Comparative Dosimetric Study using Various Applicators for Vaginal Cuff Brachytherapy; Three Ovoid Technique Proposal

Purpose: Vaginal-cuff brachytherapy is the adjuvant treatment in women with intermediate-high risk of endometrial or uterine cervical cancers. The most common applicators are single-channel vaginal cylinders and two-symmetric ovoid applicators according to the shape of the stump. For two-ovoid applicators, the distance between them depends on the therapist and vaginal size. A greater distance means a lower dose in the vaginal apex point. To overcome this problem, this study proposes brachytherapy plans using three-ovoid applicators to improve insufficient dose distribution.