Journal of Contemporary Brachytherapy
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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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Original paper

Comparative dosimetric study of single- vs. multi-channel cylindrical applicators in vaginal brachytherapy: Implications for organs at risk and vaginal surface doses

Sule Parlar
1, 2
,
Dilek Nurlu
2
,
Rusen Cosar
2
,
Yildiray Ozguven
1, 2

  1. Radiotherapy Program, Vocational School of Health, Trakya University, Edirne, Türkiye
  2. Department of Radiation Oncology, Trakya University Hospital, Edirne, Türkiye
J Contemp Brachytherapy 2026
Online publish date: 2026/04/20
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3. Harkenrider MM, Block AM, Alektiar KM et al. American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review. Brachytherapy 2017; 16: 95-108.
4. Harkenrider MM, Abu-Rustum N, Albuquerque K et al. Radiation therapy for endometrial cancer: an American Society for Radiation Oncology clinical practice guideline. Pract Radiat Oncol 2023; 13: 41-65.
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10. Kim H, Rajagopalan MS, Houser C et al. Dosimetric comparison of multichannel with one single-channel vaginal cylinder for vaginal cancer treatments with high-dose-rate brachytherapy. Brachytherapy 2014; 13: 263-267.
11. Demanes DJ, Rege S, Rodriquez RR et al. The use and advantages of a multichannel vaginal cylinder in high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys 1999; 44: 211-219.
12. Biltekin F, Akyol H, Gultekin M et al. Intensity-modulated vaginal brachytherapy applicator and single-and multi-channel applicators in vaginal cuff brachytherapy. J Contemp Brachytherapy 2024; 16: 132-138.
13. Bahadur YA, Constantinescu C, Hassouna AH et al. Single versus multichannel applicator in high-dose-rate vaginal brachytherapy optimized by inverse treatment planning. J Contemp Brachytherapy 2015; 6: 362-370.
14. Carrara M, Cusumano D, Giandini T et al. Comparison of different treatment planning optimization methods for vaginal HDR brachytherapy with multichannel applicators: a reduction of the high doses to the vaginal mucosa is possible. Phys Med 2017; 44: 58-65.
15. Vargo JA, Kim H, Houser CJ et al. Image-based multichannel vaginal cylinder brachytherapy for vaginal cancer. Brachytherapy 2015; 14: 9-15.
16. Li S, Aref I, Walker E et al. Effects of prescription depth, cylinder size, treatment length, tip space, and curved end on doses in high-dose-rate vaginal brachytherapy. Int J Radiat Oncol Biol Phys 2007; 67: 1268-1277.
17. Wang K, Jiang P, Wang J. Dosimetric evaluation of different cylinder diameters in three-dimensional vaginal brachytherapy for early-stage endometrial cancer. J Cancer Res Clin Oncol 2024; 150: 510.
18. Hou X, Liu A, Zhang F et al. Dosimetric advantages of using multichannel balloons compared to single-channel cylinders for high-dose-rate vaginal cuff brachytherapy. Brachytherapy 2016; 15: 471-476.
19. Tanderup K, Lindegaard JC. Multi-channel intracavitary vaginal brachytherapy using three-dimensional optimization of source geometry. Radiother Oncol 2004; 70: 81-85.
20. Albuquerque K, Hrycushko BA, Harkenrider MM et al. Compendium of fractionation choices for gynecologic HDR brachytherapy – an American Brachytherapy Society Task Group Report. Brachytherapy 2019; 18: 429-436.
21. Van Elburg D, Meyer T, Martell K, et al. Assessment of dose to vaginal mucosa for gynecologic template interstitial high-dose-rate brachytherapy using Monte Carlo simulation. J Contemp Brachytherapy 2023; 15: 317-324.
22. Bahng AY, Dagan A, Bruner DW et al. Determination of prognostic factors for vaginal mucosal toxicity associated with intravaginal high-dose rate brachytherapy in patients with endometrial cancer. Int J Radiat Oncol Biol Phys 2012; 82: 667-673.
23. Serban M, de Leeuw AA, Tanderup K et al. Vaginal dose-surface maps in cervical cancer brachytherapy: Methodology and preliminary results on correlation with morbidity. Brachytherapy 2021; 20: 565-575.
24. Susko M, Craciunescu O, Meltsner S et al. Vaginal dose is associated with toxicity in image guided tandem ring or ovoid-based brachytherapy. Int J Radiat Oncol Biol Phys 2016; 94: 1099-1105.
25. Zhang Y, Ascaso C, Herreros A et al. Postoperative endometrial carcinoma treated with external beam irradiation plus vaginal-cuff brachytherapy. Is there a dose relationship with G2 vaginal complications? Rep Pract Oncol Radiother 2020; 25: 227-232.
26. Zhang Y, Gómez G, Ascaso C et al. Preliminary results of a vaginal constraint for reducing G2 late vaginal complications after postoperative brachytherapy in endometrial cancer: a prospective analysis. Clin Transl Oncol 2022; 24: 875-881.
27. Rovirosa A, Noorian F, Cordoba S et al. Where are we with fractionation schedules and prescriptions in high-dose-rate 3D planning vaginal cuff brachytherapy? J Contemp Brachytherapy 2024; 16: 352-361.
28. Mao Z, Zhao H. 3D-printed vaginal cylindrical template with curved needle channels in MRI-guided vaginal cuff brachytherapy. J Contemp Brachytherapy 2023; 15: 422-431.
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