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P184 Adaptive intestitial brachytherapy of recurrence vulvar cancer based on MR
  1. R Kwiatkowski,
  2. M Brąclik and
  3. D Nenko
  1. Radiation Oncology, Oncology Centre Katowice, Katowice, Poland


Introduction/Background Radiotherapy is mainly adjuvant treatment in patients with vulvar cancer after surgery and risk factors of recurrence. Due to high toxicity of adjuvant radiotherapy and risk of developing severe injuries of vulvar and groin skin, brachytherapy as a local treatment of the highest risk area, seems a good option. In asessment of gynaecological cancer MR is recommended.

Methodology In Radiotherapy Department of KCO in 2017–2019 were admitted 63 patients with vulvar cancer after surgery. 24 patients were recognized recurrence tumour in surgical scars. MR was performed in all of those. 30 patients were treated by interstitial brachytherapy. In patients with tumour after insertion of needles MR and CT were performed. Image fusion was done. 3D brachytherapy treatment plan was prepared using Oncentra Brachy TPS. Parameters V100 and V150 were controlled. Dose range was 18-24Gy/6-8fr delivered twice a day.

Results All patients after brachytherapy treatment were controlled in our Department. In our observation we performed physical examination and MR or CT in every 3 months. In all patients we observed complete regression of recurrent tumour, but in the bed of tumour radiation necrosis was developed. 4 patients were severe injuries of vulvar tissues due to radiation necrosis and required intensive care, included narcotic drugs. 3 patients were developed another recurrent.

Conclusion MR based interstitial brachytherapy allow reduced margins of volume of high dose in recurrence tumour of vulva. in the same, it allow reduced volume of tissue necrosis and improve treatment results.

Disclosure Nothing to disclose.

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