[High dose rate fractionated interstitial radiotherapy for vulvar cancer using traction technique]

A 73-year-old woman with vulvar cancer T2NO was treated with high dose rate fractionated interstitial radiotherapy after 30 Gy of external radiotherapy. Sufficient space to insert 12 needles was made by pulling the vulva out perpendicular to the perineal skin. Four surgical threads were introduced between the vulva and the underlying pubic bones. A pair of custom-made templates were attached sandwiching the vulva pulled out with the threads. Using traction technique 12 stainless needles were easily inserted and replaced by plastic tubes. Forty Gy/10 fractions/six days was delivered, and the tumor has been controlled clinically and histologically so far.