title: Management of Bartholin's gland carcinoma using high-dose-rate interstitial brachytherapy boost.
abstract: OBJECTIVE
  To describe the patterns of use, clinical outcomes, and dose-volume histogram parameters of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the management of Bartholin's gland cancer.
  
  
  METHODS
  Five patients with Stage II-III Bartholin's gland carcinoma treated with CT-based HDR-ISBT boost were reviewed. Plans were generated using an inverse planning simulated annealing algorithm. Dose-volume histogram parameters were assessed. The total doses of HDR-ISBT and EBRT were converted to total equivalent dose in 2Gy (EQD2).
  
  
  RESULTS
  All 5 patients received HDR-ISBT as a boost (median dose, 30Gy) after EBRT (median dose, 45Gy). Three patients received postoperative irradiation for gross residual tumor or positive surgical margins and 2 patients were treated by primary chemoradiotherapy. The median V100, D90, and D100 for the CTV were 98.3%, 89Gy10, and 64Gy10 (EQD2), respectively. A complete response was observed in all patients. No local recurrence occurred. All patients remain alive and free of disease (median followup, 78 months; range, 8-93). Severe vaginal toxicities were observed, including vaginal necrosis that resolved with hyperbaric oxygen therapy.
  
  
  CONCLUSIONS
  HDR-ISBT boost after EBRT offers excellent long-term local control in patients with Bartholin's gland carcinoma. HDR-ISBT should be considered for positive surgical margins or residual tumor after surgery and for locally advanced malignancies treated by primary chemoradiotherapy.
authors: Département de Radio-oncologie, L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Québec, QC, Canada. Electronic address: isabelle.thibault.5@ulaval.ca.
authors: Isabelle
authors: I
authors: Thibault
authors: Marie-Claude
authors: MC
authors: Lavallée
authors: Sylviane
authors: S
authors: Aubin
authors: Suneil
authors: S
authors: Jain
authors: Nathalie
authors: N
authors: Laflamme
authors: Éric
authors: É
authors: Vigneault
mesh_terms: D001472:Bartholin's Glands / Q000473:pathology / Q000528:radiation effects*; D001918:Brachytherapy / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011882:Radiotherapy, High-Energy / Q000379:methods*; D014846:Vulvar Neoplasms / Q000473:pathology / Q000532:radiotherapy*
keywords: Bartholin’s gland carcinoma; High-dose rate; IPSA; Interstitial brachytherapy