Choice of afterloading endocurietherapy techniques for vaginal carcinoma

Vaginal cancer is highly curable in all stages by combining the proper interstitial or intracavitary endocurietherapy (ECT) techniques and external beam radiation therapy (EXRT). Each case must be individualized following careful evaluation of stage and local extent of disease. We describe three afterloading ECT techniques used for treatment of various presentations of vaginal cancer: 1) 137cesium vaginal obturator used for superficial lesions; 2) afterloading 192iridium tube and button technique used for localized lesions of the lower one-third of the vagina which do not involve more than one-half of the circumference; and 3) afterloading transperineal interstitial 192iridium template technique used for thick invasive lesions of the upper two-thirds of the vagina. Our technique for EXRT is also described.