidemiology Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  1. Address correspondence and reprint requests to: A. Katz, MD, Institute of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, 49100, Israel. Email: awkatz{at}


Vaginal necrosis can occur following radiation therapy for gynecological malignancies. The distal vaginal mucosa has a poorer radiation tolerance than the mucosa in the upper region. We examined the extent of vaginal shortening in patients treated by intravaginal brachytherapy with or without pelvic irradiation. Maximal extension of the vaginal cylinder above the pubis was measured for each insertion. We found that the difference in mean values between insertions (2.3 vs. 1.7 cm) was highly statistically significant (P < 0.0001). Our study shows that vaginal shortening can occur during the course of intracavity and external irradiation. These alterations in vaginal anatomy can have important consequences on doses received by the distal vaginal mucosa.

  • gynecologic malignancies
  • intracavity brachytherapy
  • vaginal stenosis

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  • Presented in part at the Annual Brachytherapy Meeting GEC-ESTRO, Naples, Italy, 11–13 May 1998