Tandem and Ring brachytherapy for Cervical Cancer

[radonc22]

Do you guys/gals use packing (to push the rectum posteriorly) when using a Tandem and Ring for cervical cancer brachytherapy? I know that you do for Tandem and Ovoid but my question is for Tandem and Ring.

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[Palex80]

Yes, we do. In my opinion it helps.

 

[thesauce]

Do you guys/gals use packing (to push the rectum posteriorly) when using a Tandem and Ring for cervical cancer brachytherapy? I know that you do for Tandem and Ovoid but my question is for Tandem and Ring.

Yep, unless there's vaginal disease

 

[seper]

Do you guys/gals use packing (to push the rectum posteriorly) when using a Tandem and Ring for cervical cancer brachytherapy? I know that you do for Tandem and Ovoid but my question is for Tandem and Ring.

Usually, I don't. I use posterior vaginal paddle that comes with the Nucletron T&R set.

 

[radonc22]

Usually, I don't. I use posterior vaginal paddle that comes with the Nucletron T&R set.

That's what I've seen too. What about anterior packing for the bladder? With tandem and ovoids we would pack anteriorly to the ovoids to move the bladder more anteriorly but I don't believe there's an anterior paddle with the Tandem and Ring.

 

[seper]

I don't put anything anteriorly. I guess you can try packing if not satisfied with placement.

 

[thesauce]

We pack both sides

 

[Gfunk6]

We pack both sides

I think this is a borderline violation of SDNs posting guidelines

 

[thesauce]

I think this is a borderline violation of SDNs posting guidelines

Wouldn't be the first time

 

[Palex80]

Usually, I don't. I use posterior vaginal paddle that comes with the Nucletron T&R set.

We also use the Vienna Ring set from Nucletron. The "rectal retractor" is really useful in my opinion too and diminishes the need for packing posteriorly, however we still pack sideways and anteriorly. This is to limit the dose to vaginal wall which otherwise would come in direct contact with the applicators. You do want to treat (at least) the upper third of the vagina in most cases and below the ring you usually get extremely high mucosal doses if you don't pack (in my opinion).