Intracavitary Thermoradiotherapy for Vaginal Carcinoma

Abstract

Cancer of the vagina has a poor prognosis with regard to both local tumor control and patient survival, the 5-year survival being approximately 38% (Pettersson 1985). Probably due to the large proportion of hypoxic cells in these tumors, reduced radiosensitivity is often observed (Fletcher and Shukovsky 1975). The standard radiotherapy is usually similar to that for cervical carcinoma, with external beam therapy and intracavitary irradiation. Since hyperthermia is known to reduce the survival of hypoxic cells in particular, the local tumor control rate might be expected to increase when hyperthermia is added to radiotherapy. Technical improvements, for example the possibility of using intracavitary microwave antennas (Roos et al. 1989), have opened up new possibilites of combined intracavitary irradiation and hyperthermia in the treatment of cervical (Hao et al. 1984) and vaginal carcinoma. Thermoradiotherapy was tried by Valdagni et al. (1988) in the treatment of cervical cancer recurrences in the vaginal apex using an individualized microwave applicator.