A SIMPLE, INEXPENSIVE APPLICATOR FOR IRRADIATION OF LOCALIZED AREAS OF THE VAGINA WITH INTRACAVITARY BRACHYTHERAPY

Purpose: To describe the construction of a simple, inexpensive applica tor for irradiation of localized areas of the vagina with intracavitar y brachytherapy Methods and Materials: It was desirable to avoid an in terstitial implant in an elderly patient with a stage T2 vaginal cance r, The final phase of radiation therapy was delivered with a custom ma de intracavitary cylinder that allowed the high-dose area to be limite d to the portion of the vagina at high risk for residual disease, The applicator was fabricated from a clear cast acrylic (Lucite) rod with dimensions 3.5 cm diameter x 5.0 cm long, The applicator contained 11 parallel grooves, each 1.8 mm deep x 2.2 mm wide, machined along the s urface of the cylinder parallel its long axis at 1.0 cm increments, Pl astic needles (15 gauge) were inserted into the grooves along the surf ace of the acrylic cylinder and held in place with heat shrink tubing, The applicator was easily inserted and positioned without anesthesia, Standard low dose rate Ir-192 ribbons were inserted into the plastic needles after positioning the applicator in the vagina, Results: Const ruction of this applicator system requires a few weeks notice and appr oximately $150. Fabrication of the grooved cylinder is a routine task for a workshop with a milling machine, A step-by-step description of h ow to construct and use the applicator is provided along with the tele phone numbers of commercial vendors to call to order all necessary mat erials. Conclusion: This article describes a simple, inexpensive metho d for constructing a customized vaginal applicator that can be used to treat a limited area of the vagina with intracavitary brachytherapy. (C) 1997 Elsevier Science Inc.