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Hello everyone, a case for opinions:
66 y.o. healthy woman, dx ovarian CA 2 years ago --> sx --> chemo (had a hard time with chemo)
Since then has had waxing and waning PET pos LN in PAN, abdomen, inguinal, etc. Not huge amount of dz
Has bx + recurrent dz in the mid vaginal area, anterior wall. 3 small areas, not much depth to them (not detected on MRI) Discussed with med onc/gyn onc who only want vaginal areas treated (works for me because the patient is terrified of any possible side effects).
How would you treat? Recurrent radiation naive endometrial is recommended whole pelvis 45 Gy then brachy boost. Im leaning 40 Gy/20 fx then 6 Gy x3 HDR to the surface. Its a lot of tx for a palliative case, but progressive dz there could be a mess, esp when systemic burden is low. I think the local control it affords would be worth it........anyone?
66 y.o. healthy woman, dx ovarian CA 2 years ago --> sx --> chemo (had a hard time with chemo)
Since then has had waxing and waning PET pos LN in PAN, abdomen, inguinal, etc. Not huge amount of dz
Has bx + recurrent dz in the mid vaginal area, anterior wall. 3 small areas, not much depth to them (not detected on MRI) Discussed with med onc/gyn onc who only want vaginal areas treated (works for me because the patient is terrified of any possible side effects).
How would you treat? Recurrent radiation naive endometrial is recommended whole pelvis 45 Gy then brachy boost. Im leaning 40 Gy/20 fx then 6 Gy x3 HDR to the surface. Its a lot of tx for a palliative case, but progressive dz there could be a mess, esp when systemic burden is low. I think the local control it affords would be worth it........anyone?