Which lymph nodes does the vagina drain to (differentiate based on location in the vagina)? -
ANSWERSLymph node drainage from upper 2/3 of the vagina is to the pelvic lymph nodes and from the
lower 1/3 of the vagina to the inguinal/femoral nodes
What is the most common histology of vaginal cancer? - ANSWERSapprox. 80% of cases are squamous
cell carcinomas
What type of vaginal cancer is associated with in utero exposure to diethylstilbestrol (DES)? -
ANSWERSClear cell adenocarcinoma
What are the risk factors for vaginal cancer? - ANSWERScarcinoma in situ, HPV, vaginal irritation,
previous abnormal Pap smears, early hysterectomy, and in utero exposure to diethylstilbestrol (DES)
How is the patient simulated for external beam radiation therapy (EBRT) for vaginal cancer? -
ANSWERSSimulate the patient supine with tumor and introitus markers. Bolus on inguinal nodes may be
needed. If treating the inguinal nodes, the patient is treated in the frog-leg position.
When using intracavitary (IC) brachytherapy to treat vaginal cancer, what size cylinder is used and why? -
ANSWERSUse largest possible vaginal cylinder to improve the ratio of mucosa to tumor dose
What brachytherapy device is used to treat the vaginal cuff? - ANSWERSDome cylinders are used for
homogeneous irradiation of the vaginal cuff
What is the simulation position for a patient with vulvar cancer? - ANSWERSSimulate supine, frog-leg
position with custom immobilization
What are the patient profile and risk factors for vaginal cancer? - ANSWERSThe incidence of vaginal
cancer increases with age. Most patients (70%) are at least 60 years old. Risk factors include a high
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