Radiation field simulation of gynecologic malignancies: Localization of the cervix and vagina with a flexible vaginal localizer contrast tampon

The authors evaluated a flexible vaginal localizer contrast tampon for radiation therapy simulation. In 51 patients, the degree of cervical or vaginal cuff displacement secondary to the contrast tampon was evaluated by comparing simulation radiographs (with tampon) and initial portal radiographs (without tampon). The same comparisons were made on the radiographs obtained in 25 control subjects who underwent simulation without a tampon. Mean displacement in the group who underwent simulation with a tampon was minimal (≤5 mm in each direction) and similar to that in the control group. This technique provides reliable cervical and vaginal cuff localization.