Image-guided Brachytherapy for Vaginal Cancer (EMBRAVE)

Inclusion Criteria: o Histologically proven primary vaginal cancer, vaginal carcinoma in situ (VAIN) or vaginal recurrence, per WHO classification. Histological proven stage I-IVA primary vaginal cancer: squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma of the vagina, other epithelial carcinoma's and carcinoma in situ * Histological proven vaginal recurrence from any gynaecological cancer for whom curative treatment is envisioned that includes image guided adaptive brachytherapy according to the target concept. * Para-aortic lymph node metastasis below L1-L2 interspace are allowed * Macroscopic visible tumour present on MRI and/or gynaecological examination at diagnosis. * Planned IGABT treatment with MRI-guided adaptive brachytherapy (at least the 1st fraction contouring and planning on MRI; CT for later fractions is allowed): * External beam radio(chemo)therapy followed by IGABT * IGABT alone for stage I \<2cm or carcinoma in situ * Treatment with curative intent * Written informed consent Exclusion Criteria: * Primary vaginal cancers with involvement of the ostium of the cervix or vulva (these should be classified as cervical cancer or vulvar cancer, respectively) * Metastatic disease beyond para-aortic region L1-L2 interspace * Sarcomas and melanomas. * Treatment only by external beam radiotherapy without brachytherapy to boost the primary disease * Primary vaginal cancer: treatment by primary surgery or debulking surgery * Vaginal recurrences: treatment by primary surgery or debulking surgery * Treatment with neo-adjuvant chemotherapy followed by surgery * Treatment with radiotherapy followed by surgery * Previous pelvic or abdominal radiotherapy * Pregnancy