Radiotherapy

♦ External-beam irradiation followed by intra-cavitary brachy-therapy (ICT)

♦ Sterilizes pre-menopausal patients

♦ ICT gamma sources (137Cs on 192Ir) in uterus/upper vagina (GA) —left for minutes (high dose rate)

♦ ICT—dose to central pelvic structures

—80 Gy to 2 cm lateral and superior to external os —dose to bladder and rectum below 70 Gy

♦ Pelvic radiotherapy for advanced cancer

—5% late morbidity (bowel and urinary tract)

—bleeding

—stricture

—ulceration

—fistula

—vaginal shortening/dryness

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