Vaginal Dose, Toxicity and Sexual Outcomes in Patients of Cervical Cancer Undergoing Image Based Brachytherapy

Background: The aim of the study was to evaluate the vaginal dose and toxicity in patients of cervical cancertreated with image guided brachytherapy at our institute. Materials and
Methods: Thirty-five patients treatedwith image based brachytherapy for cervical cancer were included. Vaginal contouring was done on MRI atbrachytherapy and with CT scans of subsequent brachytherapy fractions. Dose volume parameters (DVH) werereported in accordance with the GEC-ESTRO guidelines. These were correlated with vaginal toxicity (assessedby CTCAE version 3) and quality of sexual life assessed at one year of completion of treatment.
Results: Vaginalshortness 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 parametersand vaginal toxicity in the present study.
Conclusions: The lack of association between dose volume parametersof vagina with vaginal morbidity may be due to uncertainties involved in the delineation of vaginal wall anddosimetry. Future research is required to accurately define vaginal dose distribution to study its correlation withvaginal morbidity. Vaginal morbidity needs to be documented in order to improve the sexual outcome in thesepatients.