title: American Brachytherapy Society consensus guidelines for interstitial brachytherapy for vaginal cancer.
abstract: OBJECTIVE
  To present recommendations for the use of interstitial brachytherapy in patients with vaginal cancer or recurrent endometrial cancer in the vagina.
  
  
  METHODS
  A panel of members of the American Brachytherapy Society reviewed the literature, supplemented that with their clinical experience, and formulated recommendations for interstitial brachytherapy for primary or recurrent cancers in the vagina.
  
  
  RESULTS
  Patients with bulky disease (approximately >0.5cm thick) should be considered for treatment with interstitial brachytherapy. The American Brachytherapy Society reports specific recommendations for techniques, target volume definition, and dose-fractionation schemes. Three-dimensional treatment planning is recommended with CT scan and/or MRI. The treatment plan should be optimized to conform to the clinical target volume and should reduce the dose to critical organs, including the rectum, bladder, urethra, and sigmoid colon. Suggested doses in combination with external beam radiation therapy and summated equivalent doses in 2Gy fractions are tabulated.
  
  
  CONCLUSIONS
  Recommendations are made for interstitial brachytherapy for vaginal cancer and recurrent disease in the vagina. Practitioners and cooperative groups are encouraged to use these recommendations to formulate treatment and dose-reporting policies. Such a process will result in meaningful outcome comparisons, promote technical advances, and lead to appropriate utilization of these techniques.
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA. beriwals@upmc.edu
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Demanes
authors.forename: Beth
authors.initials: B
authors.lastname: Erickson
authors.forename: Ellen
authors.initials: E
authors.lastname: Jones
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: De Los Santos
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cormack
authors.forename: Catheryn
authors.initials: C
authors.lastname: Yashar
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Rownd
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000592:standards*; D005260:Female; D006801:Humans; D011182:Postoperative Care / Q000592:standards; D018714:Radiotherapy, Adjuvant / Q000295:instrumentation* / Q000592:standards*; D014481:United States; D014625:Vaginal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*