Development of an indigenous low-cost multichannel cylinder applicator for vaginal tumors

The purpose of this study was to report our experience regarding the development of a low-cost multichannel vaginal cylinder applicator for superficial and recurrent vaginal tumors.

The applicator mold was created by applying heated wax sheets in layers around a plastic tube. Interstitial stainless-steel needles were placed at equal distance around the mold surface to create multiple channels for treatment. Two plans were created using CT images for a patient with a recurrent tumor over the posterior vaginal wall for comparing single-channel and multichannel cylinder dosimetry. The doses received by the target (high risk clinical target volume) and organs at risk (OARs) were computed using dose-volume histograms.

There was no significant difference in terms of the prescribed dose delivered to high risk clinical target volume between the two plans. The volume of the target receiving 150 and 200 percent (V₁₅₀ and V₂₀₀) dose was higher in the multichannel cylinder plan than the single-channel cylinder plan. In terms of doses to the OARs, there was no significant difference between the rectum doses (D2cc rectum). There was a significant reduction in the dose to the bladder (D2cc bladder), urethra (D0.1cc urethra), and uninvolved vagina (D2cc uninvolved vagina).

Multichannel vaginal cylinders reduce doses to the OARs as compared with the single-channel vaginal cylinder in superficial vaginal lesions limited to the wall of the vagina. Their use is limited by the cost of the applicator. Our low-cost multichannel vaginal cylinder can be used as a reliable alternative in such situations.