The use of fluoroscopy to guide needle placement in interstitial gynecological brachytherapy.

Purpose: Interstitial brachytherapy is generally performed for gynecological malignancies with extensive parametrial involvement, by inserting the needles through a transperineal template. Often, the implanted needles are not parallel, and the multiple sources can be difficult to identify on localization radiographs, especially if obtained with a portable X-ray unit. We have used fluoroscopy to guide the needles for interstitial brachytherapy to treat various gynecological malignancies.

Perineal template interstitial brachytherapy salvage for recurrent endometrial adenocarcinoma metastatic to the vagina.

Purpose: To evaluate the use of interstitial brachytherapy salvage of recurrent endometrial adenocarcinoma metastatic to the vagina.

Methods: From September 1989 to February 1995, 15 patients with locally recurrent endometrial adenocarcinoma were treated with perineal template interstitial irradiation with low-dose-rate brachytherapy 192Ir/137Cs. Five of the 7 previously unirradiated patients received pelvic external beam radiation therapy (EBRT) of 45-50 Gy, with standard fractionation followed by an interstitial brachytherapy boost dose of 30 Gy (range 25 to 35 Gy).