Lower GI 2017

Pelvic OARs constraints: genitals

- Dose to vagina (Mirabeau-Beale 2015) - Vaginal stenosis did not correlate with DVH/dose statistics of vagina/external genitals in a group of 52 pts treated with IMRT RT+CHT (50-54Gy) for anal canal ca. Lower age as a major risk factor - Most part of vagina often included in PTV (median dose ≈ 55Gy) - Need of more studies - Potentials of image-guided IMRT to spare vagina to be still assessed (room for vagina- sparing trials ? Volumes definition issues) - Practical suggestion: spare vagina and external genitals outside PTV «as much as possible» (no relevant interplays with other structures)

Mirabeau-Beale 2015