title: Vaginal dose, toxicity and sexual outcomes in patients of cervical cancer undergoing image based brachytherapy.
abstract: BACKGROUND
  The aim of the study was to evaluate the vaginal dose and toxicity in patients of cervical cancer treated with image guided brachytherapy at our institute.
  
  
  METHODS
  Thirty-five patients treated with image based brachytherapy for cervical cancer were included. Vaginal contouring was done on MRI at brachytherapy and with CT scans of subsequent brachytherapy fractions. Dose volume parameters (DVH) were reported in accordance with the GEC-ESTRO guidelines. These were correlated with vaginal toxicity (assessed by CTCAE version 3) and quality of sexual life assessed at one year of completion of treatment.
  
  
  RESULTS
  Vaginal shortness was observed in 22 out of 30 (62.8%) patients, Nine (25.7%) had vaginal dryness and in 10 (28.5%) patients, there was contact bleeding. No association could be demonstrated between the dose volume parameters and vaginal toxicity in the present study.
  
  
  CONCLUSIONS
  The lack of association between dose volume parameters of vagina with vaginal morbidity may be due to uncertainties involved in the delineation of vaginal wall and dosimetry. Future research is required to accurately define vaginal dose distribution to study its correlation with vaginal morbidity. Vaginal morbidity needs to be documented in order to improve the sexual outcome in these patients.
authors.affiliation: Department of Radiotherapy and Oncology and Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India E-mail : bhavana1035@gmail.com.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Rai
authors.forename: Bhaswanth
authors.initials: B
authors.lastname: Dhanireddy
authors.forename: Firuza Darius
authors.initials: FD
authors.lastname: Patel
authors.forename: Reena
authors.initials: R
authors.lastname: Kumari
authors.forename: Arun Singh
authors.initials: AS
authors.lastname: Oinam
authors.forename: Vijai
authors.initials: V
authors.lastname: Simha
authors.forename: Suresh
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided; D012725:Sexual Behavior; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*; D014623:Vaginal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*