Comparison of dose delivered to vagina using two different intracavitary brachytherapy applicators for carcinoma cervix.

The aim of the study was to compare the dose to vaginal points between two intracavitary applicators used for HDR brachytherapy in Carcinoma Cervix Patients reporting to our center for Carcinoma cervix intracavitary brachytherapy were randomly allocated to treatment with either Manchester or Fletcher Suit Delclos (FSD) applicator. All patients received an EBRT dose of 50 Gy in 25 fractions along with weekly Cisplatin (40 mg/m2). Brachytherapy was administered using CT based planning. All patients received a dose of 7 Gy to Point A one week apart for a total of three fractions. For vaginal dose reporting, the PIBS points (PIBS, PIBS+1, PIBS+2, PIBS-1, PIBS-2) and dose to vagina at the level of ovoids was compared between the two applicators A total of 30 Carcinoma cervix patients were randomly allocated to receive intracavitary brachytherapy with either Manchester or FSD applicator. The mean vaginal reference length for patients treated with Manchester applicator was 4.3 and for patients treated with FSD applicator was 4.4. On analyzing dose to different vaginal points, patients treated with Manchester applicator received significantly higher mean and median doses to all PIBS points (except PIBS-2 cm) as compared to FSD applicator. On analyzing dose to the upper vagina at the level of the ovoids, the Manchester applicator delivered higher antero-posterior doses as compared to FSD applicator. Manchester applicator gives higher dose to the vagina as compared to FSD applicator for intracavitary brachytherapy in Carcinoma Cervix. The choice of using a particular applicator depends on the residual disease at the time of brachytherapy and patient anatomy [ABSTRACT FROM AUTHOR]