Individualized vaginal applicator for stage IIb primary vaginal adenocarcinoma:A case report  

作　　者：Saijilafu Yan-Jun Gu Ai-Wu Huang Chang-Fen Xu Li-Wen Qian 

机构地区：[1]Hangzhou Lin'an Traditional Chinese Medicine Hospital,Affiliated Hospital,Hangzhou City University,Hangzhou 311300,Zhejiang Province,China [2]Department of Radiation Oncology,Sir Run Run Shaw Hospital,Hangzhou 310016,Zhejiang Province,China [3]Department of the Gynecology and Obstetrics,Hangzhou Lin'an Traditional Chinese Medicine Hospital,Affiliated Hospital,Hangzhou City University,Hangzhou 311300,Zhejiang Province,China

出　　处：《World Journal of Clinical Oncology》2024年第8期1102-1109,共8页世界临床肿瘤学杂志（英文版）

摘　　要：BACKGROUND Primary vaginal cancer is rare and most vaginal tumors are metastatic,often arising from adjacent gynecologic structures.Primary vaginal cancers are also more common among postmenopausal women and most of these are squamous cell carcinomas,with adenocarcinomas being relatively rare.Vaginal bleeding is the most common clinical manifestation of vaginal adenocarcinoma.About 70%of vaginal adenocarcinomas are stage I lesions at the time of diagnosis,for which radical surgery is recommended.However,more advanced vaginal cancers are not amenable to radical surgical treatment and have poor clinical outcomes.Optimal treatments modes are still being explored.Here,we report a rare case of stage IIb primary vaginal adenocarcinoma for which an individually designed vaginal applicator for after-loading radiotherapy was used to achieve good tumor control.CASE SUMMARY A 62-year-old woman presented to our clinic after 3 months of abnormal postmenopausal vaginal bleeding.Gynecological examination,computed tomography(CT),and positron emission tomography-CT showed a large mass(about 5 cm)on the anterior vaginal wall.Colposcopy biopsy confirmed adenocarcinoma of vaginal origin.After three cycles of carboplatin plus paclitaxel chemotherapy,the lesion partially shrunk.The patient then received external irradiation of 45 gray(gy)in 25 fractions,which further reduced the vaginal lesion,followed by after-loading radiotherapy of 30 gy in 5 fractions with an individually designed vaginal applicator.Three months later,magnetic resonance imaging showed a slight thickening CONCLUSION Primary vaginal adenocarcinoma is rare,and prognosis is poor in most vaginal cancers of locally advanced stages,which cannot be treated with radical surgery.Better tumor control can be achieved with an individualized vaginal applicator that allows administration of a higher radical dose to the tumor area while protecting normal tissues.

关 键 词：Primary vaginal adenocarcinoma After-loading radiotherapy Vaginal applicator Tumor control Case report 

分 类 号：R737.34[医药卫生—肿瘤]