title: A unique approach to high-dose-rate vaginal mold brachytherapy of gynecologic malignancies.
abstract: OBJECTIVE
  Patients with cervical and vaginal cancer sometimes have a less straightforward approach for choice of brachytherapy treatment owing to the tumor's location and clinical presentation. The staff at Royal Brisbane & Women's Hospital in Queensland, Australia, is trying to solve this problem by the use of an old technique in a new approach called vaginal molds. With a patient-specific vaginal mold, the appearance of the applicator and the dose distribution can be customized to provide an optimal treatment for each patient.
  
  
  METHODS
  The technique used at the Royal Brisbane & Women's Hospital uses a flexible two-part putty, moulded to the shape of the vagina, in which standard catheters (flexible implant tubes) are incorporated, in a pattern designed to permit a dose distribution more conformal to the target volume.
  
  
  RESULTS
  The presented technique is efficient and improves the accuracy of a homogeneous target cover and sparing of organs at risk for vaginal mold brachytherapy treatments at our institution.
  
  
  CONCLUSIONS
  This technique offers a customizable option when traditional cylindrical- or dome-type applicators cannot be used, or provide inadequate dose coverage. Molds to match the patient anatomy can be created quickly, while allowing flexibility in positioning of catheters to achieve the desired dose distribution.
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia. Electronic address: sanna.nilsson@health.qld.gov.au.
authors.forename: Sanna
authors.initials: S
authors.lastname: Nilsson
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Zoë
authors.initials: Z
authors.lastname: Moutrie
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Cheuk
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Chan
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Lancaster
authors.affiliation: Radiation Oncology Mater Centre, Brisbane, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Markwell
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Jodi
authors.initials: J
authors.lastname: Dawes
authors.affiliation: Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Phil
authors.initials: P
authors.lastname: Back
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy*; D006801:Humans; D011829:Radiation Dosage; D014621:Vagina
keywords: Applicator; Brachytherapy; Cervical cancer; Fusion; Vaginal cancer; Vaginal mold