Abstract Background This study aimed to evaluate clinical outcomes in patients with vaginal recurrences treated with radiotherapy with or without chemotherapy, followed by image-guided interventional radiotherapy (IG-IRT). Methods We retrospectively analyzed patients with vaginal recurrences treated with external beam radiotherapy (EBRT) ± chemotherapy followed by endovaginal high dose rate IG-IRT. The EBRT total dose was 45 Gy. The interventional radiotherapy boost delivered 28 Gy in four high-