Lower GI 2017

Pelvic OARs constraints: genitals

- Dose to genitals (female) - Under-estimated problem in the past, now quite «hot» - Any effort should be activated to efficiently spare genitals outside PTV: beams geometry, blocking options in rotational techniques, …. - IMRT highly effective in sparing external genitals to very low dose (even <5-10 Gy) - Vaginal dryness/dyspareunia very commun problems importantly affecting QoL; impact of RT+CHT vs SURG only (Lange 2009, 2011, Bruheim 2010, Braendengen 2011, Incrocci 2013, Marijnen 2014, Ye 2014, Kunnemann 2015, Jensen 2015, Gilbert 2015) - relationship with dose-volume parameters of vagina is lacking; some evidence of a dose- volume effect in cervix cancer braky (Park 2015)